Managing Quality in Health and Social Care

This document discusses the perspectives of stakeholders regarding quality in health and social care, the role of external agencies, the impact of poor service quality on stakeholders, standards within health and social care, approaches in formulating quality systems, and barriers in delivering quality services. It also explores the effectiveness of the system, policies, and procedures within health and social care, factors influencing quality, and ways to improve quality.

UNIT 27 - MANAGING
QUALITY IN HEALTH IN
HEALTH AND SOCIAL
CARE

TABLE OF CONTENTS
MAIN BODY...................................................................................................................................3
LO1..................................................................................................................................................3
1.1 Perspectives of stakeholders regarding quality in health and social care.........................3
1.2 Role of the external agencies............................................................................................3
1.3 Impact of the poor service quality on the stakeholders....................................................4
LO2..................................................................................................................................................5
2.1 Standards within health and social care............................................................................5
2.2 Approaches in formulating quality system.......................................................................6
2.3 Barriers in delivering quality services in health and social care......................................8
LO3..................................................................................................................................................8
3.1 effectiveness of the system, policies as well as procedures within health and social care8
3.2 Factors influencing quality within health and social care................................................9
3.3 Ways for improving quality............................................................................................10
LO4................................................................................................................................................11
4.1 Methods for evaluating quality.......................................................................................11
4.2 Impact of service user involvement................................................................................12
REFERENCES..............................................................................................................................14

MAIN BODY
LO1
1.1 Perspectives of stakeholders regarding quality in health and social care
The stakeholders are basically the group of people who have the direct interest within an
organization and thus are affected by the operations of business. There are many stakeholders of
hospitals such as statutory bodies, action groups, private companies, service users etc. All they
have different perspective regarding quality services in care homes (Gardner, Linderman and
McFadden, 2018). The Royal United hospital is known for its quality; views of stakeholders are
explained as below:
 Patients: Service users always expect to get best quality treatment in hospitals. Definition
of quality for them is related to their satisfaction. They want that doctors communicate all
information with them and their family members. They also expect honest behaviour by
medical professionals and they show empathy towards care users. Professionals have to
conduct survey to know the level of satisfaction of users and accordingly staff of the
Royal United hospitals has to make changes in their services so that doctors can serve
patients well (Patient perspectives on quality, 2014).
 Strategic health authorities: This is another stakeholder of Royal United hospital, this
body has perspective that every care home serve patient well and contribute well in
minimising the death rate in nation. Hence they always make new strategies that may
improve health condition of users and can control over spreading diseases. They have
perspective that hospitals implement their strategies and give updates to them time to
time so that actual root cause of health issues can be identified and proper measures can
be undertaken to control over it. They emphases more on quality assurance (Davies and
et.al.,2018).
 Care givers: medical professionals are the most essential stakeholder in Royal United
hospital. They have perspective to provide quality care to patients hence they have
responsibility to control over quality.
1.2 Role of the external agencies
Within the health and social care, there are various external agencies which plays an
important role in setting the standards. External agencies mainly supports as well as monitors the
various health care facilities. Besides this, they also act as the quality oversight authorities as

