Royal United Hospital: Managing Quality in Health and Social Care

This report provides a comprehensive analysis of quality management within the health and social care sector, specifically focusing on the Royal United Hospital Bath NHS Trust. It begins by identifying key stakeholders, including patients, doctors, nurses, the Care Quality Commission (CQC), and management, and discusses their perspectives on service quality. The report then explores the roles of external agencies like the National Institute for Health and Care Excellence (NICE) and CQC in setting standards and ensuring quality. It examines the impact of poor service quality on stakeholders and details existing standards used to measure quality, such as those related to best practices, performance indicators, and patient rights. The report also outlines approaches to implement quality systems, including Total Quality Management (TQM) and benchmarking, while addressing potential barriers to delivering quality services, both internal and external. Furthermore, it assesses the effectiveness of implemented policies and procedures, such as safe wandering and trust policies, and explores methods for evaluating health and social care service quality, concluding with an overview of the impact on the evaluation process.

Managing quality in
health & social care

Table of Contents
INTRODUCTION...........................................................................................................................1
PART 1...........................................................................................................................................1
TASK 1............................................................................................................................................1
1.1. Stakeholders in health and social care.................................................................................1
1.2 Role of external agencies in setting standards......................................................................2
1.3 Impact of poor service quality on health and social care stakeholders.................................2
TASK 2............................................................................................................................................3
2.1 Standards that exists in health and social care to measure quality........................................3
2.2 Approaches to implement quality system.............................................................................3
2.3 Potential barriers to deliver quality services.........................................................................4
PART 2............................................................................................................................................5
TASK 3............................................................................................................................................5
3.1 Effectiveness of system, policies and procedures ................................................................5
3.2 Factors which influence to attain quality services................................................................5
3.3 Ways through which health care services can improve........................................................6
TASK 4............................................................................................................................................6
4.1 Methods for evaluating health and social care service quality.............................................6
4.2 Impact on evaluation process...............................................................................................7
CONCLUSION................................................................................................................................8
REFERENCES................................................................................................................................9

INTRODUCTION
In present scenario, health and social is one of the important agenda of government as it
is focused to tackle inequalities which occurs in HSC departments of UK. These care homes are
tend towards promoting good health as well as preventing from disease related with nutritions;
thus people can live healthy life in well being manner. As people are now more concern for
health, service providers are also concentrating on providing best and effective services for
increasing effectiveness of services (Barlow, Roehrich and Wright, 2013). To accomplish this, it
is essential for health care sectors to adhere certain principles by maintaining standards set by
government or associated bodies. In light of all these facts, the assignment is based upon Royal
United Hospital Bath NHS Trust’s which provides acute care and treatment to people. Apart
from this, the report will be describing stakeholders and roles of external agencies which are
getting involved in health care sector. There is a discussion certain policies and procedures
which manage quality standards in health care homes.
PART 1
TASK 1
1.1. Stakeholders in health and social care
Stakeholders which are getting involved in health and social care centres having their
own opinions and perspective regarding quality and service standards which must be followed by
HSC. Satisfaction level of stakeholders can be attained by quality of services. In case of Royal
United Hospital, there are several stakeholders of the organisation like – patients, doctors,
nurses, CQC and management. Quality perspective relies upon their values, morale’s, experience
as well as way of thinking. With the perspective of service users quality of services involves
treatments they get, safety, behaviour of staff members and how their dignity be respected. In
Royal United Hospital, it is overviewed that patient’s safety is decreasing; they has to wait more
for elective procedures. Due to lack of facilities, e.g. shortage of beds and number of employees
generates uncomfortableness between people (Cameron and et. al., 2014). Whereas perspectives
of workers or staff members is emphasised to maintain quality of their work staff members
should adopted necessary skills and competencies thus to deliver adequate treatment as well as
take right decisions for service users. It is viewed that if staff members will proper training and
development sessions then will be able to provide quality and value added services to their
patients by implementing new and innovative techniques. On the other hand, CQC (care quality
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commission) is another stakeholder whose appearance is also must for Royal United Hospital;
CQC focus on assessing issues which creates difference in quality of care; it has responsibility to
measure GP surgeries, facilities of hospital and further practices which are held in hospital.
