Clinical Senates play a unique role in the commissioning system by providing strategic clinical advice and leadership across a broad geographical area to clinical commissioning groups (CCGs), health and wellbeing boards (HWB) and the NHS Commissioning Board. Clinical Senates span professions and include representatives of patients, volunteers and other groups. They work with Strategic Clinical Networks, Academic Health Science Networks, Local Education and Training Boards and research networks to develop an alignment of these organisations to support improvements in quality.