well as the protector of the interest of stakeholder. The external agencies mainly increases the
oversight mechanism providing the regulatory control and monitoring to Federal, local and the
state authorities. They mainly pursue the consumer advocacy plan of action by offering the
incentives and thus are guarantors of the accreditation on the quality (Neuhuettler, Ganz and Liu,
2017). The major external agencies for Royal United hospital are
Healthcare inspectorate
The healthcare commissioner mainly monitors as well as inspects the various activities
in Royal United hospital. Upon conducting its various tasks, this government body then
publishes it's all findings gauge ratings for helping facilities to make reliable choices about the
services (Stanhope, 2017).
Care quality commission
This is basically the independent organization which regulates health as well as social
care within United Kingdom. They are mainly responsible for setting the standards within health
and social care. CQC mainly ensures that all the care facilities is being offered by Royal United
hospital to the patients with safe, compassionate, top quality services. Through these oversights,
CQC encourages the improvement as well as enhancement of quality. This government body
situated in England mainly is responsible for inspecting, regulating as well as monitoring the
health as well as social care services for making sure that hospitals like Royal United hospital
and other healthcare facilities are complying to standards continuously (Nelson and Staggers,
2016).
National institute for clinical excellence
NICE mainly provides the effective and comprehensive advice to Royla United hospital
and other NHS trusts and has been providing since the year 1999. The role of NICE is mainly to
enhance the outcomes for large number of people who are using NHS as well as different care
services. NICE mainly produces guidance along with advice on grounds if the evidence for
people who practice health and public health (Purnell and et.al.,2016).
1.3 Impact of the poor service quality on the stakeholders
One of the most important and significant reason for establishing the good quality within
health and social, care is that without having the proper facilities, mainly the health of various
stakeholders suffers. When standards as well as quality of the Royal United hospita are not
appropriately set then various serious consequences might occur. The poor service quality have a

direct consequence on the stakeholders of hospital (Curtis and et.al.,2017). Various aspects are
that these might disrupt the funding, damage organizational reputation and dampen spirit of the
caregivers. These all leads to the bad planning decisions as well as loss of the quality. Talking at
the social level, when there are poor quality of the services in Royal United hospital then it
eventually leads to the implication of the public health. Due to the poor quality services, service
users as well as the whole community mainly faces various health as well as safety issues. For
example- within hospital, people generally have contact with various substances as well as
chemicals which are hazardous to their health. The cleaning products like bleach causes harm to
them extremely.
The impact of the poor quality not only affects the entire community but also affects
people at the personal level. One of the most dangerous as well as harmful impact of the poor
service quality in Royal United hospital is that the needs of people and patients are not met. Due
to the poor quality of services, the various care needs of patients are not met. Besides this, when
the health worker in hospital does not disseminate quality services as well as treatment then it
often leads to high number of fatalities and injuries. For example- the person suffering from
extreme depression if not provided with proper services like friendly environment then it will
lead to low self-esteem in then and will severely impact their health (Gupta and Rokade, 2016).
Along with this, the impact of poor health have also surrounded the service users
professionally. The various shareholders as well as the investors of Royal Health hospital as well
as other care centers suffers to a high extent due to poor quality services. One of the major
impact is closure of the different care settings. When health care workers fail to comply to the
disciplinary actions as well as various practices of quality then they incur a high amount of fines.
These fines are mainly suffered by the shareholders as well as external agencies along with
settings who works in collaboration with them (White and Stubblefield-Tave, 2017).
LO2
2.1 Standards within health and social care
The are mainly various standards which has been set for measuring the level of quality in
health as well as social care. The main aim of these standards is to incorporate right type of
quality within health and the social care and to measure it through various means.

Equality act 2010
This is one of the most important standard which are being used in the health and social
care for measuring the quality as well as implementing the well defines strategy. This act mainly
focuses on providing the appropriate care to all the patients and thus this act mainly protects the
people who receive care as well as the workers who are being treated unfairly at health and
social care. Thus, as per this act Royal United Hospital need to comply this standards and should
provide equal treatment to the person receiving care in their settings irrespective of caste,
religion, sex (Ko and et.al.,2018).
NHS perfromance framework
This is the another standard which is mainly used in the health and social care for
measuring the level of quality. This standard mainly informs the NHS orgnazations about criteria
and standards against which their overall perfromamce will be analysed. Besides this, this
framweork is mainly set for informing the strateguic authorities of health like primary care trusts
about when they are required to intervene for adressing poor performance. Being a NHS
organization, this standard applies to Royal United hospital where they need to adheer to this
standard for ensuring high quality in their hospital (Hodgkinson and et.al.,2017).
National poccupational standarads
The national occupational standards (NOS) mainly describes the best practices as well as
procedures by compiling skills, values and knowledge together. The health as well as social care
(HSC) NOS are mainly the most significant standards for the workers in social care and in health
care in each and every part of UK. NOS mainly focuses on the premise that what workers in
social care need to know while treating people and what key activities they need to undertake in
their occupation for providing effcetive cure. According to this standard, Royal United hospital
for increasing their quality should increase the productivity of worker as well as fill the skill gap
(Hickey and et.al.,2018).
2.2 Approaches in formulating quality system
In order to have an effective quality system, there are various approaches which eventually
helps to deliver effective services to people receiving care in health and social care.

