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NHS safeguard system needs to 'evolve'

Warning sign A review of England's early warning systems in the NHS commends ongoing work by Monitor and the Care Quality Commission, but warns that processes must evolve.

England's national quality board (NQB) - led by Sir David Nicholson, NHS chief executive -explored the systems and processes in place in acute and community care for safeguarding quality and preventing serious failures.

Its report, which represents the shared view of the Department of Health (DH), Monitor and the Care Quality Commission, says the system will still 'need to evolve... and must be kept under constant review', but adds: 'We also need to consider the impact of restructuring the management and regulation of the NHS, as the distraction and confusion this creates can pose one of the greatest risks to quality.'

Lord Darzi's next stage review led to the creation of the NQB last April. It provides strategic oversight and leadership on quality issues in the NHS.

Recommendations in the NQB's report - published alongside last week's Francis inquiry into Mid Staffordshire NHS Foundation Trust - have been accepted by the DH.

NQB's recommendations

  • Trust boards to be given further guidance on how best to govern for quality
  • DH to work with royal colleges to look into how professional bodies can encourage a culture of openness and transparency among all healthcare professionals
  • As part of its evaluation of quality accounts, the DH should assess how effectively users of services and wider stakeholders have been involved in determining the priorities
  • Compliance frameworks (eg, NHS performance framework for NHS trusts) to be revised to make them more sensitive to quality issues
  • Primary care trusts (PCTs) to play a greater role in the NHS performance framework to PCT commissioners
  • NQB to conduct a review of patient engagement and feedback mechanisms
  • Strategic health authorities to be responsible for making sure that all the action being taken, whether regulatory or management, is aligned and co-ordinated

 

 

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