This course develops an appreciation of the way that the role of clinicians in health care delivery is being affected by changes in the social, legal, economic, organisational, informational and political contexts of health service organisation. At its completion, students will understand the principles of clinical governance and of the range of issues and problems that it is meant to address. The course requires students to appraise different approaches to improving clinical effectiveness, quality, service integration and the use of external value for money consideration in service design and delivery. Students carry out an extended case study and a range of problem-based exercises. This will provide students an opportunity to examine what their changed role implies for their personal skills development.They are provided also with opportunities to acquire and practice skills they require to analyse and address issues arising from efforts to extend clinical accountability.