Personal
Skill audit
This is one of the most powerful tool as well as approach for in the implementation of
effective quality system. The skill audit is baiscally the framework which helps orgnazations to
identify any skill gap and thus address it by using effective measures. This is the most
comprehensive approach which Royal United hospital can use for ensuring the great quality
system to patients and their families. Skill audit will allow the hospital to have an understading
of what are the skills that there workers lack (Brownson, Colditz and Proctor, 2017). For
example- through the skill audit, it has been found that the care workers does not effetively
monitior the people receiving care in this hospital and thus does not properly communicate with
them. Hence, this skill ausdeit will help to take effective measure for improving the effcetive
communication between people and care workers.
Social
Mentoring
This is the another approach as well as framework which helps to formulate an efficent
quality system in health as well as social care. The health care leaders in Royal United hospitals
can provide effective mentoring to their staff members in order to deliver the right kind of
services to the people. Through the proper mentoring, the care worker will be able to better
understand the condition of people and will provide the right kind of treatment along with
providing friendly environment. This will eventaully increase the quality of hospital
(Macfarlane, AbouZahr and Tangcharoensathien, 2019).
Professional
Internal as well as external training
The interal training mainly consist of providing coaching and guidance to the care
workers. Within this training, Royal United Hospital can provide the guidance as well as
coaching to their healthcare workers by pratically showing the various practices as well as
procedures. For example- to explain the proper technique of heart incision, hospital can provide
training to their worker by showing in the real world environment. Besides this, in the external
training, hospital can provide various certification courses as well as off-the job training to the
wokers by educating them about various health standards, their importance and by providing
professional certificate (Peate, 2019).

2.3 Barriers in delivering quality services in health and social care
There are many reason due to which care providers fail to offer quality care to users. Poor communication: This is considered as major barrier, if medical professionals do not
interact with each other in proper manner then it may increase chances of confusion. In
such condition patients fail to get quality care in Royal United hospital. Sometimes staff
members fail to interact with patients well, this poor coordination create problematic
situation because they fail to understand rout cause of their problem hence they fail to
provide them treatment accordingly (Hall and Hall, 2016). Staff motivation: Over workload is the major cause of poor motivation in hospitals. As
Royal United hospital has lack of staff members, in such condition doctors, nurses have
to do more than 8 hours’ duty. They fail to spend time with their family members and
when they do not get appreciation for their hard work then they become negative and feel
demotivated. In such condition they fail to perform their services well which ultimately
impacts on quality care services in the hospitals. If staff members are motivated, then
they will coordinate with patients well and will serve them well (Devine and et.al.,2016).
 Resource limitation: This is another major barrier in delivering quality services to
patients. If hospital does not have adequate resources such as skilled men power, advance
technologies then it will not be able to analyses issue within person which will create
problem in offering them satisfactory health care services. If Royal United hospital has
limited funds, then it will not be able to use costly equipment’s which will be barrier in
serving them best (Gardner, Linderman and McFadden, 2018).
LO3
3.1 effectiveness of the system, policies as well as procedures within health and social care
There are mainly various systems, policies as well as procedures which are being used
within health as well as social care for having an effective quality system and for providing
world-class services to people.
Clinical governance
Clinical governance is basically the system which are being used in health as well as
social care and makes them accountanble for constantly enhancing their service quality as well as
clinical services. The main aim of this governance is to ensure that hospitals and care centers are
relying in offering high class services and care to patients through maintaining facilitative

