Quality in Health and Social Care: Stakeholders and Service Evaluation

This report provides a comprehensive overview of quality management in health and social care, focusing on the context of St. Thomas and Guy’s Hospital. It begins by examining stakeholder perspectives on quality, including policy makers, service users, and care workers, and analyzes the role of external agencies like the Care Quality Commission (CQC) and the National Institute for Clinical Excellence (NICE) in setting standards. The report assesses the impact of poor service quality on stakeholders and explores existing standards for measuring quality, different approaches to implementing quality systems, and potential barriers to delivering quality services. Furthermore, it evaluates the effectiveness of systems, policies, and procedures in achieving quality, factors influencing quality, and ways to improve service quality. Finally, the report discusses methods for evaluating health and social care service quality from both external and internal perspectives, and analyzes the impact of involving service users in the evaluation process.

Managing Quality in
Health and Social Care

Table of Contents
INTRODUCTION...........................................................................................................................3
TASK 1 .........................................................................................................................................3
1.1Explanation about the perspectives that stakeholders in health and social care have
regarding quality.........................................................................................................................3
1.2 Analysis of the role of external agencies in setting standards..............................................4
1.3 Assessing the impact of poor service quality on stakeholders..............................................5
TASK 2............................................................................................................................................5
2.1 Standards that exist in health and social care for measuring quality....................................5
2.2 Different approaches to implementing quality systems .......................................................7
2.3 Potential barriers to delivery of quality health and social care services...............................7
TASK 3 ...........................................................................................................................................8
3.1 Effectiveness of systems, policies and procedures used in a health and social care setting
in achieving quality in the service(s) offered..............................................................................8
3.2 Factors that influence the achievement of quality in the health and social care service.......9
3.3 Ways in which the health and social care service could improve its quality........................9
TASK 4..........................................................................................................................................10
4.1 Methods for evaluating health and social care service quality with regard to external and
internal perspectives..................................................................................................................10
4.2 Impact that Involving users of services in the evaluation process has on service quality. .11
CONCLUSIONS............................................................................................................................13
REFERENCES..............................................................................................................................14

INTRODUCTION
Quality management in health and social care plays an essential role as it seeks to
improve the effectiveness of treatments as well as increases the satisfaction level of patients with
the services. The organization which is being taken into consideration in this assignment is St.
Thomas and Guy’s Hospital which is one of the large NHS teaching hospital in central London.
In addition to this, it is termed to be the part of Guy's and St. Thomas NHS foundation trust
(American Speech-Language-Hearing Association, 2016). This report will discuss about the
perspective that the stake holder possess regarding quality in health and social care as well as
about the impact of poor service quality on health and social care stakeholders. Additionally
analysis of potential barriers as well as the suggestion to deliver and improve quality in health
and social care services is also specified in this file. Lastly this presented report focuses on the
different methods for evaluating health and social care service quality with regard to external and
internal perspectives.
TASK 1
1.1Explanation about the perspectives that stakeholders in health and social care have regarding
quality
Stakeholders: It is referred to as a person, group or an organization that have interest in
the firm. They can affect or can be affected by the business policies, objectives and actions. In
addition to this, they can also be defined as the person or the group of person who owns a share
in a business such as employee, customer or citizen who is involved in a society, organization,
etc. and therefore possesses some responsibilities towards it success. Therefore in hospitality
industry stakeholder refers to the person or party who provides, receives, manages or pay for
health care(Beckford, 2016). St. Thomas hospital is one of the part of Guy's and St. Thomas
NHS foundation trust and is one of the largest NHS teaching hospital where there are number of
stake holder and each one have different perspectives in rendering quality health and social care
service. The there main types of stakeholder in health and social care services are(Cherry and
Jacob, 2016). Policy maker: They are one the one who establish the framework within which
health care is rendered to the citizen's of the country. Moreover it is being considered that policy
maker has significant role in monitoring and improving of services according to the quality
standard. Therefore, in this context policy perspectives is to answer the crucial questions like

