Quality in Health and Social Care Assignment

Introduction

In health and social care the quality of the services are very important in yielding the satisfaction of the customers or service users and it mainly depends on the perspectives and opinions of the service users in the health and social care. Though the viewpoints of the experts in the field are different but the health and social care service organizations are constantly being committed to improvements in the quality of the services offered. However assessing and evaluating of the quality of the services offered by an organization is quite difficult for both the parties, service users and the service providers. Thus the study of quality in health and social care assignment basically aims to discuss the various perspectives of quality in the field along with focussing on the strategies employed to manage and improvement in the quality of services. Thus the study aims to develop an understanding of improvement and management of quality in the care organizations taking the case of Royal United Hospital.

Lo 1 different perspectives of quality in health and social care services

1.1 Perspectives that stakeholders have in health and social care

The stakeholders are those groups or individuals who are impacted or bear an impact on the activities of any organization or field of services. Thus there are various stakeholders in health and social care services (Mays et al, 2007) as

• Care Quality Commission and government authorities who are constantly involved in designing of polices in order to yield higher satisfaction of users and provide for more accessibility of the services to people in the society in home or hospital environments

• Service users who have different perspectives of quality of services based on their own perspectives and feelings

• Service providers or facilitators who evaluate the quality of services based on their own viewpoints and experiences, which are more individual related

• Employing organizations who are concerned about communication systems, behaviour and responsibility handling of the service staff, flexibility, capability to cope up with changes, following legislation and framing policies and their implementation, etc.

As in case of Royal United Hospital Bath NHS Trust, the situation demands for better collaboration between various stakeholders to provide better health and social care services.

1.2 Role of external agencies in standard setting

The external agencies in health and social care services are mainly in the role of monitoring of the standards of services offered along with promoting the interest and rights of the service users and other stakeholders. Thus the role of various external agencies in contributing to the health care standards is as follows

• Care quality commission (cqc): in an independent organization in the UK health and social care services and it is vested with the role of ensuring that the care organizations and hospitals work effectively towards providing safe and good services to the service users in a empathetic manner. Also it handles various incidents arising in the field of services and thus improves the quality of overall services (Parvis, 2007).
• Inspectorate: is involved in monitoring of the services and facilities that are being provided to the service users and reports to the authorities by providing ratings to the care services organization and thus allowing for ensuring good services to users through providing  information knowledge  through ratings.
• Medical and health regulatory agency (mhra): has the role in ensuring the functioning and soundness of care devices, medications provided to users, etc thus contributing to the quality of services offered to the users.

Thus the contribution of the various external agencies is important in setting of standards and improving the effectiveness of care delivery.

1.3 Impact of poor quality services

The poor quality of services has direct impact on the health and well being of the service users and thus the whole society while it damages the repute of the service organization and leads to lack of motivations of those working in the service delivery (Lytle et al, 2002). For the planning authorities, it leads to non fulfillment of the health targets for the people in the society and thus ill health of the people. Also this would lead to poor patient health and experiences will lead to development of negative attitude towards recovery and care services on the whole thus impacting well being of the entire nation. As seen in case of Royal United Hospital at UK, the organization must place focus on improvising the management of their funds and must comply with the legal framework to maintain its viability and function in the field. The management at the hospital must develop policies regarding the reporting patterns for the employees and must develop the standards in service delivery at organization. Also the organization must make improvement in the level of employee motivation in order to deliver effective health care services to the users thus improving and restoration of the impacted reputation of the RUH and effective monitoring is the key consideration for the organization in this scenario.

Lo 2 strategies for achieving quality

2.1 standards that exist for measuring quality

Quality is required in the health and social care services in terms of functioning, controlling, auditing and managing and thus the setting up of standards helps in maintaining the quality in delivery of services. Various organization help in setting up of standards in the field as including CQC providing care standards, NICE, NMC, etc the assurance of quality and controlling standards are more related to improvement in the services in the field of health and social care (Chassin et al, 2008). Quality can be measured in terms of satisfaction and well being by the users and fulfilment of codes of practice in terms of the institutions. The overall efforts seek to improve the confidence and controlling of the service users thus empowering them by having complete control over systems in improving their health and well being.