enviroenmmnt. This standard will mianly help Royal United hospital to provide a friendly
eneviroenment and comprehensive cure to patients which will help in their speedy recovery
(Davies and et.al.,2018).
TQM
Total quality management is the another standard as well as procedure which Royal
United hospital mainly uses for improving the quality of their services as well as cure. Having a
robust quality system within hopsitals and care centes is highly essential as it directly affects the
health of the patients thus in view of this, incorporating TQM is highly crcuial for implementing
the right kind of quality. Total quality management helps the hospitals to provide effcetive
treatment as well as reduces the chances of clinical variations (Neuhuettler, Ganz and Liu, 2017).
ISO9000
ISO9000 which is basically the core system as well as policy which mainly addresses
high quality care and services in the health care. ISO9000 forms the integral part of hospitals and
other healthcare institution which eventually helps them to improve their overall perfromance by
relying on providing the best services as well as striving for constinous improvement. As Royal
United hospital is ISO900 certified thus this standard helps them to provide wide rnage of
clinical servies like fertility services, radiology, dental services, mental health as well as
psychological services etc by range of clinical experts and professionals (Stanhope, 2017).
3.2 Factors influencing quality within health and social care
There are generally various factors which influences the implementation as well as
achievement of good quality in Royal United hospital. These factors mainly includes
Resouce available
The acheivement of the good quality in Royal United hospital is mainly tied to the
availability of the resources. The major resource of this hospital which contributes towards
having a great quality and thus influences the overall perfromance of hospital are workers, health
care porfessionals, patients etc. These resources mainly influences the quality in hospital.
Talking of the workers and health care professionals, RUH mainly has a treasure of talented and
trained professionals which are highly knowlegeble and skilled in terms of the various medical
practices, standards, procedures etc. This base of trained staff helps hospital to provide proper
and effective treatment to the patients and thus ensures the presence of world class quality in
hospitals.The availability of proper resources helps RUH to work towards the agreed level of the

performance and hence provide quality services not only to the patients but also to the overall
stakeholders (Nelson and Staggers, 2016).
Expectaions of the service users
This is the another factor which eventually influences the attainment of proper quality in
RUH. The expectations of the service users as well as practitioners forms the integral part of this
hospital and mainly impacts its quality standards. The various quality standards helps the
hospital to recognize the expecations of the user and thus assist them to work towards their
interest. In the quest for the quality improvement, Royal United hospital mainly assess the needs
as well as expectations of users and thus strive to fulfill them. For example- people generally
have the perception that if the internal enviroenment of hospital like cleanliness, hygiene, value
for patients is well-developed then hospital will definitely provide the best services to them in
terms of treatment, medications, cure etc. Thus, this factor helps RUH to go beyond their needs
and mainatin a holistic enviroenment that is quality approved in the eyes of service users (Purnell
and et.al.,2016).
3.3 Ways for improving quality
The major probelm which has eventually reduces the level of quality in RUH is the lack
of proper records of their patients. All the records like hydratin records, monitoring of the fluid
balance is generally done informally and thus they do not have the proper record of people
receiving services. Besides this, hospital do not have a well-through quality checking system due
to which it becomes diffcult for them to assess the various risks and thus assure the safety of
patients and their family. In order to improve the level of quality, there are various ways which
RUH can adopt and thus can ensure proper quality services to patients and their families (Curtis
and et.al.,2017).
Standard
Having the knowledge of all the standards as well as practices while treating the patient
or while maintaning the proper enviroenment in hospital is highly crucial. If the professionalls as
well as care workers are unawre of the different standards and legislation, then this would not
only impact the health of patients but will also reduce their level of quality. Thuss, in order to
improve its quality RUH should make its workers and professionals well aware of different
health standards by providing an effective training to team. Besides this, the practitioner should

