Managing quality in community health care services
Community health care services provide vital care out of hospital for millions of people. From children’s services to care for older people and end-of-life support, the community sector plays a key part in meeting the challenges facing our health and care system. This report presents findings from a small-scale study into how quality is managed in community services. It explores how community care providers define and measure quality and recommends important next steps to support better measurement and management of quality.
Key findings
- Community health care providers are working hard to focus on quality, with examples of some robust quality governance systems and innovative ways to support quality improvement
- Community health care providers do have quality measurement systems but there are very few robustly comparable national indicators. This produces a dangerous blind spot in our knowledge of the overall quality in community services at a national level.
- Poor availability of information was a recurrent theme from respondents in our study, including historic under-development of data on quality and quality measures, lack of specific measures for community services, and lack of technology and data systems to support quality measurement.
- There is a particular shortage of information on quality among non-NHS providers – of especial concern in the community sector, given the high proportion of non-NHS providers.
- Many respondents listed staff shortages and caseload sizes as risks to the delivery of quality care. Financial and demand capacity pressures were also seen as risks to quality both now and in the future.
Policy implications
- National bodies (Department of Health, Trust Development Agency, Care Quality Commission, Monitor, NHS England) must act to develop and implement a clear road map for radically improving quality measurement in community services.
- The Community Information Data Set (CIDS) – comprising patient-level records of use of community services – must be developed urgently so that providers can use it to manage their services and commissioners can use it to underpin commissioning of community services
- Developing measures for quality in community services is vital, particularly as the needs of people using these services become more complex.
- Community health care providers must prioritise engaging staff in quality, supporting them with the skills and tools to improve quality.
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Comments
Just a quick read through an excellent piece of work. I do however worry that there is no male author out of 6. I sometimes think that we are in
danger - in some instances - of forgetting the vitally important lesson learned in the last 30 years that vital multi- gender perspectives in multi-author works on care are best obtained through having diverse genders in authoring
Just a quick read through an excellent piece of work. I do however worry that there is no male author out of 6. I sometimes think that we are in
danger - in some instances - of forgetting the vitally important lesson learned in the last 30 years that vital multi- gender perspectives in multi-author works on care are best obtained through having diverse genders in authoring
Our website http://www.useyourcommunity.com is a database of community providers which we are developing into a national service. Our concern is that community services do not have sufficient funding to implement quality initiatives. Clearly we can see from the sums poured into hospitals that it is not easy to implement quality systems. Is it fair to expect hard pressed local services to find funding for quality initiatives from within their own limited resources?
In Scotland we are working hard to develop strong joined-up datasets and commonality of language. As part of a national programme, Lothian is developing an intergrating tool specifically designed to empower the individual and link across all sectors providing support and care - the Indicator of Relative Need (ioRN) is Scottish and unique. It provides an objective, validated picture of a person in 'plain English' which becomes the 'spine' linking all services together: from supporting personal outcomes to providing strategic information for joint commissioning and Public Health.
September 2015 can I honestly report 'hand on heart' it is getting better for the vulnerable the serious ill. I am afraid NOT.
NHS 111 is in 'taters' too few staff, & sufficiently trained to advice on emergency care and treatment. A FACT.
The severely mentally ill are being ignored, many forced to live on the streets, due to DWP new regulations. 'fit for work' is just one example.
Severely mentally ill placed into supported unregulated accommodation live in squalor, and NEGLECTED. A FACT.
The CQC 2015 GP Inspection process is still NOT understanding the real problems WILL MAKE NO DIFFERENCE.
WHY is there NOT more Public or Carer Engagement seeing us as EQUAL PARTNERS>
HOW CAN WE CHANGE THE WAY THE CQC INSPECT GPS TO GET THE TRUE PICTURE!
GP Practices should hold a Register of all Carers in their Practice, they would be contacted each time by email or other when the CQC are coming to inspect their Surgery.
Response by email to the CQC would provide accurate account of their thoughts on their care and treatment at this Surgery. EASY.
My suggestion solves one important part of the Inspection process.
We are in the digital and Computer age, why is the CQC wasting so much
time visiting the CCG before the GP Inspections, when in fact THEY SHOULD BE THE LAST.
I AM ALSO A CARER, and can report the latest GPS Inspection process
is still NOT up to the JOB.
More time should be allocated to service users some carers are working for free as there is never enough time that is down to council cut backs as a carer on a visit so many tasks to do and paperwork to fill in carers do a lot of tasks ringing doctors district nurses family members dealing with complaints that cannot be helped then all the Cqc and media is slate the homecare workers and providers it's all down to money would you work for free no I don't think you would.
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