Under the 1999 Health Act a statutory duty of "quality" was given to National Health Service (NHS) organisations in the United Kingdom. This was matched by a comprehensive quality program. In this paper we look at the meaning of clinical governance as a mechanism for ensuring local delivery of high quality clinical care in the UK, the national structures which have been put in place to develop, reinforce and implement clinical governance and the role of the NHS Clinical Governance Support Team (CGST) in delivering clinical governance "on the ground". As part of the quality program, the CGST is working to enable national clinical governance policy to be translated into practice locally by supporting the development of better ways of working by individuals, clinical teams and health organisations to deliver a continuous, integrated approach to quality healthcare for patients.