In a paper launched today (January 8 2020), Wales’ leading think tank for health and care makes it explicitly clear that more radical solutions are needed, including an independent and externally validated quality system working across health and social care.
If not, NHS Wales is likely to continue to experience unacceptable shortfalls in the care being delivered to people across Wales.
Whilst the Commission supports the aims of the proposed Health and Social Care (Quality and Engagement) (Wales) Bill, it counsels that a reliance solely on regulation to change behaviours will fail.
Instead it calls for the NHS in Wales to become an open learning organisation that engages all organisations and employees to develop and implement continuous quality improvement and foster a passion to deliver safe, sustainable, excellent care and services.
The paper also highlights the importance of the peoples’ voice in the quality assurance and safety process, ensuring services and care are designed to meet peoples’ needs.
Bevan Commission Chair Professor Sir Mansel Aylward said, “We have to think and do things differently. We need to urgently adopt a quality management system where the needs of people are foremost, not the system or processes.
“If the recommendations in this paper and the issues they relate to are openly and fully addressed, Wales will take even greater strides forward to having a health and care system that is a world leader in ensuring quality and safe care.
“Failure to do so will court the risk of further, shortfalls in the standard of service the Welsh public have every right to expect. We have a strong legacy in Wales of providing a National Health Service which is second to none; we cannot risk any deviation from this path.”
The paper ‘Achieving Profound and Sustainable Improvement in Quality in Wales: a call for urgent action’ is an update to the Bevan Commission’s 2017 discussion paper that examined issues relating to achieving improvements in the standards of care and called for more radical solutions to make this happen.
At that time, the paper observed that Wales still had to make further progress in delivering ‘high quality healthcare at every encounter’. The Commission has continued to address this matter and has spent further time identifying and discussing potential solutions more widely with health and care service leaders, practitioners and users in Wales.
Unfortunately, there have been recent reports of failures in delivering optimal standards of care, not least, ‘The Review of Maternity Services at the former Cwm Taf University Health Board’ and the Joint Review undertaken by the Wales Audit Office and Healthcare Inspectorate Wales of Quality Governance arrangements.
This updated paper looks at the reasons why, in some parts of NHS Wales, there continues to be problems revealing unacceptable deficiencies in the high quality of care being delivered, despite a regulatory and governance system intended to avoid this happening.
The Bevan Commission has proposed a number of recommendations to address this major issue, including the need for;
Quality Standards to be shaped and owned by everyone, (people and practitioners) and built into the day-to-day working of health and care organisations.
Significant investment in leadership development and high quality and compassionate care at all levels to ensure NHS Wales becomes an open learning organisation
Fast tracked services that are safe and sustainable which meet enhanced quality criteria. Quality Indicators must be focused on what matters to patients and their needs and given equal emphasis and weighting as Financial and Performance Indicators.
The amalgamation of Healthcare Inspectorate Wales (HIW) and Care Inspectorate Wales (CIW) to be given urgent priority and together they should actively pilot the approach advocated in this report, with a view to rapid learning being developed and applied across Wales.
Bevan Commission Director Helen Howson said, “The time to act is now. If we keep doing more of the same, then we can expect more of the same. We need to engage everyone, patients, professionals and the public, in helping us to develop safe, high quality, sustainable services that meet their needs and which we can continue to be proud of.
“Instead of asking people what’s the matter with you we should ask what matters to you. It is essential that dynamic feedback is actively sought, to reinforce positive behaviours and attitudes, as well as to highlight not only problems but to help find solutions together.
“I hope this paper will provide the impetus and incentive to galvanise concerted action in which we all take responsibility to make a real difference to health and care services in Wales.”
The full paper can be read at http://www.bevancommission.org/en/publications?id=54