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The background is that clinical governance is a new mechanism for improving patient care within primary care organisations. The aim is to investigate the ability of practices in a single Primary Care Trust to improve influenza and pneumococcal vaccination uptake in high risk groups as a component of a clinical governance programme. A descriptive before and after study was undertaken at West Lincolnshire Primary Care Trust. Concludes that clinically, important improvements in influenza vaccination uptake occurred in patients over 65 years, and for influenza and pneumococcal vaccination in coronary heart disease and diabetic patients between the two audit cycles demonstrating the ability of participating practices to achieve and exceed national targets for influenza immunisation of these high‐risk groups.

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