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Quality of Care in UK National Health Service. Dr L J Patterson Consultant Physician OBE MB FRCP. UK National Health Service. England Wales Scotland Northern Ireland. What is quality?. Effective care - the right thing at the right time Responsive to an individual’s needs Acceptable
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Quality of Care in UK National Health Service Dr L J Patterson Consultant Physician OBE MB FRCP Dr L J Patterson OBE MB FRCP
UK National Health Service • England • Wales • Scotland • Northern Ireland
What is quality? • Effective care - the right thing at the right time • Responsive to an individual’s needs • Acceptable • Timely • Accessible • Equitable • Efficient use of resources • Safe care
What do patients want ? • No unnecessary death • No unnecessary harm • No unnecessary pain • No unnecessary wait • No unnecessary helplessness Dr D Berwick
Questions patients may ask • How long will I wait? • How safe and clean is the clinic or hospital? • How good is the care I will receive? • Will I be treated with dignity and respect? • How well is this organisation managed?
What do patients want ? 1 • Fast access • Effective treatment by staff you can trust • Involvement in decisions • Clear, comprehensible information and support for self care • Physical comfort and clean safe environment
What do patients want ? 2 • Emotional support and alleviation of anxiety • Involvement of family and friends • Continuity of care and smooth transitions Picker Institute 2005
How to ensure Quality? • Education and training of health professionals • Regulation of health professionals • Standards of practice • Clinical Audit • Responding to patient’s views • Inspection/Accreditation of Health care Institutions
Setting Standards 1 • Professional standards –General Medical Council • Specialist standards-Medical Royal Colleges • Standards of service –National Service Frameworks (Coronary Artery Disease, Older People, Cancer Services, Mental Health Services)
Setting Standards 2 • National Institute for Health and Clinical Excellence • National Standards of Care –Department of Health Core standards –mandatory Development standards—direction of improvement
Setting Standards 3 • Safety • Clinical and cost effectiveness • Governance • Patient Focus • Accessible and responsiveness Care • Core Environment and amenities • Public Health
Delivering Standards 1 • Modernising professional regulation Major changes for the General Medical Council - more lay involvement, • Doctors will have to show they continue to be up to standard • General standards—revalidation • Specialist standards -recertification
Delivering standards 2 • Clinical Governance • Accountability for continuous quality improvement and safeguarding high standards of care, by creating an environment in which clinical excellence can flourish
Clinical Governance • Listening to patients • Clinical Effectiveness • Clinical Audit • Staff Management • Research and development • Risk Management • Education and Training
Continuous Quality Improvement • National Institute for Innovation and Improvement (previously Modernisation Agency) • e g Reduce waiting times by reducing variation • Improve flow • Improve safety • Develop leadership
Monitored Standards Healthcare Commission (Formerly Commission for Health Improvement) Annual Health check Patient Complaints Studies of National Service Frameworks. Investigations into Serious Service Failure National Patient Surveys
Challenges • Constant reorganisation • Future funding • Patient choice • Increased use of private sector providers • Democratic involvement of the public
Choice • Individual patients to choose from 5 providers • At least one to be from the private sector
Public Involvement -- Emphasis on the individual • Patient choice, patient centred care, Expert Patient programmes • National Patient Surveys • Local Patient forums • Patient Advocacy services
Conclusion • Does a publicly funded health service have to be provided by the public sector? • How should the public be more involved? • Will choice improve quality or destabilise the system?