Assessing and Managing Quality in Health and Social Care at RUH

This report delves into the critical aspects of managing quality within health and social care, using the Royal United Hospital Bath NHS Trust as a case study. It explores the multifaceted perspectives of stakeholders, including staff, service users, and government agencies, highlighting their roles and influences on service quality. The report examines the crucial role of external agencies like the Care Quality Commission in setting and enforcing standards, as well as the impacts of poor service quality on various stakeholders. It further analyzes the existing standards for measuring quality, different approaches to implementing quality systems, and potential barriers to achieving high-quality service delivery. The report also evaluates the effectiveness of systems, policies, and procedures used to ensure quality, identifies factors influencing quality achievement, and suggests ways to improve healthcare services. Finally, it considers methods for evaluating health and social care services from both external and internal viewpoints, emphasizing the impact of involving service users in the evaluation process.

Managing Quality in Health
in Health and Social Care

Table of Contents
INTRODUCTION...........................................................................................................................1
PART 1............................................................................................................................................1
1.1 Perspectives of stakeholders regarding quality in health & social care................................1
1.2 Role of external agencies in setting standards......................................................................2
1.3 Impacts of poor service quality on stakeholders in health & social care..............................2
2.1 Standards exist in health & social care for measuring quality..............................................3
2.2 Different approaches to apply quality systems.....................................................................4
2.3 Potential barriers to delivery of quality in health & social care services .............................5
PART 2............................................................................................................................................6
3.1 Effectiveness of systems, policies and procedures used to achieve quality in services........6
3.2 Factors influencing achievement of quality in health & social care services.......................7
3.3 Ways to improve quality in healthcare..................................................................................7
4.1 Methods for evaluating health & social care service with regard to external and internal
perspectives.................................................................................................................................8
4.2 Impact of involving service user in evaluation process of quality........................................9
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10

INTRODUCTION
Managing quality in health & social care refers to focus on medical facilities or services
and apply effective strategies to improve them. It is necessary for healthcare organisations to to
apply efficient methods, techniques and practices in order to increase patient outcomes.
Moreover, effective healthcare services are important to make people disease free along with
reducing risk of complicated situations (Nelson and Staggers, 2016). The present report is based
on Royal United Hospital Bath NHS Trust which provide an acute treatment and care to around
500,000 people in Bath. They have planed surgical, medical diagnostic services for adults and
children specialised in several areas such as cancer, cardio vascular, higher levels of critical care,
orthopaedics and service to older people specifically those suffering from dementia. This
assignment will focus on perspectives of stakeholder regarding quality, role of external agencies
and impact of poor service quality on stakeholders. It will also include different approaches to
apply quality systems and factors influencing achievement of quality.
PART 1
1.1 Perspectives of stakeholders regarding quality in health & social care
The stakeholders of organisation plays an important role in decision making regarding
different aspects of organisation as they get influenced by profit and loss. It is necessary for
stakeholder of and organisation to audit and control quality of services by focus on related
aspects of quality. Moreover, the perspectives of Royal United Hospital (RUH) stakeholders in
context of service quality is given below –
Perspective of staff members – This can be described about employees of a healthcare
organisation including nursing staff, doctors, surgeons, specialist, ward boys and other
management workers (Provost and et. al., 2015). They are capable to focus on technical and
functional quality with the help of managing them at their level which facilitate to improve
medication services provided in Royal United Hospital.
Perspective of service user – The service users are also important as they provide actual
feedbacks regarding threats and problems of hospital which facilitate management of healthcare
institution to focus on them. It is necessary to take views of patients which make quality audit
easy and helps to put efforts in correct direction to improve service delivery in Royal United
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hospital. Additionally, service users are helpful to get assurance about improvement in medicinal
facilities after implementing new strategies.
Perspective of government agencies – There are several external agencies like Care
Quality Commission (CQC) which conduct inspections in healthcare organisation to analyse
problems and prepare appropriate guidelines for clinical practices. However, they have
responsibility to set standards and codes of practices for different healthcare organisations in
order to make sure that desired quality of services are provided to people (Aveyard, 2014).
