OECD Reviews of Health Care Quality: United Kingdom 2016
Raising Standards
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Health systems in the United Kingdom have, for many years, made the quality of care a highly visible priority, internationally pioneering many tools and policies to assure and improve the quality of care. A key challenge, however, is to understand why, despite being a global leader in quality monitoring and improvement, the United Kingdom does not consistently demonstrate strong performance on international benchmarks of quality. This report reviews the quality of health care in the England, Scotland, Wales and Northern Ireland, seeking to highlight best practices, and provides a series of targeted assessments and recommendations for further quality gains in health care. To secure continued quality gains, the four health systems will need to balance top-down approaches to quality management and bottom-up approaches to quality improvement; publish more quality and outcomes data disaggregated by country; and, establish a forum where the key officials and clinical leaders from the four health systems responsible for quality of care can meet on a regular basis to learn from each other’s innovations.
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Health care quality in England
The English NHS takes health care quality seriously and makes great effort to be a system that learns. England has internationally pioneered many initiatives, including clinical guidelines, continuing professional development and use of patient surveys and patient-reported outcomes. Professionalism was for many years the base upon which quality monitoring and improvement activities rested. Over time, though, the governance model shifted toward a quality management approach, more reliant upon transparency and regulation. There has been a proliferation of national agencies, reviews and policies that address quality, leading to a somewhat congested and fragmented field of actors. This chapter recommends three key actions for England. First, greater emphasis on bottom-up approaches, led by patients and clinicians, should be encouraged. As the same time there is scope to simplify the range of institutions and policies regulating health care quality at national and local level. Finally, renewed focus on the quality at the interfaces of care, as well as on community-based services, is needed.
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