An In-depth Study: Managing Quality in Health and Social Care Systems

This comprehensive report delves into the critical aspects of quality management within the health and social care sector. It begins by identifying and analyzing the varied perspectives of stakeholders, including management, nursing staff, and patients, regarding service quality. The report assesses the impact of poor service quality on these stakeholders, highlighting the detrimental effects on patient care and the working environment. It examines the role of external agencies like the Care Quality Commission in setting and enforcing standards. The report then explains the standards used to measure quality, such as record-keeping and patient dignity, and evaluates strategies like Total Quality Management and benchmarking for implementing quality systems. Potential barriers to achieving quality are discussed, along with an evaluation of the effectiveness of current systems, policies, and procedures. Furthermore, the report suggests ways to improve service quality and explores methods for evaluating health and social care service quality from both external and internal perspectives, emphasizing the importance of involving service users in the evaluation process.

Managing Quality in
Health and Social
Care

Table of Contents
INTRODUCTION...........................................................................................................................3
TASK 1............................................................................................................................................3
1.1 Identifying reasons and presenting the extent to which different stakeholders having varied
perspectives in relation to the quality aspect...............................................................................3
1.2 Assessing the impact of poor service quality on stakeholders..............................................4
1.3 Analyzing the role of external agencies in setting standards.................................................4
TASK 2............................................................................................................................................5
2.1 Explaining the standards for measuring quality in the context of health and social care......5
2.2 Evaluating different approaches or strategies that assists in implementing quality systems
in the firm....................................................................................................................................6
2.3 Analyzing potential barriers that might prevent achieving quality in Health and Social care
.....................................................................................................................................................8
TASK 3............................................................................................................................................9
3.1 Evaluating the effectiveness of systems, policies and procedures used in health and social
care organization..........................................................................................................................9
3.2 Analyzing factors that have influence on the achievement of quality.................................10
3.3 Suggesting ways through service quality can be improved.................................................10
TASK 4..........................................................................................................................................11
4.1 Methods for evaluating health and social care service quality with regard to External and
Internal perspectives..................................................................................................................11
4.2 Discussing the impact involving users of services in the evaluation process has upon
quality........................................................................................................................................12
CONCLUSION..............................................................................................................................12
REFERENCES..............................................................................................................................13

INTRODUCTION
In the recent times, each and every sector lays high level of emphasis on providing
customers with the quality products or services. Hence, health and social care organizations
make more focus on quality management which in turn ensures that services offered by it are
consistent. Aspect of quality management mainly includes for elements such as quality
assurance, control and improvement. Thus, by working on all such aspect health care firm would
become able to enhance brand image and thereby profit margin. The present report is based on
different case situations which will provide deeper insight about the extent to which
inappropriate or poor quality affects concerned stakeholders. Besides this, report will shed light
on the measures through which quality of the offerings can be measured. It will also describe the
ways through which care unit can deal with the barriers associated with the quality service
offering. Report also depicts how users of services have potential in relation to influencing the
service quality.
TASK 1
1.1 Identifying reasons and presenting the extent to which different stakeholders having varied
perspectives in relation to the quality aspect
Stakeholders imply for the individuals or authorities who have interest in the operations
and functions of firm. Main list of stakeholders include suppliers, investors, customers,
management team etc. that closely influences from the actions, objectives and policies of
organization. In the context of St Thomas and Guy’s hospital, management team, nursing staff
and patients are recognized as the main stakeholders. Due to having varied objectives,
perspectives of stakeholders regarding quality differ significantly. Management team perceives
quality of the services as providing patients with appropriate medication facility that contributes
in their well-being (Goodwin, Gruen and Iles, 2016).
Further, nursing staff makes focus on providing patients with the services as per the
instructions given by the doctor. Thus, from the perspective of St Thomas and Guy’s hospital
nursing staff quality mean offering services to patients as per the budget. Along with this,
nursing staff has accountability to offer suitable medicine to the patients on time (Fakhimi and
Probert, 2013). Thus, nursing staff’s perspective also varies from other one. In the case of

