Dr L J Patterson Consultant Physician OBE MB FRCP

1. Quality of Care in UK National Health Service Dr L J Patterson Consultant Physician OBE MB FRCP Dr L J Patterson OBE MB FRCP

2. UK National Health Service • England • Wales • Scotland • Northern Ireland

3. 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

4. What do patients want ? • No unnecessary death • No unnecessary harm • No unnecessary pain • No unnecessary wait • No unnecessary helplessness Dr D Berwick

5. 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?

6. 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

7. 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

8. 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

10. 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)

11. 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

12. Setting Standards 3 • Safety • Clinical and cost effectiveness • Governance • Patient Focus • Accessible and responsiveness Care • Core Environment and amenities • Public Health

14. 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

15. 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

16. Clinical Governance • Listening to patients • Clinical Effectiveness • Clinical Audit • Staff Management • Research and development • Risk Management • Education and Training

17. 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

19. 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

20. Challenges • Constant reorganisation • Future funding • Patient choice • Increased use of private sector providers • Democratic involvement of the public

21. Choice • Individual patients to choose from 5 providers • At least one to be from the private sector

22. Public Involvement -- Emphasis on the individual • Patient choice, patient centred care, Expert Patient programmes • National Patient Surveys • Local Patient forums • Patient Advocacy services

23. 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?

24. Thank you for your attention