The London quality standards: a case study in changing clinical care

By:

Vaughan, Louella

Contributor(s):

Publication details: London 2017ISBN:

9781910953198

Online resources:

Click here to access online

Summary: <p style="box-sizing: inherit; margin: 0px 0px 24px; padding: 0px; border: 0px; font-variant-numeric: inherit; font-stretch: inherit; font-size: 16px; line-height: 24px; font-family: "Utopia W01", "Times New Roman", serif; vertical-align: baseline; color: #0e1b26; background-color: #f4f4f4;">From 2011, the NHS in London embarked on a major programme to improve care for patients in emergency and acute services by introducing a set of professional standards. The London Quality Standards set out a range of minimum requirements, including regular consultant review during out-of-hours and at the weekends. Several formed the basis for the Seven Day Services Standards which the NHS is now committed to rolling out across England. Our evaluation draws on surveys and interviews with those responsible for developing the standards and the frontline staff responsible for making them a reality. We found that the introduction of the LQS worked well in making people aware of shortcomings in care, and drove real change in how people worked. Our initial statistical analysis did not show any evidence that they achieved consistent improvement in patient outcomes.The most important factor in making the standards a reality was a bottom-up effort from clinicians. We saw some deficiencies in hospitals’ ability to manage complex changes, and evidence of a deep disconnect between frontline staff and top managers. The use of reconfiguration as a “stick” to drive the standards demotivated staff, and eventually came to be seen as an empty threat.

List(s) this item appears in: Barts Health - Inclusion and Diversity Collection

Holdings
Item type	Home library	Class number	Status	Date due	Barcode
Book	Ferriman information and Library Service (North Middlesex) Shelves		Available

E-books

156 p.

<p style="box-sizing: inherit; margin: 0px 0px 24px; padding: 0px; border: 0px; font-variant-numeric: inherit; font-stretch: inherit; font-size: 16px; line-height: 24px; font-family: &quot;Utopia W01&quot;, &quot;Times New Roman&quot;, serif; vertical-align: baseline; color: #0e1b26; background-color: #f4f4f4;">From 2011, the NHS in London embarked on a major programme to improve care for patients in emergency and acute services by introducing a set of professional standards. The London Quality Standards set out a range of minimum requirements, including regular consultant review during out-of-hours and at the weekends. Several formed the basis for the Seven Day Services Standards which the NHS is now committed to rolling out across England.&nbsp;Our evaluation draws on surveys and interviews with those responsible for developing the standards and the frontline staff responsible for making them a reality. We found that the introduction of the LQS worked well in making people aware of shortcomings in care, and drove real change in how people worked. Our initial statistical analysis did not show any evidence that they achieved consistent improvement in patient outcomes.The most important factor in making the standards a reality was a bottom-up effort from clinicians. We saw some deficiencies in hospitals’ ability to manage complex changes, and evidence of a deep disconnect between frontline staff and top managers. The use of reconfiguration as a “stick” to drive the standards demotivated staff, and eventually came to be seen as an empty threat.

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