1.2 Role of external agencies in setting standards
In health & social care centres, external agencies play a vital role to deliver efficient and
qualitative care services to users and also sets certain standards for these organisations. These
agencies set out benchmarks for care homes which should be followed by them. There are two
main external agencies, i.e. NICE & CQC. In which, National institute for clinical excellence
renders guidance in respect of promoting effective health and social care services which supports
to treat ill people. In Royal United Hospital, doctors assure before suggesting any prescriptions
to patients whether or not they have problem of panic attacks and requirements of regular pills
for sleeping (Twigg and et. al., 2011). NICE also focus to provide training to health care
professionals as they get strong command on excellence of care services and treat diverse
medical conditions. On the other side, Care quality commission is anon-departmental public
body of UK which works for safeguarding care services at home care as well as also implement
certain standards thus service users can get better and basic facilities. Along with this, Care
quality commission also supervise services provided in health care centres as well as it also
ensures rights of vulnerable people. In Royal United Hospital, CQC makes minimum three
inspections per year to measure service quality, cleanliness and safety. Care quality commission
has power to take strict actions if service users are treated in well being manner.
1.3 Impact of poor service quality on health and social care stakeholders
Due to poor quality of services, health and social care organisations like – Royal United
Hospital affect adversely in terms or reducing the number of customers, organisational
productivity as well as profitability. If customers' get low quality service and does not well with
treatments or care; it leads to reduces their satisfaction level which force organisation to shut
down. Ignorance of patients' rights and values can also be a reason of poor quality services.
Therefore, CQC and other health regulatory bodies can take serious actions that might be destroy
market image of health and social care centre (Cherry and Jacob, 2016). On the other hand, poor
quality of services also has a vast impact on patients as if their satisfaction level will decrease
upon Royal United Hospital; it leads negative mouth publicity and organisation may lost its
customers' trust or loyalty.
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TASK 2
2.1 Standards that exists in health and social care to measure quality
In HSC, standards means to sets a degree of services through which health care can be
assessed. It is fundamental for Royal United Hospital to keep a standard thus to ensure about safe
and effective practices. Various standards to measure quality of services are stated like - RUH
has regulated a minimum standard and apply it in working activities so as to obtain efficiency
among services. It puts pressure upon health care professionals to work with ethics which also
helps in overall improvement. A best practice is also followed by the HSC organisations which
signifies having good operating system; it helps to get consistently superior and positive results
of care services. There is implemented certain benchmarks; it helps RUH to compare its own
business by applying best practices of health and social care. Here, certain targets are being set
up each individual and determine that all of them are performed well or not. Along with this,
health and social care apply certain efficient standards for all nurses to follow code of conducts
and obtain required skills which helps in fulfilling needs and wants of service seekers (Hibbard
and Greene, 2013). To maintain quality standard of work life, other standards like – ISO
9000/14000, standards of NMC, code of practices, care quality commission and so on. If RUH
follow all these standards then efficiency of health care facilities will be automatically improved.
In addition to this, performance indicators also get implemented for booming up
performance level of employees; in this applying certain key performance indicators which
indicate productivity of staff members and help Royal United hospital to evaluate its growth and
success. To improve quality of care service, it is essential to chose right KPL. Apart from this,
quality standards are also related with right of clients as they can demand quality services or
treatments on time; it can provide an efficient base to health and social care organisation and
assuring the standards of their services.
2.2 Approaches to implement quality system
It is essential for health and social care sectors to evaluate various approaches as it is
crucial while regulating quality systems. As the system emphasis upon well being or level of
satisfaction of patients and also derive to value of their money. In order to obtain continuous
growth and success, Royal United Hospital Bath NHS Trust can apply TQM (total quality
management) approach. It leads to increase efficiency and credibility of care services; thus
patients will get better treatments. Most of care homes focuses on quality assurance as it
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concentrate on several issue, such as – documentation of service users, administrative process
and health care professionals as well (Lober and Flowers, 2011). Although, TQM is considered
as one of the effective approach because revealing and extensive analysis can be done by this. It
also supports to remove defects within home cares which results raising client satisfaction level
at fast pace. The approach works upon specific problems and strengthing those areas which cross
departmental lines.
