I've been on a "Guidelines" course, essentially this is a course that tells us that we are already doing the right thing, and to introduce a new "book" with our treatment guidelines in in. It takes two days and tomorrow will include learning about child abuse (do we have to bring our own child?) So far the course has been a trainer telling us that this course changes nothing, and we are to continue doing what we are doing at the moment. At least the days are short, 8am 'til 2pm. At the start of every Powerpoint presentation is the same definition of "Clinical Governance".
We had to write our own scenarios - then swapped them around to other groups (this is a really easy teaching technique - you don't have to plan anything). There was also a chat about how our complaints to compliments ratio is about 50/50, and that most of the complaints are because of "staff attitude". So far I have had no complaints, and no compliments - I'm a strong believer of flying under the radar.

However there is a problem - the Guidelines book we should be getting is version 3.0, but the book we are actually getting is version 2.2.
The reason for this? Copyright. It seems that the London Ambulance Service wants to change a few bits to make it more relevant to London. But because the organization that wrote it maintains the copyright - it can't be changed for us. Lawrence Lessing's "Free culture" and the Suw Charman article I linked to on the 25th both state that you get value added when others can build on your work. This is a perfect example of this principle.
So the people of London are not getting the best clinical care because of copyright.

Clinical Governance is about getting the best care to the public, so it's a bit of a mixed message.