be provided thorough education as well as practical demonstration on various aspects of the
health (Gupta and Rokade, 2016).
Cost effectiveness
Quality and cost have a direct relation. People generally have the perception that hospitals
which charges low prices does not provide effective services and hospital having moderate range
or high price generally provides quality services. Thus, in this view, by providing quality
services in a reasonable range will eventually increase their customer base and thus will help
them to treat patient properly. Besides this, charging right price is not the only thing but using
the resource in cost effective manner will also help hospital to maintain the appropriate quality of
services. For example- Besides measuring the quality of each and every department separately
like cardiology department, radiology etc, hospital can install a sigle quality system which will
reduce their work as well as will be cost effective (White and Stubblefield-Tave, 2017).
LO4
4.1 Methods for evaluating quality
Inspection report
The inspection report is one of the most effetive method which RUH can use within its
internal setting for evaluating the level of quality as well as their standards. Inspection report is
basically the document which helps the organization to ensure that each and every department
are complying to the quality standards and hence are performing as required. RUH can make use
of inspection report which will help them to examine the performance of each and every aspect
of their department that whether the professionals are providing proper treatment or not, whether
the management is monitoring the needs of patients effectively or not (Ko and et.al.,2018).
Service user feedback
This is the another method which RUH can use within their hospital to know whether
their hospital is meeting the required quality standard or not. By soliciting the feedback from all
the people who are using their services or have used their services, RUH will come to know the
various attributes of quality like cleanliness, service, hygiene, proper monitoring etc. Service
user feedback is one of the most reliable method which will help RUH to have genuine response
as these are the people who have actually experienced the services of hospitals and thus will give
their genuine feedback. The service user feedback is one of the highly reliable as well as
remarkable method which RUH can use for improving the quality of their services. The service

user feedback provides the actual response to the hospital and thus helps to make improvement
in the level of their quality (Hodgkinson and et.al.,2017).
Focus group
Focus group is predominately the group of large number of people who are assembled for
discussion and thus for providing their feedback. RUH can use this method in its external setting
for recognizing their level of quality which they are providing to the people. Through their
websites, online application RUH can solicit the feedback from people who have used their
services or people whose relatives or any friend have gone through their services to know their
current quality status. This focus group will help them to know the expectations of people
regarding quality, services, health care professionals etc and will help to make the required
improvements. Talking of the external setting, this is one of the major method which will help to
improve the quality of the services (Hickey and et.al.,2018).
4.2 Impact of service user involvement
Within the entire process of the evaluation, service users are majorly impacted and thus
their involvement mainly influencs the decision-making process of RUH.
Empowerement
With the involvement of service users in the evaluation process of quality improvement,
the decision which is being made by the authority is mainly empowered. This leads to the
effective decison making. Due to the involvement of service users, the service providers come to
know about the expectations as well as perception of the users and hence this eventually helps in
the empowerment of the overall decison. Baiscally involving the users of services within the
evaluation process, the quality is highly empiowered. Thus, this is the main impact which the
involvement of service users poses on the overall quality. User involvement mainly can help
RUH to improve their overall quality and thus improve the health behaviour of patients. Like for
example the patients having long-term illness generlly have the insight about the care which
health care providers in RUH lacks thus through their involvement, it will become easy for the
hospital to provide better treatment. This will evetually lead to the empowerment as well as
strengthening if the clinical and other services (Brownson, Colditz and Proctor, 2017).
Cost effectivenss
The involvement of the service users are mainly considered as the most cost effective
process. Due to their involvement as well as feedback, RUH does not incur the additional cost of

