A new national strategy for quality in adult social care will be developed following a review by NHS England chair Dr Penny Dash into patient safety across healthcare settings.
The review itself, published earlier this week (July 7th), looked into six specific organisations that were set up to assure or contribute to improving safety of care, while referencing the wider landscape of other organisations influencing quality of care. These six bodies are:
– The Care Quality Commission
– The National Guardian’s Office
– The Patient Safety Commissioner
– Healthwatch England and Local Healthwatch
– The patient safety learning aspects of NHS Resolution
– The Health Services Safety Investigations Body
Safety of care
Health system quality is recognised as being multidimensional, including safety, patient experience, effectiveness, equity, efficiency and accessibility.
Effective care is that which is provided to evidence-based standards to those who need it, with ineffective care leading to avoidable harm.
Safety of care, meanwhile, is typically understood as minimising the harm that could arise during care-giving activities, concerned with the avoidance, prevention and improvement of injuries and negative health outcomes related to healthcare processes.
There are around 600 million NHS patient interactions annually, with one in 200,000 resulting in a safety investigation, but 780 fewer deaths per year could be seen if safety of care is improved.
Furthermore, of all avoidable deaths in 2022 in England and Wales, approximately 82,000 of these could be attributed to preventable conditions, suggesting that there’s still significant opportunities to ensure that high-quality care is delivered more consistently.
Treatment gaps exist with diabetes, for example, a condition that affects some 4.4 million people, yet less than two-thirds are in receipt of recognised best practice care.
As for inequality, this is evident across all dimensions of quality. For example, people from the poorest parts of the country die on average ten years earlier than those in more affluent regions. Disadvantaged groups are disproportionately impacted by unsafe and ineffective care.
And poor care management contributes to ineffective care, unsafe care and poor patient experience, with costs to NHS trusts of more than £5 billion a year due to a five per cent efficiency gap.
Issuing a call for the development of a national quality strategy that details exactly what good looks like in adult social care, Ms Dash recommended:
– That a set of metrics be agreed upon to assess quality of care, focusing on outcomes and outputs
– That agreements are made on how to disseminate best practice
– That work is carried out to ensure appropriate governance structures, processes and systems are in place
– And that action is taken to improve adult social care commissioning
Government confirmation
Health secretary Wes Streeting has since confirmed that the government has accepted in full Dr Dash’s nine recommendations contained within her report, saying: “These changes will improve quality, including safety, by making it clear where responsibility and accountability sits at all levels of the system, and making it easier for staff, patients and users to directly feed into the system to improve quality of care.”
These commitments will now form an important component of the government’s 10 Year Plan for Health.
