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HEALTHCARE DELIVERY
Quality action must be part of the solution
Kate Woodhead RGN DMS acknowledges that action must be taken to tackle the financial pressures in the NHS, but argues that we must not forsake the momentum on delivering quality. It is vital that all those working in healthcare maintain a core focus on improvement, quality and evidence-based decision-making.
The majority of recent healthcare news headlines have been focused on potential cuts in order to tackle the severe financial deficits reported last year. It is difficult to see why there is such a panic – the deficit is entirely predictable with an ageing population, continuing efficiency savings to be made and sinking morale. There has also been a raft of patient organisations complaining that no one has told them what the cuts are going to be. The plans are currently being formulated and will be subject to local consultation, we hear, when they are in a sufficiently robust form to be rejected or built upon. There cannot just be local consultation meetings with no plans to discuss – I believe we must be patient. The concern I have is to ensure that not only are we considering efficiency in the health sector, but that we also keep improvement, quality and evidence-based decision-making at the core of what we need to do and not throw it all away while merely making financial decisions.
Quality improvement
Quality improvement has long been on the minds of healthcare professionals as they practice. In recent times, it has also become a science and now has a body of research and a growing archive of tested tools and resources. There are small groups of strong proponents of the science who are leading transformational improvement within the NHS. For the most part, however, the tools and ways of working instigated and spread by the Modernisation Agency is the basis of
what we know about improvement science. We know much more about what we call quality improvement and many practitioners would set out each day to do a better job than the day before. However, there are often substantial barriers to that action being effective. Many of the transformational change leaders would say that the moves need to be not only by individuals but also by teams and strongly led teams, to achieve substantial and transforming change to the patient experience.
Chris Ham writing in 20141 stated that
Transforming the NHS depends much less on bold strokes and big gestures by politicians than on engaging doctors, nurses and other staff in improvement programmes.
OCTOBER 2016
‘transforming the NHS depends much less on bold strokes and big gestures by politicians than on engaging doctors, nurses and other staff in improvement programmes’. However it is likely that in the current climate of fear, financial challenges will override all other activities, after all we have been here many times before and it is a familiar pattern. Ham also cited quality improvement changes by highlighting that the best experience of high performing healthcare organisations shows the value of leadership continuity, organisational stability, a clear vision and goals for improvement, and the use of explicit improvement methodology. He also mentions that improvement needs to be based on commitment rather than compliance, i.e. buy-in from professionals is when lasting change occurs rather than top- down measures applied across the board. The north west of England has a group, based at the Salford Royal Foundation Trust
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