Almagro 26 October 2006 Dr L J Patterson OBE MB FRCP Dr L J Patterson Consultant Physician OBE MB FRCP Quality of Care in UK National Health Service

Dr L J Patterson OBE MB FRCP UK National Health Service  England  Wales  Scotland  Northern Ireland

Dr L J Patterson OBE MB FRCP What is quality?  Effective care - the right thing at the right time  Responsive to an individual’s needs  Acceptable  Timely  Accessible  Equitable  Efficient use of resources  Safe care

Dr L J Patterson OBE MB FRCP What do patients want ?  No unnecessary death  No unnecessary harm  No unnecessary pain  No unnecessary wait  No unnecessary helplessness Dr D Berwick

Dr L J Patterson OBE MB FRCP Questions patients may ask  How long will I wait?  How safe and clean is the clinic or hospital?  How good is the care I will receive?  Will I be treated with dignity and respect?  How well is this organisation managed?

Dr L J Patterson OBE MB FRCP What do patients want ? 1  Fast access  Effective treatment by staff you can trust  Involvement in decisions  Clear, comprehensible information and support for self care  Physical comfort and clean safe environment

Dr L J Patterson OBE MB FRCP What do patients want ? 2  Emotional support and alleviation of anxiety  Involvement of family and friends  Continuity of care and smooth transitions Picker Institute 2005

Dr L J Patterson OBE MB FRCP How to ensure Quality?  Education and training of health professionals  Regulation of health professionals  Standards of practice  Clinical Audit  Responding to patient’s views  Inspection/Accreditation of Health care Institutions

Dr L J Patterson OBE MB FRCP

Setting Standards 1  Professional standards –General Medical Council  Specialist standards-Medical Royal Colleges  Standards of service –National Service Frameworks (Coronary Artery Disease, Older People, Cancer Services, Mental Health Services)

Dr L J Patterson OBE MB FRCP Setting Standards 2  National Institute for Health and Clinical Excellence  National Standards of Care –Department of Health Core standards –mandatory Development standards—direction of improvement

Dr L J Patterson OBE MB FRCP Setting Standards 3  Safety  Clinical and cost effectiveness  Governance  Patient Focus  Accessible and responsiveness Care  Core Environment and amenities  Public Health

Dr L J Patterson OBE MB FRCP

Delivering Standards 1  Modernising professional regulation Major changes for the General Medical Council - more lay involvement,  Doctors will have to show they continue to be up to standard  General standards—revalidation  Specialist standards -recertification

Dr L J Patterson OBE MB FRCP Delivering standards 2  Clinical Governance  Accountability for continuous quality improvement and safeguarding high standards of care, by creating an environment in which clinical excellence can flourish

Dr L J Patterson OBE MB FRCP Clinical Governance  Listening to patients  Clinical Effectiveness  Clinical Audit  Staff Management  Research and development  Risk Management  Education and Training

Dr L J Patterson OBE MB FRCP Continuous Quality Improvement  National Institute for Innovation and Improvement (previously Modernisation Agency)  e g Reduce waiting times by reducing variation  Improve flow  Improve safety  Develop leadership

Dr L J Patterson OBE MB FRCP

Monitored Standards Healthcare Commission (Formerly Commission for Health Improvement) Annual Health check Patient Complaints Studies of National Service Frameworks. Investigations into Serious Service Failure National Patient Surveys

Dr L J Patterson OBE MB FRCP Challenges  Constant reorganisation  Future funding  Patient choice  Increased use of private sector providers  Democratic involvement of the public

Dr L J Patterson OBE MB FRCP Choice  Individual patients to choose from 5 providers  At least one to be from the private sector

Dr L J Patterson OBE MB FRCP Public Involvement -- Emphasis on the individual  Patient choice, patient centred care, Expert Patient programmes  National Patient Surveys  Local Patient forums  Patient Advocacy services

Dr L J Patterson OBE MB FRCP Conclusion  Does a publicly funded health service have to be provided by the public sector?  How should the public be more involved?  Will choice improve quality or destabilise the system?

Dr L J Patterson OBE MB FRCP Thank you for your attention