HEALTHCARE DELIVERY


respect individual needs and values and demonstrate compassion, continuity, clear communication and shared decision making. The Health and Social Care Act 2012


also sets out the outcomes or domains by which healthcare will be measured in the future. The National Institute of Health and


Clinical Excellence (NICE) will publish guidance on each of these domains: 1 Preventing people from dying prematurely.


2 Enhancing quality of life for people with long-term conditions.


3 Helping people to recover from episodes of ill-health or following injury.


4 Ensuring that people have a positive experience of care.


5 Treating and caring for people in a safe environment and protecting them from avoidable harm.


Quality oversight Which other organisations that currently provide oversight or direct measurement of care standards and quality will remain in place after April 2013? Among those remaining will be


professional regulators which undertake, on behalf of the public, to ensure the competence of their registrants, as far as possible, and to take action when the standards of behaviour, competence and education fall short of requirements. Examples of regulators are the General Medical Council and the Nursing and Midwifery Council and they will remain in place, although there is some current speculation regarding their effective oversight of competence and behaviours by their registrants. The Care Quality Commission (CQC)


which inspects and monitors that all registered providers of healthcare are meeting the quality and essential standards, will remain the statutory


‘Quality is defined as: care that is effective, safe and provides as positive an experience as possible.’


regulator. Indeed during the last year, its remit has broadened considerably and by April 2013 all GP practices will have to be registered in addition to dental practices, domiciliary care, care homes, all hospitals and other specialist providers. NICE will continue to be a source of


national guidance, clinical research and new technology assessments. It has recently published clinical guidance and quality standards for a wide variety of patient pathways. In addition, it provides new guidance on the adult patient experience.4


The 14 statements are


described as being about the best care that patients should receive: 1 Patients are treated with dignity, kindness, compassion, courtesy, respect, understanding and honesty.


2 Patients are cared for by staff who can communicate with them in a clear and understandable way.


3 Patients are introduced to all healthcare professionals involved in their care, and are made aware of the roles and responsibilities of the members of the healthcare team.


4 Patients have opportunities to discuss their health beliefs, concerns and preferences, and these are taken into account when making decisions about their care.


5 Patients are helped by healthcare professionals to understand relevant treatment options, including benefits, risks and potential consequences of care.


6 Patients are actively involved in making


decisions about their care, and supported to make fully informed choices about investigations, treatment and care that reflect what is important to them.


7 Patients have their choices respected and supported when deciding whether to accept or decline treatment, and when choosing between treatments.


8 Patients are made aware that they can ask for a second opinion.


9 Patients experience care that is tailored to their needs and personal preferences, taking into account their circumstances, how easy it is for them to use the services they need, and any other health problems they have.


10Patients are regularly checked and asked whether they need any extra support, for example with eating and drinking, pain relief, continence problems or anxieties.


11Patients see the same healthcare professional or healthcare team throughout a course of treatment whenever this is possible.


12Patients can expect information about their care to be exchanged in a clear and accurate way between relevant health and social care professionals, so that their care is coordinated with the least possible delay or disruption.


13Patients are asked if they want their partner, family members and/or carers to be given information about their care, and their preferences are respected and reviewed throughout their care.


14Patients are given clear advice about who to contact about their healthcare needs, how to contact them and when to contact them.


The publication of quality standards, as above, for the quality that patients can expect from their healthcare comes at a time when the British Social Attitudes Survey5


suggests that public satisfaction


with the NHS is at an all time low. In June 2012, it reported that satisfaction has fallen from 70% last year to 58% – the largest annual drop since the poll began in 1983. The Government said the survey contradicted its poll among patients, which showed satisfaction rates where 92% of patients said their experience was good, very good or excellent. However, whether or not there is agreement, future structures which need to be put in place to ensure that patient experience and quality care are delivered, measured and are fully transparent; need to be robust and clear. The report from the National Quality Board6 describes the interaction between


national and local structures. Locally there will be a series of Quality Surveillance Groups (QSGs), which will


18 THE CLINICAL SERVICES JOURNAL NOVEMBER 2012


www.balad.afcent.af.mil


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