HEALTHCARE DELIVERY
safety and quality are seen as priorities. They also make a clear recommendation that engaging and supporting staff to serve patients to the best of their abilities by developing cultures within providers based on a commitment to improvement and learning rather than compliance with external standards.
The paper is a ‘must read’ – putting as it does, the key features of a quality improvement strategy, and the role of organisations at different levels in realising it, offering ten design principles to guide its development. The authors argue that, in their view, there are few higher or more urgent priorities that face the NHS at present. Each of the principles is expanded and examples given. They say that the challenge of implementation is not to be underestimated, and that it should be recognised that time and resource commitment must be made. It will take time to demonstrate progress (as the Modernisation Agency and subsequent organisations also reported) but without a doubt it is worth the effort.
Conclusion
The measured approach of the King’s Fund also identifies that they see little alternative to what they recognise will be a herculean effort. They re-iterate that quality and finance are loosely related through the many opportunities that exist to deliver better outcomes at lower cost.7
They specify that, if
staff are to be engaged with the project, the value of the quality initiatives should be recognised and work done to ensure the value of both.
It is clear that action on a number of fronts must be taken and quickly to tackle the financial pressures but they are right to state that engagement of the clinical staff and leadership must not solely be on delivering
fiscal cuts. Movement on delivering efficient services which give value for patients and serve the public better are at the heart of what the NHS does every day. We must not forsake the momentum on delivering quality as part of every activity we do.
References
1. Chris Ham. 2014, The King’s Fund. Reforming the NHS from within. Accessed at
http://www.kingsfund.org.uk/sites/files/kf/field/field _publication_file/reforming-the-nhs-from-within- kingsfund-jun14.pdf
2. The Advancing Quality Alliance, accessed at
https://www.aquanw.nhs.uk/about-us/
3. Marshall M, Pronovost P, Dixon Woods M. 2013, Promotion of improvement as a science. The Lancet accessed at
http://www.thelancet.com/pdfs/
journals/lancet/PIIS0140-6736(12)61850-9.pdf CSJ
4. Ham C, Berwick D, Dixon J Improving quality in the English NHS. The King’s Fund. Accessed at
http://www.kingsfund.org.uk/sites/files/kf/field/field _publication_file/Improving-quality-Kings-Fund- February-2016.pdf
5. A promise to learn – a commitment to act. Improving the safety of patients in England. National Advisory Group on the safety of patients in England. Accessed at
www.gov.uk/government/ uploads/system/uploads/attachment_data/file/226 703/Berwick_Report.pdf
6. Ibid 7. Alderwick H, Robertson R, Appleby J, Dunn P, Maguire D (2015). Better value in the NHS: the role of changes in clinical practice. London: The King’s Fund. Accessed at
http://www.kingsfund.org.uk/ publications/better-value-nhs
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