patients quality means care, communication, doctor’s support, hygiene, waiting time and other
facilities (Entwistle, and Quick, 2016). For instance: Elderly people or patient considers services
as high quality when it involves pleasing treatment as well as freedom. On the other side, family
members of the patients relate quality with the ways in which services are provided by the care
personnel. By taking into account such aspect, it can be stated that varied stakeholders having
different perspectives in relation to the quality aspect.
1.2 Assessing the impact of poor service quality on stakeholders
From assessment, it has been identified that service quality has greater influence on the
stakeholders of St Thomas and Guy’s hospital. Patient is the one of main stakeholder of care unit
who expects high quality services from the hospital. But due to poor quality services they are not
able to get appropriate treatment and are unable to get rid of their problems. Thus this increase
the temperament of patients and they show their anger on employees which results in unhealthy
working environment (Hockenberry and Wilson, 2014). All this results in the demotivation
among patients already present there and it will effect to both surrounding and quality of care. It
is well known that when patient feel stressed and tensed it may lower down the recovery
progress and may further deteriorate the condition.
Thus will also pose serious impact on the nursing staff as they are unable to provide
effective care to the patients. Due to less availability of resources both managing team and nurses
staff face many problems and results in poor quality services. Along with this, the security of
nursing staff and other social workers is also hindered sue to poor services in heath and social
care setting. Due to risk at work place many nurses are not able to concentrate on their nursing
profession which results in poor health care services. But at the end most affected stake holders
are patients as they are key care receiver and poor quality will affect their health. However this
poor services quality can be improved by proper monitoring measuring the quality of services
provided to patients (Anhang Price and et.al., 2014).
1.3 Analyzing the role of external agencies in setting standards
Many role are played by external agencies in order to provide high quality services and
help in setting appropriate standards of care provided in healthcare centers. Number of external
agencies are available such as: National institute for clinical excellence, Health service

Commissioners, local authorities and Care Quality Commission. Each of these agency play a key
role in setting appropriate standards in health care stings.
 National Institute for Clinical Excellence: This organization play an important role in
promoting the good quality health and treat patients with advanced methods. According
to this organization professionals in St Thomas and Guy’s hospital tends to reassure the
prescriptions provided to patients dealing specially with anxiety and panic attack. Along
with this health care professionals working in St Thomas and Guy’s hospital take special
training related to National Institute of Clinical Excellence guidelines for providing
effective treatment to patients with different medical conditions (Tunçalp and et.al.,
2015). Care Quality Commission: The major task of this commission is to regulate the care
provided by NHS, local authorities, voluntary organization and private companies. The
main of this organization is to provide better quality care services to its user. In St
Thomas and Guy’s hospital minimum 2 to 3 inspections on the yearly basis for assessing
the quality of care, cleanliness and working skills of professionals and nurses. And this
organization have authority and power to take actions hospitals and healthcare settings on
behalf of patients if they found quality of care is not up to the level and is inappropriate.
Thus is solely work on improving the performance of hospitals.
TASK 2
2.1 Explaining the standards for measuring quality in the context of health and social care
Standards are generally termed as certain level of quality that is necessary to be
maintained in all particular hospital. It is necessary for hospitals and healthcare centers to have
certain standards which ensure that they follow safe and highly effective practices. By the
implication of certain standards particular individual is able to get best quality service in health
and social care and also encourage better service environment in health care (Van Eijk and Steen,
2014). Along with this quality standards also facilitate person centered approach in healthcare
setups. Thus overall it can be inferred that these standards help in increasing the quality of care
and protect the patients from incorrect treatment.

Many quality and safety standards have been introduced by Care Quality Commission
and one of them is record keeping. On the basis of record keeping standard patients have the
opportunity to get safe and correct treatment to the patients. As the name suggest in record
keeping procedure it is important for the service providers to keep the track record of the patients
treatment procedures, medical information and other information related to health condition of
patients on the regular basis. These records are maintained properly and can be assessable to
healthcare professional and patient’s family whenever required (Hockenberry and Wilson, 2014).
This standard of record keeping further help in raising the level of care provided by healthcare
professionals along with increasing the trust of patients over them. It is known that St Thomas
and Guy’s hospital follow the Care Quality Commission standard hence it is clear that it also
follow the record keeping standard.
Next important standard that is established by Care Quality Commission is respecting the
rights and dignity of individuals in order to maintain the high quality care. Thus by provision of
proper respect to the care receiver’s the satisfaction level is highly increased among patients
regarding the specific type of care. It is well known that dignity is completely related to patients
behavior and feeling thus by the provision of this standard the quality of care can be highly
improved. And it was found that this standard is also applied in St Thomas and Guy’s hospital in
order to maintain the dignity of patients along with the provision of effective care. COC also
provide the standard that is essential for safeguarding the people who tends use these services in
healthcare settings and hospitals. Thus the standards are helpful in protecting the patients from
abuse along with respecting the human rights of patients through nursing staff (Van Boekel and
et.al., 2013).
2.2 Evaluating different approaches or strategies that assists in implementing quality systems in
the firm
Setting up of standards for the provision of quality care is not that much enough to
provide patients with effective care. Along with this there is need to understand and evaluate the
different strategies and approaches that are helpful in implementing the quality system in
healthcare organization. There are various quality management system that are important and
play major role appropriate satisfaction of patients and provide them with value of their invested
money.