who is eligible to receive care, how are services paid for, are services being delivered well, what
health care concern do they need to plan for next and many more aspect are being considered.
Service user: Resident of client is termed to be the services user for health care organization (De
Vibe and et. al2017).In addition to this quality standard is need to be taken into consideration by
St Thomas Hospital as it is termed to be essential for organization so as to meet the service user
objectives. For example MRSA is a disease which is affecting to the great extent on the health of
the peoples. So it’s the responsibility of St.Thomas health care organization to meet the level of
satisfaction of the patients by offering quality service as per their needs. While rendering quality
services the organization should also taken into consideration cleanness and privacy of
information about the individual service users. Care workers: It is being analyzed that care
workers of St. Thomas organization plays an essential role in offering and developing quality
services. In addition to this care workers are termed to be key aspects in managing the resources
as well as t mange delivery of on time services to the patients. Therefore the main role of staff
members is to follow the needs of the clients so as to offer services as per their requirements in
orde to encoiurage the brand value of an organization and to meet the satisfaction level of the
patients. Thus, it involves equality and safety for managing and offering care services to the
patients.
1.2 Analysis of the role of external agencies in setting standards
There are various agencies and authorities who helps in analysing the different
conditions, needs and aspects of patients as per the changing environment. For St. Thomas
organization in health care sector, it is very essential to follow the quality standard benchmark so
as to meet the satisfaction level of patients as well as to maintain sustainable growth of an
organization. In UK there are many external agencies which help in evaluating the quality
standard specially while rendering services like maintaining healthy environment, offering the
information, effectiveness of products which are used for medical services. There are two
important external agencies in health and social acre so as to set standards and they are
(Dickinson and O'Flynn, 2016). Care quality commission(CQC): It is one of the external
agency which set standard in health and social care and is termed to be a non-departmental
public body. The main responsibility of this agency is to safeguard the services of the home
cares and also to set standards so that the service seeker of St. Thomas can get the basic facilities.
Moreover it also ensure the right of the vulnerable individuals and take actions if the social care

doesn't meet the re-defined standards. National Institute for Clinical Excellence(NICE): It is
another External agency who set standard for health and social care as it provide advises to the
national health service(NHS) in United Kingdom. Main role of this agency is to generate the
guidelines and to render advices from time to time to the health care service4s like St. Thomas.
Moreover it also evaluate the standard for home cares and side by side impart wide range of
information specifically to the healthcare institution. Thus, there are other external agency as
well like Business of NHS which defines standard of quality health services. Overall these
agency helps in the development of setting positive standard by rendering quality health care
services.
1.3 Assessing the impact of poor service quality on stakeholders
The key stake holders of St. Thomas are specifically responsible for managing the health
care services by setting the quality standard. It is being formulated that there has been spread of
infectious diseases like Methicillin- resistant staphylococcus aureus(MRSA) and this is mainly
because people share eating and living accommodation. Thus, it is termed to be the clear case of
poor health care services quality(Drummond and et. al., 2015). Moreover the process and
approach which the St Thomas health care organization follows have direct impact of
stakeholder involvement. Therefore major reasons behind lack of poor health care services is
just because of lack of monitoring, lack of optimum utilization of resources and many other
aspects. Furthermore, lack of skilled human resource is also the other major reason for increase
in poor health of peoples which indirectly influence the decisions of local population. Thus, the
government, service render must take the initiatives to encourage the quality and utilization of
health care services.
TASK 2
2.1 Standards that exist in health and social care for measuring quality
The standard of health care quality can be set by following several guidelines, like
through code practice which should be adopted by the staff members of St Thomas organization
so that they can provide medication accurately. In addition to this the organization need to
measure standard of working with the actual efforts rendered by medical professionals so as to
determine the gap between them. Additionally it will help in facilitating to identify the issues
that may arise while rendering health care services in order to improve the quality of

