MedicalDirectors’Bulletin. Sections P1 Voicepiece P2 Quality Accounts consultation Quality markers for end of life care P3 Setting quality standards for the NHS P4-5 South East Coast Quality Observatory P5-6 The quality and productivity challenge P6 Swine flu update P7 Indicator development P8 EWTD update News you can use P9-10 News in brief
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Issue 96 September 2009
Consulting on quality This month, there are two specific issues I would like to draw to your attention. The first relates to the formal consultation on Quality Accounts, which started on 17 September. Ara Darzi’s report made it explicit that Quality Accounts would be a key vehicle for making information on quality available to the public. But how will they contribute to improving quality in our NHS? Public disclosure of information on provider performance has been advocated as a mechanism to drive improvement through a variety of means, including public and professional accountability, patient-informed choice or the commissioning process. The published evidence suggests that public disclosure does not generally drive improvement through the resulting actions of patients or commissioners. Rather, it is the
organisational response that providers put in place to improve their record on quality that drives improvement. Consequently, the primary purpose of Quality Accounts is to encourage boards to assess quality across the totality of services they offer. If designed well, the accounts should assure commissioners, patients and the public that trust boards are regularly scrutinising each and every one of their services. The proposals outlined in the consultation document (see page 2) are the result of engagement, testing, and detailed design work over the last year by the DH; Monitor; the Care Quality Commission; NHS East of England and others. For us as medical leaders, the challenge is how to refine a format and methodology for the accounts that is concise, yet provides assurance that quality issues are being analysed and addressed across the full spectrum of an organisation’s activity. We should
also consider how the preparation and presentation of Quality Accounts could be used to reduce the duplication of data flow between NHS organisations. So please review, analyse and constructively criticise the proposals outlined in this consultation and send us your feedback by 10 December. The second issue relates to swine flu and staff vaccination (see page 6). My worry is that, if the virus takes hold, staff will become ill and sickness absence will increase, making it even more difficult to provide the sort of service we would wish to offer. Historically, the uptake of seasonal flu vaccine has been low. If swine flu takes off, our staff will have a professional and social responsibility to seriously consider vaccination to maintain levels of service under increased demand. Please could you give this your thought as the pandemic picture develops. Professor Sir Bruce Keogh NHS Medical Director