The most commonly used quality management system is Total Quality Management
which is applied throughout the organization. The major aim of this organization is that it is
person focused quality management system and it mainly aims in increasing the customer
satisfaction along with provision of better value for their money. This system focus on problem
that hinders the normal working of organization and provide appropriate solution to the people
working in that organization.
Another available quality management system is benchmarking system which works on
the basis of performing comparison among different organizations. Comparison of quality of
organizations along with type of care provided in both organization plays a major role in
discovering the new trends and techniques in their daily practice (Riekert, Ockene and Pbert,
2013). Along with this it also help in improving the working skills of nurses and other health
care providers working in organization. Through the appropriate comparison this system provide
information to the manager of organization for the changes to be brought in organization.
Approaches and strategies to implement the quality system:
Resources: Resources play an important role in effective functioning of any organization.
Adequate amount of staff members are needed in order to provide the efficient and effective
services to the patients at appropriate interval of time. With sufficient resources adequate amount
staff members is maintained.
Policies and procedures: In health care setting various policies and procedures are implemented
for different type of cases that come in health care setting. For example in accidental case,
hospital first file the report of individual who face accident and then family members are
informed about accident. Along with this there are many policies regarding infection control that
help in preventing the infection in health care setting. This can be done by proper handling of
waste that can lead to infection (Macinko and Harris, 2015).
Benefits of applying adequate amount of resources:
 With the effective provision of various types of policies and procedures hospitals get safe
from facing any kind of legal consequences.

 In case policies and procedures are followed in effective manner it will create positive
image of the hospital among public. Along with by proper implementation of policies like infection control will help in
preventing patients and other health care staff working there and will maintain good
standard of the hospital. Availability of adequate amount of resources help in providing efficient services to
patients at appropriate interval of time.
Consequences :
Due to lack in availability of adequate amount of resources the provision of treatment
procedures and many quality standards is hindered which lead to dissatisfaction among patients
as they are not able to get good quality of care at appropriate interval of time (Bowling, 2014).
2.3 Analyzing potential barriers that might prevent achieving quality in Health and Social care
In general sense barrier is defined as something that acts as an obstacle and hinders the
something from happening. There are many external and internal barriers that may prevent health
and social care centers form achieving quality care.
External Barriers:
There are many barrier that are generated from external factors which prevent St Thomas
and Guy’s hospital from implementing the quality standards. Following are external barrires that
are faced by St Thomas and Guy’s hospital:
Social policies: There are many cases in which due to presence of many social policies, care
providers are not able to provide patients with efficient care. Thus it hinders the hospitals from
increasing the experience of user by providing them with high quality services and proper value
for their money (Al-Borie and Sheikh Damanhouri, 2013).
Legislation: Along with the implication of social policies there are certain cases in which St
Thomas and Guy’s hospital have to face many legal issues. This in turn directly impact the
image of hospitals in public along with warning notice from CQC.
Internal Barriers:

Along with external barriers there are certain internal barriers also that impact the
delivery of quality health and social care services:
Organization structure: There is need of some changes in organization structure of St Thomas
and Guy’s hospital in order to gain some quality standards. Along with this there is need of
improving the values, beliefs and ethics among staff members with the provision of effective
training.
Interaction among people: Due to lack of communication and proper interaction among different
staff members and with patients act as the barrier is provision of effective care to the patients
(Edelman, Mandle and Kudzma, 2013). As due lack of effective communication between
patients and nurses are and other healthcare professionals, they are not able to identify the
problems of patients they are dealing with.
TASK 3
3.1 Evaluating the effectiveness of systems, policies and procedures used in health and social
care organization
St Thomas and Guy’s hospital offers many policies and procedures for the betterment of the
patients. Trust policy is one of the major policies in our organization. In our organization we
have a system of attaching bracelets to the wrist of the patient who are suffering from dementia.
This policy contains the detail of how and when the bracelets should be provided. These
bracelets are also implemented in safe wandering policy. The patient may wander around the
wards, so these bracelets might help in order to locate the patient. These bracelets are only
recommended under the approval of the head (Burgess and Radnor, 2013).
Communication is another policy. According to this policy all the information about a patient is
documented, so that next time whoever takes the charge of the patient knows all the information
and proper care will take place. Regular meetings are arranged so that if any staff is having any
issue, it could be sorted out. A common language is used so that an effective communication
system is maintained.

