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Getting the measure of quality

Opportunities and challenges

Quality has been at the centre of recent NHS policy, and the NHS Next Stage Review highlighted the role of information and measurement in supporting quality improvement, particularly in relation to patient safety, clinical effectiveness and patient experience.

It is therefore important to be clear how quality can be measured and by whom – and how the information can be used to improve services. If quality measurement is going to have greatest impact, all those involved – policymakers, commissioners, board members, managers and clinicians – need to be aware of the opportunities and challenges it presents.

Getting the Measure of Quality offers information about how quality is defined and how quality measures can be used – and misused. It sets out the main debates and choices faced by those involved in measuring and using data on quality and outlines some practical issues to be considered in choosing and using quality measures.

The paper emphasises that understanding how to produce good indicators of quality is only the first step; what is critical is having systems in place to make use of the information to improve patient care. This will be particularly important in the current economic climate, which puts pressure on the NHS to improve the quality of care at the same time as improving productivity and efficiency. The paper suggests that the scope of quality measurement is widened to include measures of productivity, efficiency and inequality.

Other recommendations include:

  • improving measures used for performance management and external assessment to reduce 'gaming' in the system

  • ensure clinicians are engaged in the development of performance measures and are empowered to use data to understand where and how to improve their own performance

  • take steps to minimise the risk of misinterpretation and confusion among patients and NHS organisations when reporting data publicly.