Since the start of 2016, bad news stories about the state of the NHS have proliferated, from a larger than expected deterioration in the state of NHS finances, to the junior doctors strike; alongside evidence of increases in waiting times, cancelled operations and bed occupancy figures. All pointing to an NHS under siege with concerns over quality of care increasing. The publication this week, of the King's Fund report on Improving Quality in the English NHS: A strategy for actioni, provides a timely reminder of the importance of building capability for quality improvement in each and every NHS organisation. This week's blog provides my take on the report and the discussion that accompanied its launch.
The King's Fund report argues that the NHS urgently needs to adopt a quality improvement strategy if it is to rise to the significant financial and workforce challenges it is currently facing. It defines quality improvement as designing and redesigning work processes and systems that deliver healthcare with better outcomes and lower cost wherever this can be achieved.
The report sets out 10 design principles to guide the development of a quality improvement strategy. This includes building in-house capacity for quality improvement, by committing time and resources to acquire the necessary capabilities and learning from the experience of trusts such as "Salford, Sheffield and Wigan where quality improvement is well established". It also recommends that organisations should work together through improvement collaboratives, and the importance of shared learning and mutual support. It highlights the achievements in the north-west of England's Advancing Quality Alliance and in London, UCLPartners academic science partnership.
A more contested suggestion is the proposal to establish a "modestly sized" national centre of expertise, learning from the experience of the NHS Modernisation Agency. While most of the audience at the launch appeared to wholeheartedly support the design principles, like a number of other commentators, I was less convinced about the need for a new central organisation. Believing that quality improvement needs to be owned by and generated by staff on the front line and that previous attempts at creating a central organisation with such a remit have largely failed to deliver the desired impact.
The report recognises the importance of staff buy-in to a coherent and unifying quality improvement strategy and the need to implement...