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 Northern Ireland
Northern Ireland has established a robust strategic agenda for quality of care, but faces a difficult challenge in maintaining public confidence amidst sustained economic pressures and ongoing concerns over access. While the small scale of the system promotes a culture of trust, it is over-burdened by a governance structure that may benefit from further consolidation. Amidst an array of grassroots initiatives there exists a need to further promote effective learning and sharing across services and scaling-up of good practices. More metrics to drive benchmarking across services along with a strengthened role for the regulator are indicated. The integration of health and social care governance has been poorly exploited to date, with funding and service arrangements still in silos and a lack of incentives to encourage change. Further integration and development of general practice as a principal agent for co-ordinating community responses to health and wellbeing needs will help drive reform.
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