As per CSCI report in 2009, the UK health and social care services are insufficient in meeting the needs of users and thus the government had been committed to personalization regime in providing funding to the service users in order to decide money allocation to services in order to yield best satisfaction of the needs. The overall aim is to provide class facilities to the people in the society and providing for improvement in well being of the people.

2.2 different approaches of implemeting quality systems

The organizations in health and social care services make use of various kinds of models in measuring the quality of care services.

• Benchmarking model: makes use of investigations in health based on the designed questionnaires and social care along with certain equation in order to attain quality of care services and thus developing quality standards based on these findings, which are low performing as seen in care organizations implementing it.
• Total quality model /continous quality improvement model: is where the total quality of the services offered by any care organization is managed through monitoring of services, auditing and changes in the performance standards with the changes in environments. This model is based on the idea of occurrence of immense opportunities for improving in care services (Donabedian et al, 2008).

As the TQM is based on detailed and complete analysis of the care services by an organization, thus it is best suitable for the RUH by focussing on the improvement in the commitment and performance of the organization by helping the  quality management  in implementation of policies and procedures in organization along with reviews and audits in the systems.

2.3 potential barriers to delivery of quality services

There can be subsequent barriers in effective delivery of quality services as in case of RUH. The potential barriers to effective delivery of quality services may be internal to organization as

• Poor communication systems and complaint mechanisms: as the organization may not be having proper complaints procedure allowing the patients to file complaints against the services offered or anything else that could lead to improvement in services at the organization.
• Need for improvement: as the organization may not be dedicated to improving the level of commitment of its employees in improving the quality of services rendered to patients.
• However the various causes or barriers may lie outside of the care organization as:
• Lack of funds: which leads to poor management and allocation of funds in the care organization thus impacting the facilities to the users and impacting overall quality.
• Lack of support from families and society: as their level of participation in the promotion of the quality of the services offered in health and social care through providing information in needs assessment and follow up related with the suitability of budgets and services in meeting the care needs of the patient.

Thus the participation of the family members and other representatives in control of the situation or disease in a patient is utmost important for effective delivery and need identification in health and social care services.

Lo 3 evaluation of systems, policies and procedures in health and social care

3.1 effectiveness of systems, policies and procedures in attaining standards of services

The care services should be safe, helpful in patient recovery clinically, focus on well being and must aim to reduce the complication or symptoms in the service user thus ensuring improvement in survival.  For the effective delivery of health and social care services to the users in the society, various organization like RUH at UK in the case appoint employees such as physicians, nurses, etc that are vested with the responsibility of delivering the care needs of the patients. The various programs and policies include

• Disease management policies
• Improving the Healthcare coordination
• Provision of motivation to the employees in health and social care through incentive schemes
• Performance based promotions and compensations
• Providing for support needs of patients and setting up of care homes

Thus the health care organization seeks the effective support of the legislative framework in order to improve the quality of services offered and a reduction in the operational expenses through setting up of policies and formats in the organizations. Also in case of high risk situation in the patients, the policies and procedures help in coordination of the services and make quality provisions to the service user (Downs et al, 2007).

3.2 factors that influence achievement of quality

As seen in the case study of Royal United Hospital at UK, the various factors that influence the quality attainment of the services offered to the service users includes the following:

• Patient orientation: is necessary for the services must be aimed at reducing the illness in the patient and must be clinically effective and improve the survival of the user.
• Past performance: records are important in quality attainment and thus the care organization must keep track of the measured and valuable achievements at organization in care services,
• Funding capability: of the organization has a deep impact on the facilities offered by the organization to the service users and thus the organization must focus on improving its trust amongst the investors or funding agencies.
• Credibility of organization: is a valuable input in the success of the quality service provisions by the organization and thus the organization must improve the level of trust and commitment in the stakeholders and especially its employees in order to attain a better quality of services (Scott, 2001).

Thus as seen in case of RUH, the organization must work based on certain care standards in order to attain quality services.