medications. In addition to this St Thomas can utilize standard like benchmark, charters, code of
practice, performance indicators, legislation so as to result better quality outcome of treatment.
Furthermore minimum care standard the organization can operate by taking into consideration
legislation, best practice and guidance. Minimum standards specifies about proper procedure and
planning in respect of medicine infection prevention etc. Lastly it can be said that an
organization can best use of technology assessment, evidence based medicine and appropriate
clinical practice guideline.
Moreover other external agencies like National Institute for Clinical
Excellence(NICE) and Care quality commission(CQC) in setting and developing quality
standard within St Thomas organization. As both plays different role which is specified with the
helps of table(Gradinger and et. al 2015):
National Institute for Clinical
Excellence(NICE)
Care quality commission(CQC)
It is an executive non departmental public body
which provide guidance and advice to St
Thomas by rendering care planning and
structure education to the staff of the industry
which helps in promoting health avoidance
and result in developing and setting quality
standard so as to render quality service to the
service seekers.
It is also an executive non departmental public
body of which major purpose is to regulate,
monitor and inspect health and social care of St
Thomas service sector. It carries out this role
by checking out during registration process so
as to set quality standard for organization so as
to render better services to the service seekers.
Thus, it is very much essential for St Thomas hospitality trust to set the quality standard
because day by day health care is getting complex thus, health care industry need to adopt
different and more integrated approaches. Therefore St Thomas adopt certain measures like
effective leadership, clear communication and innovative technology equipment's and thus this
measures are evaluated and regulated by the quality improvement authority in home care. In
addition to this foremost part of home health care is to render safeguard to service seekers by
ensuring that essential requirements of the service seekers are being fulfilled. Moreover its the
responsibility of the member of St Thomas to ensure efficiency about the services which are
being rendered taking into consideration the fact to avoid wastage and excessive use of
equipment's like machineries.

2.2 Different approaches to implementing quality systems
In order to enhance quality standard, it is very much essential for St Thomas health care
sector to execute quality system in social and health care. In addition to this health care sector
should also focus on setting up of standards and norms for the workforce so as to meet the
preferences of the care-home and to reduce the diseases which is mostly taking place in like
Diabetes(Hardyman, Daunt and Kitchener 2015). This can be ensured if the care worker will
effectively understand their roles and responsibilities by using different approaches such as
coordination's, effective communication, evaluation and monitoring and thus it will result in
effective execution of quality system in care home. Moreover government of UK has developed
NICE(National Institute for Clinical Excellence) external agencies specifically for diabetes as
well as to define purpose of high quality service care like to inform the planning of services, to
render people with information about what care they should expect to receive .
One of the best approach which can be used by St Thomas organization is total quality
management(TQM) so as to execute quality system effectively and efficiently. As this approach
will help in meeting the expectations and demands of the patients by removing the defects in the
home care as well as helps in enhancing the care home standard by increasing the customer
satisfaction level. Next best approach is by making effective procedures and policies at
workplace so as to render services in an effective manner in order to increase customer
satisfaction as well as to reduce the disease like diabetes. Thus, such approaches can be adopted
by the staff members of St Thomas organization by enhancing training and development sessions
for them regarding how to render quality services taking into consideration policies and norms of
an organization. Therefore it will help in providing service user with protection and care of their
health.
2.3 Potential barriers to delivery of quality health and social care services
There are specifically two types of barriers when the St Thomas organisation render
quality heath and social care services and they are internal barriers and external barriers. Internal
barriers may exist due to lack of improvement, improper organization structure, lack of use of
modern technology and equipments, lack of effective communication and in interaction among
the people etc. which result in generating dissatisfaction among the service seekers(Leyerle,
2016). Whereas next is external barriers which may take place due to lack of financing system,
lack of health insurance, lack of social and family support, social policy, legislation etc. Thus,

both these barriers may lead the St Thomas organization to the adverse conditions. For example;
lack of communication among the workforce of St Thomas organization will result in poor
handling of service seekers. On the other hand if the management is weak then the organization
will unable to drive innovative change. Poor financing will result in mismanagement in St
Thomas organization as well as lack of health insurance will lead in inefficiency in the progress
of all the natives. Additionally lack of quality system will result in developing poor leadership
management within the organization. Thus, it can be clearly stated that all these factors turns
into a barriers while delivering quality health and social care services. In addition to this
organization is also supporting the regulations and norms which were proposed by council of
health and social care. Apart from all this the system that St Thomas organization is following
has positive impact upon health care system as business has proposed for managing operational
activities and for maintaining the practices as per the needs of the patients. Moreover St Thomas
wants to achieve its organizational goal by implementing policies such as providing better health
care to service seekers, by rendering disease programs and by rendering incentives and other
benefits to the technical staff and professional of an organization. In addition to this it may
include monetary and non monetary reward, performance base pay as well. Thus all these
policies, system and procedure helps in effective implementation of home care and social care
services which indirectly result in quality improvement of St Thomas health service sector.
TASK 3
3.1 Effectiveness of systems, policies and procedures used in a health and social care setting in
achieving quality in the service(s) offered
In St Thomas health care organization, there are various policies, systems and procedure
which are followed so as to maintain the effectiveness and the standard. As it is being specified
by the government of UK that individuals have the right to obtain standard and quality health
care services in both the private and public health care settings. Effective policies of St Thomas
organization is to promote the quality and standard of health care services in all all over the
world as well as to maintain professional standard while rendering health care services(Nelson
and Staggers 2016). Furthermore, St Thomas is planning to get feedback from patients and
caseworkers so as to make improvement while framing new policies, procedure and system of an
organization.