1.2 Role of external agencies in setting standards
The external agencies refers to outside institutions affiliated by government organisations
consist role to conduct inspection in hospitals, monitor practices, evaluate threats and provide
guidelines to them for applying immediate changes. According to given case of Royal United
Hospital, CQC conduct an unannounced inspection in order to monitor, inspect and regulate
services to ensure that RUH has meet fundamental standards of quality and safety. It is essential
to focus on quality of medical facilities because a minor misconception may cause a severe
complications in medical condition of an individual. However, these agencies are helpful to
maintain their effective quality of medical facilities and support people to get accurate
medication properly.
At the other hand, there are several external agencies like Care Quality Commission,
National Institute for Clinical Excellence, Supporting People, Health Service Commissioners and
local authorise. These institutions put efforts on their own level to improve quality of
medications and treatments to reduce health problems in society (Dunning, Sinclair and
Colagiuri, 2014). However, they analyse problems in healthcare organisations like RUH and
provide directions to them and support to improve their clinical practices which facilitate to
decrease risk of further problems in medical condition of sick individuals accordingly. Moreover,
such external agencies are helpful to hospitals as they render an appropriate framework or
guidelines to conduct clinical practices accurately which facilitated to generate self confidence in
staff and beneficial for improving experience of sick people.
1.3 Impacts of poor service quality on stakeholders in health & social care
The poor service quality effects overall stakeholders of organisation in health & social
care. Stakeholders include employees, investors, service users and government agencies which
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get affected due to inappropriate facility of Royal United hospital. However, the impacts on
stakeholders are as under –
Employees – The staff members of hospital get effected due to increase in complications
of patients' condition which results into reduce in self confidence and perfection in practices
(Glasby, 2017). The poor service quality generate more risk of creating severe situations for sick
individuals which is required to be reduced because it will results into decrease in profit of RUH
hence declining incentives or compensation of employees.
Service users – This include service users i.e. patients who get affected in more severe
manner as they may face extreme complicated situation or lost their lives. However, a single
mistake of staff or minor carelessness can be responsible for generating severe condition of sick
individuals in Royal United Hospital.
Government agencies – The government agencies like CQC have specific criteria to
monitor number of healthcare organisations in order to analyse threats and provide guidelines top
overcome them. Apart from this, due to poor service quality in affiliated hospital get evaluated
then it impacts on goodwill of such agencies among society.
2.1 Standards exist in health & social care for measuring quality
The healthcare organisations are required to follow specific standards and guidelines to
conduct clinical practices appropriately on regular basis to gain better outcomes. It consist
several effective standards that are required to be followed by Royal United Hospital in respect
of measuring quality of medical services provided to needy people accordingly. However, these
guidelines are helpful to evaluate threats of medical procedures and other related problems in
order to overcome with them (Glasby and Dickinson, 2014).
Minimum standards – This include quality standards which is a kind of wide
framework that provide support to hospitals to improve quality of health & social care facilities.
It include codes of practices and legislations which should be followed properly by hospitals to
increase patient experience. However, these standards are based on dignity, respect, compassion,
be included, responsive care and well-being which are required to be considered by Royal United
Hospital.
Best practice – The best practices can be described as to conduct most suitable
medication and diagnosis procedure for particular patient which facilitate to gain better
outcomes. It include accurate diagnosis, rights of patient, plan of medication procedure and
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promote effective communication which should be followed by Royal United Hospital to
improve service quality.
Benchmarks – The benchmarks are basically for outcomes of medication and diagnosing
procedure which ensure about effectiveness of the same in hospitals. It is a comparison among
actual performed practices to national standards of procedures to provide effective health service
to sick people for their welfare.
2.2 Different approaches to apply quality systems
There are various kinds of approaches which can be used by different kinds of healthcare
organisation in order to implement quality system at workplace to improve service quality
respectively (Cherry and Jacob, 2016). It is necessary for Royal United Hospital to utilise
appropriate planning, policies and procedures to apply quality system for increasing patient
outcomes by boosting benefits of medications. Some of techniques which can be used by given
hospital are explained further –
Planning
Target setting – This can be described as to make goal of particular procedure to be
carried out for providing desired medication to sick person for making them healthy. The Royal
United Hospital should set a target to maintain medical records accurately and establish a
measurable objective before conducting specific treatment process of patient.