Another approach is benchmarking which relies on compare and implement; it is needed
to compare organisations with its competitive rivals. With this, various effective market trends
also get identified and projected into business practices.
2.3 Potential barriers to deliver quality services
There are various issues or barriers which can occur due to internal and external
environment of RUH which affects in accomplishing care standards, such are defined as under:
External barrier – These obstacles involves legislations, social policy and customers. It
is determined that Royal United Hospital is facing certain legal issues, i.e. health and safety
issue, providing minimum wages issue. These controversies can influence brand image of
hospital and service quality also get affected (Valentine, Nembhard and Edmondson, 2015).
CQC has also issued a warning notice after making inspection. Apart from this, social policies
can also affect quality of services because to ensure about experience of patients, safety must be
promoted and value of money taken into account in place of health. Due to lack of social setting,
employees are unable to empower with appropriate skills and essential training.
Internal barrier – These barriers are linked with employees, organisational policies and
communication policies within health and social care associations. For example – having staff
members with diverse nature and attitude towards quality of services can generate conflicts or
disputes towards managing good quality in HSC. Less interaction between service providers also
generate other potential barriers for hospitals. On the other hand, changes in organisational
structure of RUH can also affect quality of services (Molassiotis and et. al., 2011). It is essential
for management to consider values, believes and ethics of employees while re-formulating
organisational structure.
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PART 2
TASK 3
3.1 Effectiveness of system, policies and procedures
Effectiveness of policies, system and procedures which are being used in Royal United
Hospital is substantial so as to accomplish quality standards. It also helps in coping effectiveness
of working activities and operations. According to National government of UK, the basic of all
human being is to get standard health care services to live well being. In this manner, the first
policy which can be adopted by HSC is safe wandering policy which is applied for people who
have problem of dementia and there is risk of wandering off the ward. Another is, trust policy
can be acquired by RUH which signifies that how and when to use bracelets (Powell and et. al.,
2012). This policy also focus on Deprivation of Liberty Safeguards.
On the other side, various procedures are also get implemented for several situations, for
example – in accidental cases hospital will firstly file report then informed their family
members, the patients get treated. Beside this escalation procedures will help RUH to cope
waiting time. Arriving of new referrals can affect appointment of previous patients; it is right of
service seekers to notify it and ask lead consult to complete their services.
The system is followed by RUH to minimise errors is innovation; it is a good way of
saving time, money and energy. Innovation also supports in managing quality of services and
increases efficiency of operations as well. Royal United Hospital can acquire digital technology
to get feedback from clients and stakeholders.
3.2 Factors which influence to attain quality services
Following are the key factors which has a crucial impact on obtaining service quality in
health and social care sector: - Availability of resources – If health and social care associations does not have sufficent
resources then they cannot perform in well being manner. There are numerous resources,
i.e. financial, human and technological. In present aura, natural resources are getting
limited and process of quality products demand more resources (Schoen and et. al.,
2011). Size and service mix – It has a significant influence to retain quality of care services and
potency. Royal United Hospital serve its services in rural and urban both locations, but
due to lack of well skilled and qualified staff members affects the quality of services.
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 Economic factors – Economic condition of health and social organisations plays a vital
role in formulating services and further activities for improving quality. NHS does not
has strong economic viability that can directly influence on service standards or
provisions; it lead organisation cannot meet needs and wants of service users.
3.3 Ways through which health care services can improve
For making necessary improvements in health care services, Royal United Hospital could
follow certain legislations or laws thus to improve brand image among clients. Whereas
evaluation of national development plan for health care services should be also done by
management in order to meet desired goals and objectives. As per views of CQC, issues in HSC
can create differences to attain quality of care services thus they should ensure about safety and
security, availability of resources, effectiveness of treatments on regular basis so as to obtain
quality provisions. In order to satisfy clients' needs and wants as well as recognise current market
trends, senior doctors of RUH should conduct a marketing research by using questionnaire and
survey methods. It can be done by telephone calls and social media sites. Another method of
improving quality of services is to provide training and development assistance to staff members
as they have knowledge regarding services as well as legislations associated with needs of
service users (Phelan and et. al., 2015). In this manner, continuous professional development
(CPD) must acquire by RUH; its a personal commitment which keeps up to date professional
knowledge of staff members as they can use best medical treatments.