In addition to this,TQM(total quality management) and continuous quality improvement helps in
facilitating increase in effectiveness of medication services. Moreover several policies under
which the organization work helps in reducing issues and control of activities like by avoiding
threats helps in increasing the effectiveness of health and care services. Lastly it can be said that
the hospitality industry on a continuous basis must render training and development session to
the staff so that they can provide better quality services to the patients. Thus, it will help in
increasing the level of satisfaction.
3.2 Factors that influence the achievement of quality in the health and social care service
The services which is being taken into context is St Thomas hospitality industry and there
are basically three key factors which have the significant influence on the achievements of
quality in health and social care services and the are (Phelan, and et. al 2015)Availability of
resources: It is one of the essential factor which have influence during the process of
achievement of quality in health and social care services. It is being identified that in current
scenario resources are limited but in order to improve quality St Thomas need more of resources
so as improve the quality of service they render to their patients. Service and size mix:This
factor has significant influence when the St Thomas company want to maintain effectiveness and
quality of services. As per the analysis it is being identified that St Thomas render services in
both rural as well as to urban sector but due to lack of skilled staff process of achieving the
quality health care is being affected. Economic factors: This factors influence the St Thomas
organization during the planning of services and craft improvements in quality. As is is being
identified that economic condition of UK is not good enough and that St Thomas has direct
impact upon the services provisions of new services so as to meet the satisfaction level of service
users. Thus planning and forecasting of services is very much essential concept which every
organization must take into consideration so as to meet quality objectives.
3.3 Ways in which the health and social care service could improve its quality
In order to improve health care services and products St Thomas must adopts different
ways which are mentioned below(Schön, 2017):
 In order to analyse and evaluate national development plan and policies for health care
services so as to meet objectives than it is very much essential for organization to collect
feedback from patients

 Secondly national government should also focus to improve quality of private sector
organization as these organization make effective use of resources. Thus, it will help in
achieving and meeting the quality objectives criteria.
 Online registration and follow up is another entail criteria which should be taken into
consideration by St Thomas as it is cost effective and time saving which also result in
improving quality of health care services In addition to this patient can easily make
decision and can draft feedback for effectiveness of services by taking into consideration
the rating and cost of services.
 Lastly, it can be recommended that St Thomas should update its technology system so as
to make working environment more efficient. Thus, because of which organization need
to expand its structure too.
 Customer services: It is very important for company to provide best service that will
attract large number of customer. They provide various coupon and discount facilities to
customer so that more visitor will come to St Thomas at a particular time period.
 Valuing first-line staff: It is the responsibility of manager of St Thomas to have skilled
and qualified staff member at their front desk that will treat will to all of their visitor.
This will make them satisfy and they prefer hotel again.
 Company must set predefined standard: It that will help to use their resources in
predefined and appropriate manner. If they manager are not able to manage their
resources than they may lack in their performance and productivity.
TASK 4
4.1 Methods for evaluating health and social care service quality with regard to external and
internal perspectives
There are different methods for evaluating health and social care service with regards to
their external and internal perspectives. This evaluation is done to identify the problems related
to patients in the health and social care services. The hospital taken in this context is St. Thomas
and Guy's hospital which is based ion central London, UK. The evaluation process of services in
this sector is done to take the feedback of customers. The services offered in this hospital can be
evaluated with different methods which are stated as below(Smith and et. al, 2015):