Communication – The planning involve to communicate particular information about
particular infected individual to a group of professionals deal with that case. Moreover, effective
communication is required to be carried out between team of professionals associated with
specific case to gain proper outcomes of treatment procedure in Royal United Hospital.
Information – The information should be planned to communicate to few of
professionals linked with specific case and maintain privacy of information about sick individual
in given healthcare organisation (Geelen, 2014).
Policies
Audit – The policy of conducting audit which refers to conduct an inspection to re-check
financial records, clinical practices and other activities of hospital to evaluate threats on regular
basis. It is helpful to Royal United Hospital to prefer audit regularly and take suitable actions for
applying effective strategies to improve service quality.
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Adaptation to change – This is an effective policy to adopt modifications and systems
and methods of Royal United Hospital to implement quality systems.
Procedures
Monitoring – The Royal United Hospital should monitor the different practices &
procedures conducting on regular basis to evaluate threats and implement desired quality policies
to increase patient experience.
Resources – There are different types of resources such as financial, equipment,
personnel and accommodation which are required to be available for conducting treatment
procedure accurately. However, the given healthcare organisation should focus on their resources
for improving quality of facilities (Henderson and et. al., 2014).
2.3 Potential barriers to delivery of quality in health & social care services
The potential barriers to delivery of service quality are needed to be evaluated in
healthcare organisations in order to take actions to remove them. It refers to determine threats
and problems which are responsible for providing better quality of medical facilities in order to
take appropriate actions in Royal United Hospital. However it consist internal and external
barriers which are as under –
External barriers
Inter-agency interactions – The inter-agency interactions create conflicts among them in
order to set accurate guidelines for clinical practices which is considered as a barrier in terms of
providing better quality of service to people (Brownson, 2017). The Royal United Hospital face
confusion regarding codes of practice which effects accuracy of medications and other clinical
activities.
Legislation – There are several laws which are mandatory to be followed in hospital like
Healthcare Quality Improvement Act of 1986 (HCQIA), Children’s Health Insurance Program
(CHIP) and Health Insurance Portability and Accountability Act (HIPAA) of 1996. however,
these legislations has specific criteria to be obeyed which prevent many times to implement
quality oriented attempts in Royal United Hospital.
Internal barriers
Resources – The improper availability of different kinds of resources create problems in
order to deliver better quality services to people in health and social care. In context of Royal
United Hospital, they should analyse need of resources regularly and ensure actual quantity of
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materials at work place so that appropriate medical facility can be rendered to sick person for
their well-being.
Organisational structures – The organisational structure in hospitals including policies
generate an issue for critical situation of patient who requires immediate medication and due to
rules of organisation, they did not get treatment on time (Berwick, 2016). The Royal United
Hospital should modify their organisational structure so that emergency case of sick individual
will get medication on time to become well-being.
PART 2
3.1 Effectiveness of systems, policies and procedures used to achieve quality in services
There are several kinds of policies, procedures and systems which can be utilised in
hospitals in order to attain quality in services respectively. It consists more effective as well as
efficient activities and strategies which facilitate to improve quality in medical facilities in
respect to get better outcomes. The Royal United Hospital can use some of appropriate policies
and procedures which are as under –
Total Quality Management – This can be described as an effective approach for
improving internal procedures and policies in terms of increase satisfaction of service users. In
context of Royal Hospital, they are required to apply modifications in practices and processes to
improve patient experience.
(Source: Total Quality Management, 2019)
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Illustration 1: Total Quality Management

Continuous Quality Improvement – The continuous quality improvement refers to a
process of applying new strategies or techniques for improving clinical processes and practices
in respect of increase quality of services. The given hospital should adopt continuous quality
improvement which reduce risk of complications and increase quality of services (Baxter and et.
al., 2014).
Control of processes – The different types of operational activities and procedures
carried out in hospital are required to control them in order to direct in correct direction to gain
desired outcomes. The Royal United Hospital can adopt approach of control of processes as it is
helpful to increase quality of medical services.
3.2 Factors influencing achievement of quality in health & social care services
The factors influencing achievement of quality in health & social care services are
necessary to be evaluated to increase outcomes from operational processes. It is important to
analyse such elements to implement them to boost up quality of health and social care services.
