Maintain focus on quality

111. We accept this recommendation, and strongly agree that the emphasis on quality of care must be maintained, and that service changes should put the safety and quality of patient care as central objectives. Indeed the recent NHS reforms to the structure and assessment of the health service, including GP-led commissioning and an expert-led inspection system have put clinical priorities and patient care at its heart. The Government will continue to prioritise the quality of care, and will hold its arms-length bodies to account on their commitments to reinforce and improve the quality of care. This will be a key focus of the newly re-established National Quality Board, in providing leadership for quality across the NHS.

The Thirlwall Inquiry has noted action taken in response to this recommendation. In April 2021, the National Quality Board (NQB) published a position statement on ‘Managing Risks and improving Quality through integrated Care Systems’. Alongside this, the NQB and NHS England developed a wide portfolio of quality guidance and tools to support ICSs as they develop. These include: • A refreshed shared commitment to quality (April 2021) to provide a common definition and vision of quality for those working in health and care systems. It uses the existing Darzi-based definition of high-quality care as being safe, effective, and providing a positive experience, with a greater emphasis on population health and health inequalities.

• Preparing for handover: Managing Quality Risks and Improving Quality through integrated Care Systems in ICSs (October 2021) which summarises the key responsibilities and considerations for ICSs relating to quality and to aid the operational transition from Clinical Commissioning Groups (CCGs) to ICBs. It refreshes the 2012 NQB handover publication that supported quality in the transition from Primary Care Trusts (PCT) to CCGs.

• A refreshed framework for System Quality Groups. NQB Guidance on System Quality Groups (Dec 2021, working document – ICS Quality Hub – FutureNHS Collaboration Platform), which refreshes existing NQB guidance on ‘Quality Surveillance Groups’ and provides clarity on System Quality Groups and broader ICS quality governance structures in which key health and care partners come together to share intelligence and risk on quality of care.

In April 2021, the NQB published a position statement on Managing Risks and Improving Quality through Integrated Care Systems.

Alongside this the NQB and NHSEI have progressed a wide portfolio of quality guidance and tools to support ICSs as they develop. These include:

• A refreshed Shared Commitme nt to Quality (April 2021) to provide a common definition and vision of quality for those working in health and care systems. It uses the existing Darzi-based definition of high-quality care as being safe, effective, and providing a positive experience, with a greater emphasis on population health and health inequalities.

• Preparing for Handover: Managing Quality Risks and Improving Quality through Integrated Care Systems in ICSs (October 2021), which summarise s the key responsibilit ies and considerati ons for ICSs relating to quality and to aid the operational transition from CCGs to ICBs. It refreshes the 2012 NQB handover publication that supported quality in the transition from PCTs to CCGs.
• A refreshed framework for System Quality Groups (SQG) (B0894- nqb-guidance-on-system-quality-groups.pdf (england.nh s.uk) which refreshes existing NQB guidance on ‘Quality Surveillanc e Groups’ and provides clarity on SQGs and broader ICS quality governance structures in which key health and care partners come together to share intelligence and risk on quality of care.

The Department is committed to ensure that services across the health and care system are of the highest quality through ongoing system regulation and oversight.

The Care Quality Commission is the independent regulator of quality for health and adult social care in England, it uses its powers to provides assurance and encourages improvement.

The new regional architecture has quality embedded into the role and responsibility of Clinical Quality Directors and other regional leads as well as through clinical networks and Local Maternity Systems.

The National Quality Board is reviewing the national model of quality surveillance, specifically the role of Quality Surveillance Groups in monitoring and managing quality issues within local health and care systems.

Department of Health (July 2015):

Accepts this recommendation.

“The Government will continue to prioritise the quality of care, and will hold its arms-length bodies to account on their commitments to reinforce and improve the quality of care. This will be a key focus of the newly re-established National Quality Board, in providing leadership for quality across the NHS.” (p. 96)