12 Pillar Clinical Governance Programme (12-PCGP) is an evidence-based solution developed by Professor Joseph Ana for health sector and system strengthening in Low and Middle Income Countries (LMICs). It provides an overarching framework for protecting patients and supporting health workers simultaneously. Building on the UK NHS principles, it adds five pillars—Policy/Law, Funding Mix, Infrastructure, Equipment, Utilities (24/7 power and potable water), and Ambience (24/7 sanitation and hygiene)—to strengthen healthcare delivery in resource-limited settings.

Clinical governance in the UK NHS originally consisted of seven pillars: Risk Management, Education & Training, Clinical Audit, ICT, Clinical Effectiveness, Finance/Management, and Research & Development. It ensures continuous improvement, accountability, and a safe environment for patients and staff.

Joseph Ana's framework demonstrates that without the additional five pillars, effective clinical governance is not achievable. Organizations must be accountable, transparent, and provide safe, well-equipped work environments to support healthcare professionals and patients alike.

The 12-PCGP framework has proven effective for governments and institutions in LMICs, improving day-to-day patient care, promoting patient advocacy, safety, and staff development simultaneously.