There are several organisational issues like – lack of service providers and equipments,
affects hospital in respect of generating difficulties to admit new patients due to overcrowd. In
order to resolve such issues, comprehensive and palliative approach can be acquired by the firm;
it support to reduce the problem to under staffing and HSC can hire more staff members. On the
other hand, Royal United Hospital should also adopt digital technology in its working processes
which keeps up to date organisational system; due to this RUH may expand its premises as well
as infrastructure too.
TASK 4
4.1 Methods for evaluating health and social care service quality
In order to measure the efficiency of care service quality, there can be used numerous
methods or techniques, i.e. questionnaire, focus groups and surveys so as to get relevant
information with clients. It helps Royal United Hospital to make necessary modifications in its
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working activities. As an employee of RUH I have shortlisted several methods that supports me
to make necessary improvements in quality of services. By using questionnaire method, I am
enable to evaluate and recognise feedback upon quality of services. Focus groups and online
surveys are being held to know public response. Along with this, to deliver qualitative health
care services I consider surveys thus to know viewpoints, values and morale of patients.
Royal United Hospital has conducted a survey through which it get realised several issues
and measures which are based upon health care services. It supports me to know about the way
of treatment what a customer want, then accordingly staff will respond. Higher level of clients
will improve safety indicators of the HSC; thus to attain and retain people for long term period.
On the other hand, I also acquire questionnaire methods supports to provide an area of
improvements, motivation and measuring satisfaction level as well as deliver information
regarding desired needs of patients. This method is supportive for me in respect of diminishing
errors in services or facilities and operating system of organisation.
After assessing both these method I come to know that there are numerous benefits of
surveys and questionnaire as it involves several people who can provide wide information,
feedbacks and suggestions which can be a great opportunity for RUH to make modifications
accordingly and attain its goals. Beside this, its main disadvantage is lack of detail information,
clients' ignorance and validity of information.
4.2 Impact on evaluation process
Study of evaluation process has an impact on both service user and provider. In this
modern era, patients are considered as priority in all aspects of planning and delivering services,
hence their response or suggestions are valuable for health and social care sectors. Working in
Royal United Hospital Bath NHS Trust, I get to know measures quality of its services at care
centres; the management promotes equality and independence. It is essential for HSC to improve
performance level of hospital by assessing way of doing things thus to obtain high standard of
services. In addition to this, I also have to done time to time inspection and monitoring as it will
be beneficial for hospitals. As a member of senior management, I can understand that there is a
need of improving standards accordingly so as to gain satisfaction level of service users. It is
essential for service staff has adequate skills and knowledge level so as to cater proper care and
treatment as well as take corrective decisions for patients health. For example, when a client
comes at RUH who expects to be served or treated in pleasant manner; he also wants that
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employees care him well. Whereas requirements of old age people is to get pride and respect.
Thus, their perspective towards quality is to get freedom of doing things without putting any
restrictions. Old age prefer would like to treat with conventional methods rather than high tech
gadgets. Therefore, it is essential for care workers to have good relations with patients thus to
winning their trusts. Working in health and social care sector, I also should understand mind
state of patients along with giving physical treatment. All these aspects put a positive impact on
evaluation process of measurement of service quality.
CONCLUSION
From the above mentioned report, it get concluded that to improvise quality of service, it
is essential for health care sectors to maintain all standards and follow certain principles. The
report that stated the impact of quality services of stakeholders' opinion, there are numerous
external agencies, i.e. CQC & NICE put a huge impact on working activities of RUH. Health
and social care organisations should also follow various laws and legislations of UK government
so as to manage effectiveness of all policies and procedures of quality services. Furthermore,
evaluation of internal and external barriers is also discussed which can affect working activities
of RUH.
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REFERENCES
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