ntions, when deployed in the field for a particular patient or population, do what they are intended to do, i.e. maintain and improve health and secure the greatest possible health gain from the available resources." However, these approaches focussed more on saving money usually at the expense of clinical care. Therefore, action was still needed to improve the quality of care delivered at the coalface. (Mcsherry & Pearce, 2002).
             However, it must also be acknowledged that there are identified potential barriers to implementing CG. This is perhaps compounded by the many bureaucratic changes to the health service over many years. It is not surprising then that new initiatives are greeted with scepticism.
             A shift in attitudes and culture is needed from a negative to a positive view of clinical governance. Examples of such perceived barriers to implementing clinical governance are fear and lack of understanding and poor leadership style. Marquis and Hutson (2000) suggest that a democratic style of leadership may be preferred in that it offers a strong vehicle for breaking down barriers by the development of a collaborative, empowering and trusting culture based on a strong foundation of communication and partnership. (Mcsherry and Pearce, 2002).
             People with learning disabilities are amongst the most vulnerable and socially excluded within our society; the government identifies that this needs to change. The recently launched Government White Paper &
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