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Is the quality of care in England getting better?

QualityWatch Annual Statement 2013: Summary of findings

The quality of NHS care in England has been scrutinised more in the past year than in any other since 1948. This is because of a number of high-profile failings in care and concern about other potential lapses. Each has been, or is being, subjected to detailed inquiry resulting in several landmark reports, such as Robert Francis QC’s inquiry into care failings at Mid Staffordshire NHS Foundation Trust (Francis, 2013); Sir Bruce Keogh’s review into the quality of care and treatment provided by 14 hospital trusts in England (Keogh, 2013); Don Berwick’s review into patient safety (National Advisory Group on the Safety of Patients, 2013); and the Care Quality Commission’s (CQC) investigation report into University Hospitals of Morecambe Bay NHS Foundation Trust (CQC, 2013). However, these reports do not fully answer the question about what is happening overall to the quality of care funded by the NHS and local authorities across England.

There are well documented challenges facing health and social care services, including spending constraints; organisational change resulting from recent reforms to healthcare structures; and growing care needs arising from increasing levels of chronic disease in an ageing population. But there are also opportunities as new treatments emerge and our ability to assess quality increases, in part because of better information technology and greater innovation. Given this, will the quality of care generally improve or worsen? And which aspects will improve or worsen, for which populations, and in which areas of the country?

To try to help answer these questions two independent organisations, the Nuffield Trust and the Health Foundation, have begun a five-year programme of analysis: QualityWatch.

In this programme, an extensive range of indicators will be analysed to assess the quality of health and social care services in England. This range of indicators will be developed over time so that they provide a more comprehensive assessment of quality. To supplement these indicators, we will also produce a number of in-depth analyses into specific topics in health and social care, using a range of methods.

Every year we will synthesise our research and analysis through an annual statement. This will provide commentary on what we have observed in the landscape of quality in health and social care, and build a picture of the quality of care delivered to patients and service users in England. This paper is a summary of the first of these annual statements.

The aims of the programme are to:
• provide an authoritative and independent analysis on the quality of health and social care over time, while at the same time augmenting and informing other statutory and non-statutory national initiatives
• highlight where there are clear and compelling gaps between existing standards of care and what is possible, in order to prompt action to improve quality
• help develop the way quality of care is measured.