The National Quality Agenda and its implications for specialist societies.

摘要

The focus on quality heralded in 2008 by Lord Darzi was welcomed enthusiastically by the Royal College of Physicians (RCP). As the professional body that has always aimed to improve the quality of care by continually raising medical standards, it approved of any move away from assessing care by activity measures alone. However, to translate the aim into specific goals and targets that can be supported by managers and politicians, as well as by clinicians, is more challenging. The National Quality Board (NQB) was set up in 2009 to provide leadership for this agenda. It is chaired by the chief executive of the NHS and includes the chief medical and nursing officers, the NHS medical director, the president of the RCP (in a personal capacity) and the chair of the National Institute for Health and Clinical Excellence (NICE). Its Clinical Prioritisation Committee makes evidence-based recommendations on the areas to prioritise for quality improvement. It will commission and evaluate reviews of quality in healthcare. These will include the interface between health and social care, an area which has emerged as particularly important to the lay members of the NQB. Evidence will be evaluated within Lord Darzi's three domains of patient safety, effectiveness (now both clinical and cost effectiveness) and patient experience. Consultation with stakeholders will include the royal colleges and specialist societies, giving clinicians a real opportunity to influence future developments. The NQB will provide advice and oversight of the various developing tools for quality assessment, such as NICE quality standards, indicators for quality improvement and quality accounts. The NQB will also address practicalities, in its work stream of system alignment, considering how quality improvement actually occurs and what obstacles to change exist.