various tools of the marketing as well as advertising like communication cost with external
stakeholder and thus their engagement make the whole evaluation process less expensive. As the
service users are mostly the people who have already used their services or are using thus
solicing the feedback from them saves hospital from utilizng additional resouirces for quality
improvement. It has been found that instead of making use of various tools like advertisements,
TV commercials for improving the quality of services, involving the actual users on wide
platform is highly effective process in terms of both cost and applicability. Becuase service users
are highly aware of the services in which RUH is lacking behind thus their feedback will
eventually help to know that what strategies they need to adopt for enhacning their services. For
example- Upon the feedback from users, the management of RUH finds that the families of the
patients are highly dissatisfied with the food served in canteen and is unhygienic and due to this
they bring their own food from house. This will help the hospital to take steps regarding the food
standards and cleanliness. Therefore, in this way users involvement help hospital to improve
their level of quality (Macfarlane, AbouZahr and Tangcharoensathien, 2019).
Client-centered care
The major impact which the involvement of service users in evaluation poses on RUH is
that it helps hospital to provide client-centered services. When the users are being involved in the
evaluation process, then the feedback which is being generated from them helps the hospital to
make an improvement in the areas where it is needed. For example- the patients complaint that
the improper hygiene as well as cleanliness in the hospital often brings bad vibes in their mind
and thus badly affects theirn health. Thus, in this case, RUH will come to know that major
improvement in terms of quality which is needed in their hospital in cleanliness department.
Hence, involvement of users in evaluation is highly imperative as it becomes the major factor
based on which health and social care are able to improve their quality (Peate, 2019).

REFERENCES
Books & Journals
Brownson, R.C., Colditz, G.A. and Proctor, E.K. eds., 2017. Dissemination and implementation
research in health: translating science to practice. Oxford University Press.
Curtis, S and et.al.,2017. Impact of extreme weather events and climate change for health and
social care systems. Environmental Health.16(1). p.128.
Davies, H.T and et.al.,2018. Managing Quality: Strategic issues in health care management.
Routledge.
Devine, T and et.al.,2016. Making quality health websites a national public health priority:
toward quality standards. Journal of medical Internet research.18(8).p.e211.
Gardner, J.W., Linderman, K.W. and McFadden, K.L., 2018. Managing quality crossroads in
healthcare: An integrative supply chain perspective. Quality Management Journal.25(1).
pp.2-17.
Gupta, K.S. and Rokade, V., 2016. Importance of quality in health care sector: A review.
Journal of Health Management.18(1). pp.84-94.
Hall, M.F. and Hall, S.E., 2016. Managing the psychological impact of medical trauma: A guide
for mental health and health care professionals. Springer Publishing Company.
Hickey, K.T and et.al.,2018. Low health literacy: Implications for managing cardiac patients in
practice. The Nurse practitioner.43(8). p.49.
Hodgkinson, S and et.al.,2017. Improving mental health access for low-income children and
families in the primary care setting. Pediatrics.139(1). p.e20151175.
Ko, M and et.al.,2018. Managing Diversity To Eliminate Disparities: A Framework For Health.
Health Affairs.37(9). pp.1383-1393.
Macfarlane, S.B., AbouZahr, C. and Tangcharoensathien, V., 2019. National Systems for
Generating and Managing Data for Health. In The Palgrave Handbook of Global Health
Data Methods for Policy and Practice (pp. 3-23). Palgrave Macmillan, London.
Nelson, R. and Staggers, N., 2016. Health Informatics-E-Book: An Interprofessional Approach.
Elsevier Health Sciences.
Neuhuettler, J., Ganz, W. and Liu, J., 2017. An integrated approach for measuring and managing
quality of smart senior care services. In Advances in The Human Side of Service
Engineering (pp. 309-318). Springer, Cham.
Peate, I., 2019. Leading and Managing Care Provision. Learning to Care E-Book: The Nurse
Associate. p.118.
Purnell, T.S and et.al.,2016. Achieving health equity: closing the gaps in health care disparities,
interventions, and research. Health Affairs.35(8). pp.1410-1415.
Stanhope, M., 2017. Managing quality and safety. Foundations for Population Health in
Community/Public Health Nursing-E-Book.p.276.
White, A.A. and Stubblefield-Tave, B., 2017. Some advice for physicians and other clinicians
treating minorities, women, and other patients at risk of receiving health care disparities.
Journal of racial and ethnic health disparities.4(3). pp.472-479.
Online
Patient perspectives on quality. 2014. [Online]. Available through <
http://primarycare.imedpub.com/patient-perspectives-on-quality.pdf >