Questionnaire is the process of preparing questions with set of answers to conduct a
survey or statistical study. It is an external approach to conduct a survey in which the respondent
is asked to answer questions with choice of answers given with. This study is done to identify the
feedback of customers to a particular sector. The formation of questions should be ethical that it
will not harm the intentions of respondents. The respondents are mostly asked to answer in three
format i.e. Yes, No, and no idea. In case of St. Thomas and Guy's hospital a questionnaire is
prepared to answer the questions in search of the quality of facility provided by the hospital. The
format of the questionnaire should be simple that it would not allow the respondents to think
most. Thus it will help the surveyor to check the data of quality of survey. Thus, it will help the
hospital to identify the problems related to the quality of service. With the help of thus they can
provide good quality service by meeting the requirement of customers.
Complaints procedure is another aspect of surveying about the quality of services
offered by hospital. Complaint is about the expression of dissatisfaction to the services by
verbally or in written format. It is an internal procedure in which the patients are offered wit this
service to provide their valuable feedback to hospital. A feedback box is prepared by which any
patients can provide its detailed information of dissatisfaction. This box is opened at regular
interval of time by which hospital is able to know about the problems of patients services in
hospital. The problems which may include in department of health can be improper
administration, delays in services like information/ response, attitude and conduct of staff etc.
These are the problems which could be faced by patients in hospital, therefore solution to their
problems can be rectified with the help of this facility.
Focus Group is another process of gathering information about the customer's perception
of a particular sector. This is a process of gathering of delicate people in a non-threatening
environment. They are gathered to discuss the issues related with the services to hospital. In case
of St. Thomas Hospital, the problems related to patients are discussed by this group to identify it.
Therefore they will provide information regarding the issues. This will help the hospital to meet
the requirements of its customers by eradication the problems with patients.
4.2 Impact that Involving users of services in the evaluation process has on service quality
The impact of user of services to evaluate the quality of services is big because suers are
the centre of interaction to which these services are prepared. If these services are not in the
quality of standards than the issues related to quality cannot be evaluated better than customers.

The users of services with the impact are stated as below(Voorberg, Bekkers and Tummers, ,
2015).
Consultation is the process of discussion about the quality of services in hospital. The
members included in quality of services are allowed to discuss about the issues related to the
patients so that these issues can be resolved easily. The issues related to hygiene of patients and
response of staff can be included in the consultation process of services. The members in this
process consult with the patients about the quality of services offered. The impact of customers is
great in maintaining the quality because these are the end users of services offered by St. Tomas
hospital.
Panels are made to involve a group of people gathered to discuss a specific topic in front
of audience to answer their questions. These are the expertise in their fields. There is a moderator
required to guide the discussion in a particular direction. In case of hospital St. Thomas, the
members of panel are liable to answer the problems related with quality of patients. The impact
of these users has great in this panel because they know what to ask and what to be required. The
members of panel will provide effective information to satisfy the needs and wants of its
customers.
Empowerment is the system in which a person who has given power to change
something. In case of improving the quality of services to hospital St. Thomas, empowerment is
necessary from the hospital to change the system which causes problem for its customers. The
person who has given power will be liable to change the things related to problems of customer
in hospital. The problems could be any type such as issues related to management of services etc.
The person who is responsible in maintaining the challenges affects the working of hospital in a
positive manner.
There is a model named SERVQUAL which means the quality of services(World Health
Organization, 2016). This model is used to improve the quality of services to users. Improved
service of quality can give an organization a competitive edge so that it can compete itself with
its rivals. This model is totally based on qualitative analysis because its main purpose is to
maintain the quality. This model is used to expose the shortcomings in the quality of services and
fill those gaps of shortcomings, therefore it is also called Gap Analysis. This model focused on
what was expected and what has experienced by the customer. Therefore, hospital can identify
the problems and provide accurate solutions to those.

CONCLUSIONS
From the above mention report, it can be concluded that there are various views and
factors which affect hospitality industry in the both the way positively as well as negatively,
Specifically to the service provider and the patients. In addition to this external agencies plays an
important role in order to improve the quality in health and social care service specially in
residential care facilities. Moreover it also assist the organization in identification of system
policies and procedure used in health sector as well as aid management by rendering proper
suggestion to improve the quality in providing health and social care facilities to the patients.
Overall, it can also be concluded that external agencies also helps the hospitality industry in
creating appropriate structure for the user so as to render better quality service to the patients
which will result in improvement in their health and social care.

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