Quality and Innovation
High Quality Care For All is built on the foundations of quality and innovation. When initiating dialogue, it¹s important to focus on these issues. What do we mean by quality? How do we build innovation into everything we do?
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| At the heart of High Quality Care For All is one simple yet radical idea: to put quality at the heart of the NHS. That is quality defined as patient experience, patient safety and clinical effectiveness. | Innovation in healthcare does not just mean new drugs or devices, important as these are. It means clinical professionals finding new solutions to the problems they face in their daily working lives – from designing a new patient pathway to finding new ways to measure patient experience. |
By keeping quality and innovation at the heart of the NHS, we will continue to raise standards across all areas of the health service and deliver on our commitment to High Quality Care For All.
Telehealth holds so much potential for health and welfare improvements while reducing the costs of care provision, it is a great disappointment that it has made such limited progress. Why is this?
Many papers about telehealth trials and pilots point to the limitations of the technology used. This seems odd when there are so many new powerful multi-media communications facilities available to all. But they have not been pulled together in a way that can be applied rigorously to the needs of providing remote care to people in the comfort of their own homes, on a large scale.
They are not designed to support multiple organisations ‘sharing’ the multi-media platform, nor are they purposed for many concurrent telecare operations. This ‘multi-tenanted’ telecare service platform is a key technical challenge in the provision of cost effective next generation telehealth services.
On the patient side, there is a similar challenge in providing a single point of connection for multiple telehealth monitoring devices. This universal telecare agent must support secure multimedia services and be capable of integrating with a wide range of telehealth monitoring devices without requiring manual upgrades. The agent provides a common, client side, point of integration, allowing all telehealth services to be connected to the communications network, ensuring security and providing a single point of delivery.
InMezzo are building this network, calling it Smartcare, and collaborating with ntl:Telewest for its delivery, which will be offered as a ‘plug-and-play’ service.
Would you care to discuss in more detail?
Thank you
Tim Craig
We have been working hard in the NorthWest to take innovation seriously and we have organiseed a strategy and delivery meeting to debate and discuss Darzi’ vision.
‘Innovation Partnerships for Quality, Efficiency and Growth’, Important Event For NHS Leaders and Senior Directors, Thursday 12 November 2009, Bridgewater Hall, Manchester,
Endorsed By: NHS Institute for Innovation and Improvement & NHS North West SHA
In order to regain quality in health-care, patients need to be put first! Starting with Primary Care providers, GPs need to scrap the time-limit system in use everywhere at present - time given to a patient depended on time needed by that patient - a patient who is attending for test results, or to give an update on how a new medication is working for them, may only require a few minutes, whereas a patient who has recently been given a difficult diagnosis by a specialist, will need time to find out more about the condition. Also, as psychiatric care is being handed back to GPs in a lot of cases, they must be prepared to give whatever time is needed if a patient is suffering from psychosis, paranoia, or maybe a schizophrenic episode! It is also time that GPs started recognising that, even if a person has been suffering from mental health problems for most of their life, it does not mean that they cannot also have a physical illness - it is not ‘all in their mind’.
When it comes to Hospitals, there could be enormous savings made simply by getting rid of all the ‘managers’ and their associated satellites. Quality of Care would be greatly enhanced by the reintroduction of a Matron as Head of Nursing (not Nurse Managers) in each hospital - Matron will be responsible for the costing of the nursing part of patient care - she will also ensure that patients are treated as people, not targets to be met. The Surgical/Medical side will be overseen and managed by a Chief Surgeon, who will also ensure that costs are managed properly - not necessarily the cheapest equipment, but the best value. Also under their control would be the running of Clinics, X-ray Departments, and Physiotherapy.
Nursing needs to return to being about patient care rather than paperwork. Nurses used to be the ones who damp-dusted window-ledges, locker tops, and bed trays - at the same time they would chat to the patients and find out how they were really feeling, rather than a straight question (how are you today?)-and-answer (fine, thank you). Make cleaners do the cleaning, not the hot drinks and the lunches!
I would love to talk to someone about these and other thoughts and ideas I have on this subject.
Anne, thanks for your comments - please do keep joining in the debate here on the blog posts, strong voices are encouraged and we’ll always respond. The future of nursing in particular is a topic we’ll return to. On the issue of GPs making time for patients with mental health issues - and we read in your other comments that you have personal experience here - we think that in many cases they already are…
I would like to see more Hospital Consultants provide patients with copies of the letters that they write to GPs, if the patient requests it.
But I would really like to see much more Clinical Governance and general supervision of single-handed GP Practices. I am firstly concerned about the lack of services available for patients attending these Practices.
I also believe it is now time that the practise of employing family members as managers was prohibited. The problems exposed when some MPs employed family members is widespread in single-handed practices. Do these people have Job Descriptions and what checks are carried out to test value for money and suitability to do the job? Also is there a standard time by which a patient’s name should be removed from a Practice register when they have left the Practice? What checks are being done to see if all names on registers are still active patients at the Practice.
It seems to me that most of the New money that has been pumped into the NHS was used to improve GP services, I know in customer surveys that has been what patients put as a top priority. However it now seems unfair that Acute Trusts and Community Services are to find 10% - 20% cost improvement savings when money is just washing through GP Practices without any cost improvement pressure and without much accountability as far as I can see.