3.3 ways of improving quality of services

Improvement in the quality of services offered as in case of RUH which was facing a sort of inability to meet the demand of large number of service users and it could be improved as:

• through the elimination of the long wait time in case of the service users through the increment in the facility provisions such as extra beds and other amenities and thus reducing waiting time and admitting more service users at the organization
• making arrangements for equipments and staff in order to meet the demand as seen in form of large number of patients at the hospital
• through developed of a more  personal and professional  outlook towards the care provisions as in case of RUH, there is a need for development of more better outlook in providing for palliative care services to the patients
• Through improving the understanding of the legislations, policies and procedures that apply to the health and social care practice amongst the employees and improving their commitment in the organization
• CPD could help in keeping track of the personal skills and knowledge and keeping them in acceptable standards for better services provision (Cleary, 2007)

Thus by making arrangements to meet the needs of the demands of service users through procurement of more equipments, more facility arrangements and improved level of staffing, the organization could improve its service quality by reducing waiting time and meeting needs effectively.

Lo 4 methodologies for evaluation of services

4.1 methods of evaluating service quality with respect to internal and external perspectives

The service quality is evaluated based on its internal and external perspectives, which are outside the organization and as in the case of Royal United Hospital the external perspectives include Care Quality Commission. The application of the care standards in the care environments help the evaluation of the care services offered to service users. The CQC’s role is important in documentation of the factors and analysis of the care environment that impacts the care services in a particular health and social care setting. The external factors are important in initiatives relating to changes in the processes and policies of the care delivering organizations (Noar et al, 2007). Thus the external perspectives help in informing about care standards and policies as formulated by the authorities or CQC and thus forming the positive feeling in the society about the services offered to them thus impacting the level of satisfaction in the service users.

In case of the internal perspectives, the TQM helps to ascertain the financial aspects of the organization along with its relation with the efficiency of the care services delivery in the organization. Also the programs such as quality assurance helps the care organization in dealing with proper documenting procedures, monitoring of service and reviewing of the policies and procedures to manage the quality of the services offered (Dowd, 2010). The internal perspectives of the modern care organization involve Continuous Quality Improvement in quality in terms of practices and policies. The organization can make use of various techniques in evaluation as:

• Questionnaires
• Focus groups
• Interviews
• Feedback mechanism
• Complaints procedure and handling (Chassin et al, 2008)

In the case of RUH, the organization may make use of the techniques like TQM in order to improve the service quality at the organization and manage the internal and external factors affecting the quality of services offered. This helps the organization in order to improve financial performance and credibility through reduction in the expenses and costs and thus allowing for the better performance of the organization through development of a holistic approach. Thus the TQM can help the hospitals and care organization in improvement of the services long with development of a competition edge and growth.

4.2 impact of involving users in evaluation of health and social care services has on service quality

As the government at UK had developed a person centred approach in the process of care planning and delivery to improve the satisfaction of the needs of the service users in a better manner thus the organizations must consider the participation of the service user not only in assessment of needs and development or delivery of care plan but also in evaluation of the quality of services (Anon, 2014). Thus by involving the service users in the evaluation process, the organization including RUH tempts to improve the rights of the service users and allowing access to better services to them. Also this helps in development of a better relationship between the user of services and the provider. Users come from varying cultures and backgrounds and they can help in development of better services and infrastructure through their fresh concepts and this could be valuable for the whole organization on implementation.

The disadvantages for not involving the users in the evaluation process could be severe and working without understanding of the quality perceptions of the stakeholders in the care process could be damaging to the organization (Turno, 2010).

In the health and social care services, various reforms are being done in order to understand the quality perception of stakeholders and more importantly the service users who are at center of planning and implementation of the care services in personalized approach. Thus the care organizations must keep the user at the centre of the services evaluation and thus improve the delivery of services and satisfactions. Thus RUH must develop quality standards and control mechanism in the organization along with setting up of better monitoring of services. Thus the organization could improve the quality of services offered through building up of confidence levels of the clients.

Conclusion

The quality of the health and social care services is an important concern for gaining the maximum  customer satisfaction  of the needs related to health and well being of the service users. The government of UK analysed that the service user was not benefitted in the health care regime based on the reports in 2009 and decided to allow for personalisation of the health care services and thus providing for person centred planning and needs assessment in order to allow the empowerment of the individual or service user and protection of the rights and interest of the service users. The various legislations and care standards are developed by CQC and other governing bodies with a view to promote the benefits and choice of service users and thus improve the overall quality of the services offered to them by NHS. Also the care organization must improve the services by improving the level of participation of the care users in the evaluation process. However, making arrangements for additional or extra facilities to meet increasing demand for services and recruiting more staff and procuring more equipments can help the care organization to improve their services and reducing the waiting time for the service users.

References

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