Clinical governance: culture, leadership and power--the key to changing attitudes and behaviours in trusts.

Clinical governance places for legal duty for quality on Trust chief executives. The article deals with how chief executives can overcome the cultural and behavioural obstacles to change which impede the journey to developing effective structures for clinical governance. To establish effective structures for clinical governance, chief executives will need to address these features of organisational life--culture, power and leadership. The article seeks to provide practical ways in which they can do this.