To prevent infection in the organization they maintain a proper infection policy that helps
to maintain an infection free environment. The most important measure is proper hand washing.
So, they have provided hand wash gel in every patient’s room, toilets. They also have proper
waste control system that collects all the clinical and other waste time to time.
They also have the comparison policy in which they compare the organization with other
competitive organization. From this type of comparison they get to know the different trends and
this helps to improve the policies (Slade and et.al., 2014). This improvement helps to meet the
expectation of the people working in the organization. They also compare their present and past
data which helps to know their performance and if there is any issue recorded, then the manager
takes care of it.
3.2 Analyzing factors that have influence on the achievement of quality
To achieve success in any work, hard work is one of the major key-factor. Along with
that support is also important to achieve success. So our organization also has many factors that
help us to fulfill the expectation of the users.
The organization has set some standards and we work according to that only. So to
maintain this standard we have to perform very well. To perform properly, to achieve all the
targets, to meet all the expectation funding is also required. Our organization receives funding
that helps us improve its facilities. We also introduce new ideas and techniques for better
treatment. As we receive funding, the expectation also increases. To meet this expectation we
have to do quality work. We always have a pressure to do excellence job and that makes our
organization to improve day by day. We also provide a proper and safe documentation service so
that the information of the patient and the workers are safe and privacy is maintained (Ben-Zeev
and et.al., 2013).
3.3 Suggesting ways through service quality can be improved
Firstly we have to find problems, after that only suggestions could be provided. In St
Thomas and Guy’s hospital, the major problem is shortage of beds. Sometimes there are so many
patients that the extra beds are also not free and the hospital becomes so overcrowded. So to
solve this issue the area of the hospital should be increase. The number of staffs should also be
increased because sometimes according to the number of patients the staffs are less and a proper

environment and safety couldn’t be maintained. One of the major issue is lack of proper
equipment and because of this reason new patient could not be admitted. Surgeries and operation
could not be performed in time. The hospital should hire some experienced staff so that the
working efficiency could be maintained.
The quality of service provided by the hospital is totally depended on the patient’s way of
thinking, their nature, experience. In accordance with that the hospital will provide the facilities.
The standard and quality of hospital is denoted by the response of the patients (Goodwin, Gruen
and Iles, 2016).
TASK 4
4.1 Methods for evaluating health and social care service quality with regard to External and
Internal perspectives
Surveys and feedback questionnaires play an important role in evaluating the health and
social care services. With the help of survey it was observed that perspectives of patients
regarding quality of services provided in health care settings depend on their way of thinking,
experience and their values they gain as experience from health care service. According to
patients quality depends on type of treatment they received, provision of care with dignity and
respect and responsiveness of nurses and other health care professionals working in that
organization. Along with this from surveys various other information is also gained related to
availability of beds and staff and any lack in effectiveness, safety and efficiency of services
provided to patients (Fakhimi and Probert, 2013).
SERVQUAL is an effective instrument in determining the quality of a service with
respect to five dimensions which represent service quality. It is a multi- dimensional research
instrument which obtains the perception of customers and their expectations regarding a service
(Anhang Price and et.al., 2014). Service quality at the St. Thomas and Guy’s Hospital can be
evaluated with the help of SERQUAL. The five dimensions of service quality according to this
instrument are reliability, assurance, tangibles, empathy and responsiveness. The quality of
service provided at St. Thomas and Guy’s Hospital can be evaluated on these five parameters.

On the other hand questioners provide with information related to level of satisfaction
gained after using service, area of improvement and need of motivation among working staff
regarding their work. Thus the advantages of using survey and questionnaires as an evaluating
technique are: it help in actual observation of involvement of working staff and quality of
services provided by them to the patients. Thus, this information is helpful for hospitals in order
to improve their quality of service.
4.2 Discussing the impact involving users of services in the evaluation process has upon quality
Patients play an important role in providing advices and responses to hospitals for
effective delivery of care services. Many measures are taken by St Thomas and Guy’s hospital in
order to place patients at center of service. Through the appropriate inspection and regulation of
hospitals CQC also helps in maintaining the quality standards of hospital (Van Eijk and Steen,
2014). CQC also believe in updating the available standards to fulfill the needs and provide
satisfaction to patients by provision of effective services to the patients. Their main aim is to
adapt new skills and take right decisions regarding patients for the provision of effective care and
treatment procedure.
CONCLUSION
From the above discussion it can be concluded that different stakeholders have different
opinions regarding maintaining the quality standard in hospital. Thus it is prime duty of the
management of hospital to respect their opinion and improve the quality of services accordingly.
Along with this it was also found that there is need to follow proper principles, guidelines and
procedures which are set by government and other authorities for the improvement of efficiency
and productivity of services provided by healthcare settings to the patients.

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