HEALTHCARE DELIVERY
be charged with oversight of quality and to provide forums for intelligence and information sharing. They are designed to act at two levels, both local and as part of the NHS Commissioning Board’s regional teams. The idea is that the forums will be able to create a culture of open and honest co-operation, sharing information and ensuring data regarding performance management, commissioning and regulatory activities are scrutinised in order to maintain quality in the system. The author assumes that the creation of specific quality boards is to flag up organisations which are experiencing difficulties, before they become harmful organisations and where proactive management can prevent further damage and harm to patients. The model described within the report
identifies that regular (even day-to-day) conversations are envisaged between commissioners and providers; area surveillance with suggested monthly meetings and regional surveillance at quarterly meetings. The model envisages a complex network among all the new organisations, with whom all the new players at one level or another, will openly share information. Many organisations are already sharing information in this way. However, QSGs, supported and
facilitated by the NHS Commissioning Board, will encourage consistency across every locality and region. Creating a culture of openness, transparency and cooperation, ensuring that organisations work together proactively to spot potential problems early on. The fallback option to everyday
communication will be a ‘risk summit’. Should concerns arise regarding one organisation – whether local, regional or national – then the Quality Surveillance Group members, relevant to the provider in question will come together to give specific focused consideration to the concerns raised. This should facilitate rapid collective judgements to be taken about quality and where there has been a breach, the CQC will be required to take regulatory action. If the CQC determines that no actual
breach of the essential standards of quality and safety have occurred, other players may be brought in to provide support or action to safeguard patients. These players, may be Monitor, the
regulator for Foundation Trusts or its sister organisation, the NHS Trust Development Authority, whose role it will be to provide support and guidance to Trusts as they morph into Foundation Trusts. As part of any risk summit, the CQC
can ask other members of the QSG to carry out a rapid impact assessment of any potential regulatory action it is considering, such as closing a service, where it would find this analysis useful.
Roles and responsibilities The National Quality Board report defines the specific responsibilities for the future safeguarding of quality care. In summary, it has specified: • Individual health and care professionals, their ethos, behaviours and actions, are the first line of defence in maintaining quality.
• The leadership within provider organisations is ultimately responsible for the quality of care being provided by that organisation.
• Commissioners are responsible for commissioning services that meet the needs of their local populations. They must assure themselves of the quality of care that they have commissioned.
• Regulators should performtheir statutory functions with the best interests of patients at heart.
• Commissioners, regulators and other
‘Regular improvements to practice must become much more of a way of life in the future and it is to be hoped that the new structures will go some way to providing the means to provide a safe environment for care.’
NOVEMBER 2012
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