Promoting quality

In the UK there has been a change of focus in the delivery of health services from the speed and timeliness of care to the quality of that care

With this change in focus there is also a new drive to measure quality in order to improve it, particularly in England.

Quality Metrics (England)

A quality metric is defined as anything for which data or information is collected about your service, either routinely, periodically or as a one off, and which tells you something about the quality of those services in the widest sense. Data can include:

• speed of service
• outcome measures for particular interventions
• feedback from service users on their experiences of using a particular service or group of services

Source: Consultation Response to ‘Measuring for Improvement in the Allied Health Professions’ Matrix/Department of Health.
 
Quality metrics are being introduced as a means of improving the quality of services, where quality is defined as client experience, client safety and outcome/effectiveness (of intervention).  The principles behind the approach are:

• you cannot improve a service if you cannot measure outcomes
• increases in resources for services have not necessarily led to proportionate increases in quality
• measurement tends to lead to improvement

Quality metrics were introduced in the NHS Next Stage Review (2008) and are being developed for both acute and community services. The idea is that health care providers will have a menu of indicators and they will be able to choose relevant indicators in order to demonstrate quality. Relevant metrics are being compiled by the Measuring for Quality Improvement Programme.
 
Further information on this is available here while Quality Metrics are also being introduced via the Quality Framework for Community Services.
 
An initial set of indicators has been identified, those of potential relevance for occupational therapists is given in the Table of Indicators for Quality Improvement relevant for OT.
 
An initial response to the framework has been provided by COT is available.

Quality Strategy: April 2010 (Scotland)

This strategy builds on previous health policy,(‘Better Health, Better Care), in terms of building a ‘mutual NHS’, with patients being co-partners in their own care.
 
The strategy aims to deliver measurable quality improvements that people who use services see as important. The dimensions of quality are defined in ‘Better Health Better Care Action Plan’ (2007) (Scotland):

• patient centred
• patient safety
• effectiveness
• efficiency
• equity
• timeliness

NHS Quality Improvement Scotland 

Supports improving the quality of services by providing advice and guidance on clinical practice and assessing NHS performance.  Find out more on the Healthcare Improvement Scotland website
 

Northern Ireland

In Northern Ireland there is no specific quality strategy, but quality standards are included in the service frameworks for specific conditions. The six measures of quality are similar to those for Scotland’s Quality Strategy, but 'timeliness' is replaced by 'accessible'.