The Principles And Patterns Of Clinical Governance

One of the biggest obstacles to successful management of the NHS, and also to any analysis of its current well being, remains the significant lack of any valid information as to what the NHS does, how much it costs and where the money is spent. Indeed, it is perhaps surprising that 'the 1990 changes' were conceived and implemented as fast as they were, given the lack of information that was available in 1988. (Ham, 1996) Attempts were made at the start to ensure that hospitals began from a 'level playing field' so that they were in fair competition with one another, but the sometimes 10 fold differences in the early quoted costs for identical services in different hospitals had as much to do with differing costs of maintaining buildings

After the serious shortcomings within the Mid-Staffordshire NHS Trust came to light, The Francis Report (Francis, 2013) investigated how the conditions of inexcusable care could prevail within the trust. The Francis Report proposed several extensive changes that could improve the National Health Service (NHS). Garner (2014) informs that these changes include that leaders need to be effective and accountable, staff should be empowered to work in partnership, each trust should aim to improve innovation and quality, whilst putting the patient first. The Department of Health (DH) reflected on the findings and in response to The Francis

Starting with the organizational structure of the NHS, it is basically an umbrella organization that comprises of four regional branches, in particular, NHS (England), NHS Scotland, Health and Social Care in Northern Ireland and NHS Wales. The financing for all these institutions comes from a universal source, particularly the tax-payer money of residents of UK, although they operate to an extent as self-governing institutions. The treasury allocates money to the department of Health, which in turn allocates money to NHS England (Understanding the new NHS). In other words, the top executives of these four institutions take decisions independently for day to day operations although they abide by broader governing directives applicable to the UK region as a whole. Governance is an important aspect of the operating of the NHS, for without it exploitation by private vested interests is likely to happen. (National Health Service (NHS): A study of its Structure, Funding and Regulation, Strengths and Weaknesses, n.d.)

NHS quality improvement programs main purpose is to collect and review data entered in order to recognize the opportunities to improve business operations in healthcare. To bring changes in quality, it is necessary to respond to patient’s ideas and implement them for the better results. The key issues that are to be considered for quality-improvement NHS program, as it moves forward are the needs for the patients, necessity of the funds for quality improvements, needs of the service providers and expectations of the community. Outcomes for people and also change expertise. And to improve business operations in healthcare and also recognize opportunities.

Assignment: Critically analyse an incident experienced whilst in practice, allowing opportunity to explore professional responsibilities, concepts of care management and the impact of health policy/legislation on care provision. You should demonstrate fitness of practice (NMC, 2008).

Today’s changes to the NHS have been called the most radical in the whole of the 60 years that it’s been in existence. In today’s NHS charities and private firms are now involved much more widely, in areas such as mental health and end of life care. Although they do have a much smaller role in hospital setting than they used to have. One of the biggest changes is that doctors now have budgets from which they buy healthcare, it could be from NHS trusts or private sectors, the new scheme is called GP

They define what an organisation or service carries out and how they do so. Clear policies and procedures support effective decision making and allocation because they provide guidelines on what individuals can and cannot do, what decisions they can make and what activities are appropriate. (rcvda, N.D) Charters state what an individual can expect from an organisation such as the Department of Health, they can be used as a benchmark for service users. There are a number of factors relating to how jobs are designed or carried out that may increase the risk of violence or crime occurring within a workplace. As well as ensuring legal rights and responsibilities are met, they motivate and encourage individuals to be more productive. Good working practices can positively impact service users and workers, help build individuals self-esteem and promote individuals rights. (HSE, N.D) Within health and social care settings, there are many different professionals with different skills, expertise and knowledge. A multidisciplinary team is a group of health care workers who are members of different disciplines each providing specific services to the patient. Multidisciplinary teamwork is viewed as one of the key methods, through which care is achieved in the NHS. This is a very important element in the provision of meeting a service user’s needs. (HSE, N.D) Although, health care services and the whole of society have a role and duty to safeguard vulnerable adults, there are a

In 2007 Julie Bailey and family members of those who died due to the negligent care at the Mid Staffordshire hospital set up a campaign which they named ‘Cure the NHS’ BBC News (2010) expands on this story. This prompted an investigation that changed everything. The scandal grabbed national attention following a yearlong investigation made by the Healthcare Commission in 2008 at the Stafford hospital. Sir Robert Francis led the investigation in which he made a staggering 290 recommendations

Over the last 15 years or so a number of cases concerning patient care and safety have come to light prompting investigations and inquiries that have led to changes in the way care is delivered. These include inquiries at Winterbourne View hospital, Mid-Staffordshire hospital(Mid staffs) and Harold shipman to name a few.

The Health and Social Care Act 2012 came into force with crucial principles including new structures and arrangements in health care services to safeguard and strengthen the future of NHS and maintain the modernisation plan. In this Act, many new changes has been made to a number of existing Acts, National Health Services Act (NHS 2006), in order to enable health care system to tackle the existing challenges and also avoid any potential crisis in future. It has also introduced the proper allocation of NHS fund and budget, and improved the integrated care between NHS and social care services to promote patients’ choice in terms of delivering quality care.

“Running a health care organization is a team sport. It is very important that all members of the team-whether on the medical staff, in management or on the board-understand the role of governance and what constitutes effective governance” (Arnwine, 2002). Running a hospital is a difficult task. Several factors need to be seriously thought of and considered in every decision and undertaking. Unfortunately, all the three important factors in governing a hospital is not always in harmony. As likened to a team sport, if the three major components are not working with each other as a team, there will be tension and a great divide will be experienced. And often times, the patients will be in the middle and will be greatly impacted. This writer believes that there are several factors that contribute to the tension that usually exists among the medical staff, the board and administration. One factor is the disconnect, where each entity is not seeing each other eye to eye and their visions may be different from each other. Another factor may be the lack of communication in order to bridge the gap and to build a respectful and a relationship wherein there is trust for each end every member of the group. Often times, the medical staff is concerned with ensuring that patients are cared for in a manner that their practice is protected as well as the patients are getting the appropriate care. On the other hand, the board of trustees may be focused in ensuring that that

This essay seeks to discuss the factors that facilitate change in health and social care. This can be achieved by assessing the challenges that the major factors of change bring using the Care Quality Commission of the Quality Care Commission for the Royal United Hospital Bath NHS Trust (RUHB). The second task aims to evaluate contemporary changes being inaugurated in the provision of health and social care services. In addition to this, a strategy and criteria will be devised in order to measure these recent changes including how the impact of these changes can be measured and evaluated.

Some hospital trusts and health authorities consistently outperform others on different dimensions of performance. Why? There is some evidence that “management matters”, as well as the combined efforts of individual clinicians and teams. However, studies that have been conducted on the link between the organisation

The concept of governance within a health care organization must be well design and welcome cooperation (Berger, S. (2011). When those that make policies can understand how to apply cooperative regulatory structure in healthcare setting it is noted that self-interest is not the only way of motivating positive behavior. The concept of governance spells out who is responsible for ensuring and providing support and services to all members needing health resources (Berger, S. (2011).

A clinical audit is a quality improvement process which aims to improve care through a systematic review of practice against evidenced based criteria, followed by the implementation of change (Healthcare Quality Improvement Partnership, 2011). There are many different audit cycles to choose from which could be confusing for practitioners (Dixon & Pearce, 2011). The audit cycle pictured below (figure1) was selected as a bases for this project because it is simple to use and emphasises the importance of maintaining improvements.