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PEGI: Clinical governance in health and social care


This project aims to explore the professional experience of governance and incentive arrangements in relation to the management of patients with long-term and complex conditions in health and social care. 

Research team

Jill Manthorpe, SCWRU
Fiona Ross, St. George’s Medical School and University of Kingston (Principal Investigator)
Sara Christian, St. George’s Medical School and University of Kingston
Sally Redfern, King’s College London
Celia Davies, King’s College London
Sally Brearley, King’s College London
Pam Smith, University of Surrey
John Larsen, University of Surrey (Now Rethink)
Maureen Mackintosh, Open University
Richard Byng, Peninsula Medical School
Sally Brearley, User Consultant


NHS Service Delivery and Organisation Research and Development Programme


Little is known about the professional experience of governance and incentive arrangements in relation to the management of and support of people with long-term and complex conditions by health and social care practitioners. A range of governance processes are at work and some of these relate to incentives. This project explores the interrelation of governance and incentives on practitioner working to inform commissioning and policy development as well as new ways of working.


This was a three phase study:
Phase 1 involved an analysis of the context to establish and describe the governance and incentives arrangements in the three community sites at the level of the organisation, team and the individual, to examine the organisational objectives and targets for long-term conditions and to describe the funding arrangements in place to achieve the targets. This was undertaken by documentary analysis; analysis of Healthcare Commission staff survey data; interviews with key staff and information gathering.

Phase 2 involved further interviews to explore the emotional experiences and reactions of staff to the organisational priorities and funding arrangements for care and to investigate from the perspective of staff how the governance and incentive arrangements make an impact on performance and effectiveness.

Phase 3 involved construction and interrogation of an analytical framework.


April 2006 – September 2008


Ross, F., Christian, S., Clayton, J., Byng, R., Price, L., Smith, P., Allen, H., Redfern, S., Brearley, S., Manthorpe, J. & Mackintosh, M., (2009), 'The Professional Experience of Governance and Incentives: Meeting the needs of individuals with complex conditions in primary care conditions in primary care' [pdf, 1.4 MB], London: National Institute for Health Research.
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