In context of Royal United Hospital, few of factors impacts on quality achievement which are
given below –
Management of patient records – This is very important to manage patient medical
records in order to boost up accuracy of medication to provide better quality of services for sick
people. The given hospital should apply strict rules at work place to maintain patient records
which facilitate to improve quality of medical facilities (Nakanishi and Nakashima, 2014).
Availability of sufficient resources – The availability of required resources must be
accurate in healthcare organisations so that proper treatment can be provided to patient
accurately. In case of Royal United Hospital, they must ensure availability of resources for
clinical practices in order to provide better quality of facilities.
Legislations – This involves legal rules and regulations like Health & Medicines Act,
Health & social care Act 2012 and Care standards Act 2000 which should be followed by
selected hospital. It will facilitate to conduct practices in correct manner which improve quality
of services appropriately.
3.3 Ways to improve quality in healthcare
The improvement of quality in medical services and facilities is important through apply
more effective as well as efficient methods. It is necessary to evaluate the areas required
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improvements and adopt appropriate ways to increase quality in healthcare. Some of methods
which can be used by Royal United Hospital are given below –
Functional quality – The different types of functional departments such as emergency
unit, cardiology, neurology, intensive care unit, oncology etc. which are required to be improve
their functions to increase quality of services. Moreover, the given hospital can focus on different
functional department and put efforts top improve their activities in order to gain improvement in
quality (Leung, Yu and Memari, 2016).
Putting people first – The requirements and views of service user are required to be
focused and put their priorities first in respect of improving their satisfaction regarding medical
services. Royal United Hospital can use this method and give priority to patient actual desires
which facilitate to improve quality of facilities respectively.
Internally generated standards – This include the criteria of preparing care standards
on organisational level to improve quality of services which should be followed by selected
hospital to increase patient experience.
4.1 Methods for evaluating health & social care service with regard to external and internal
perspectives
The evaluation of health care services is essential to understand present problems or
threats of them so that proper cations can taken to solve them accordingly. It is necessary to
apply different methods in terms of evaluating medical services in Royal United Hospital in
which few of them are as follows –
Questionnaire – This refers to a series if question related to specific topic to collect
information which can be used to evaluate threats of services by providing questionnaire to
services users. It is helpful for given hospital to analyse problem of patients and issues in
medical practices which facilitate to take actions for solving them.
Interview – The Royal United Hospital can conduct interviews of services users and staff
to evaluate actual problem of medical services or facilities which helps to make appropriate
strategies to reduce them for improving quality.
Surveys – The surveys can be used for selected hospital to conduct investigation for
analysing healthcare services to take desired actions for improvement along with increasing
experience of sick people (Erdley, Anklam and Reardon, 2014).
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4.2 Impact of involving service user in evaluation process of quality
The involvement of service users in process of evaluating quality impacts positively
because actual threats of medical facilities can be analysed properly. It will provide support to
management of hospital for preparing accurate strategies for solving problem and improve
quality of services respectively. The Royal United Hospital can involve patients while
conducting procedure of quality analysis in order to understand actual threats to remove the
easily. The effects of involving services users include that it can be empowering for them and
helpful to learn fresh skills & built confidence. However, it is supportive to make decision
making more open & democratic along with improving reputation as well as credibility of
services in given hospital. Moreover, it challenges stigma and myths with the help of boosting up
perceptions of services users. In addition to this, it enables diversity in experience and opinion
which impacts on decision making in hospital. Meanwhile, it is helpful in terms of conveying a
message of organisation's commitment to services users.
CONCLUSION
From the above report, it is conclude that Managing quality in health & social care can be
described as to focus on medical facilities in order to improve them. It consist perspectives of
staff members, service users and government agencies regarding quality along with role of
external agencies for the same. Moreover, it include methods to apply quality systems like target
setting, communication, audit, adaptation to change, monitoring and resources. Meanwhile,
involves policies and procedure including total quality management, continuous quality
improvement and control the processes to attain quality of services. Additionally, it include ways
to improve quality like functional quality, putting people first and internally generated standards.
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Total Quality Management. 2019. [Online]. Available through: <http://www.lisbdnet.com/total-
quality-management-tqm/>
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