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Whenever the healthcare services are being provided to the individual than it is important to ensure that the best quality care should be provided to the patients.Continuous quality improvement is important for the healthcare sector(Braithwaite and Travaglia, 2008). Better improvements in accordance with the technological advancement and changing medical environment it is important to make improvements in the services delivered by the healthcare service providers. The concept of the quality care to the patients is being introduces by the National Health Services (NHS) which is named as clinical governance(Flynn, 2002). This can be defined as the framework which is being implemented on all the organisations of NHS and all the staff members are responsible and accountable for making continuous improvements in the quality of patient care. Along with this the staff is also required to ensure that they are using effective systems and processes for maintaining high quality of the care which is being provided to their patients. The clinical governance of NHS UK focuses on seven different pillars such as clinical effectiveness, risk management, audit, staff management, continuing education and training, information, patient experience and involvement(Scally and Donaldson, 1998). This essay will critically analyse and clinical governance of UK and how the quality of the care is being influenced due to social and political climate of the country.
Earlier in UK only the wealthy peoples are able to have high quality healthcare services but when the NHS was being developed things have greatly changed in the context of healthcare services available for the UK population to a greater extent. The NHS was being found in 1946and is offering the public healthcare sector of UK which is responsible for providing different healthcare services to the citizens of UK. The idea of NHS was firstly proposed in 1942 to the parliament but it had become its operations in 1948. Several changes are being made in the working practices of the NHS on the basis of the different policies developed by the UK government(Snowden, et. al. 2017). The Health Act of 2009 is the one which had established an NHS Constitution which formally brings together the values, principles and the purpose of the NHS in UK which had helped them in proving better services to their patients. The Health and Social Care Act of 2012 had also developed several changes in the way NHS operates and deliver the healthcare services. NHS had their own definition for quality care and according to them the quality care is referred as the care which is effective, safe and provide the best possible experience to the patients.
The healthcare service providers needs to follow a lot of legal rules and regulations and on the basis of it they need to make changes which are being imposed by the government. As the UK government's concern for the providing high quality service is increasing and on the basis of it the UK government had changed the mandate to NHS England. The mandate had mentioned the government's objective and all the different requirement which are important to be considered by the NHS while providing healthcare services(Macfarlane, 2019). The healthcare sector of UK is focusing on having highly skilled labour from all the EU nations which makes it easier for them to have better workforce which can deliver high quality care to their patients. Breixt, which is considered to be one of the great event in the history of UK had changed the way in which the businesses operate in UK and will affect the entire healthcare sector also.
Among the entire workforce of NHS the EU staff accounts for around 6% of the NHS workforce and this will have an significant impact on NHS. The firm needs to make changes in their policies related to the recruitment and have to develop better strategies for retaining the employees. Shortage of skilled workforce is expected to be experienced by NHS which will affect their business practices(Simpkin and Mossialos, 2017).The impact of the political factors will also affect the NHS in terms of their access to the medicines and medical devices. As a part of EU the NHS is following the regulations related to the medicine which are being made by European Medicines Agency but not after the transition phase NHS will have to focus on the sovereign regulatory framework(Hensmans and van Bommel, 2020). This will be quite challenging for NHS as following new regulation is not easy as the NHS will have to make changes in their medicines and devices as well. Before brexit the European Union was governing the UK citizens access to different health and care services but after brexit the UK government had to make new regulations for their citizens right to healthcare services. Supply of medicines would also be affected after brexitand NHS had to face the challenges related to this also(Appleby and Dayan, 2018).
The rising education level is increasing the individual concern for better healthcare and quality services. Patients with better education wants to know regarding the autonomy and wants to get involved in the decision making in the treatment of saviour diseases. The increasing concern of the individuals towards their healthcare and their expectations from the healthcare service providers is increasing significantly which is important social factor that is driving the healthcare sector. Along with this the factors such as aging population, increasing diseases, demographic changes, change in the disease profile are the major factors which are having an influence on the healthcare sector. In UK some of the major diseases are increasing to a greater extent and the healthcare sectors and the NHS is focusing on heart diseases, cancer, lung and liver diseases, obesity, diabetes and stroke. These diseases are affecting the UK population to a greater pace and the healthcare service providers needs to focus on these disease and develop better programs for managing and treating these diseases in an effective manner. NHS had developed several programs for controlling obesity and type 2 diabetes as these diseases are also the risk factors for other chronic diseases(McKee, 2016).
In the context of the present social and political climate it had become important for the healthcare service providers tofocus on multiple dimensions of the clinical governance which can help them in offering the best and high-quality services to the patients. The below mentioned description of this essay will explore that how the healthcare organisations can focus on application of the different principles for delivering high quality care to the patients. Three important principles which are critically evaluated in this essay are staff management, patient involvement and clinical effectiveness in the context of NHS are being mentioned.
Patient experience and Involvement
Patients are the most important stakeholder for the healthcare service providers, and it is important for them to focus on what the patients feel and experience while getting the treatment and what are the different issues and complications faced by them at the time of treatment. NHS focus on taking feedbacks from the patients that what are their experience and point of view after using the healthcare services which are being offered by them.NHS considered this as one of the important components of their own for offering the quality healthcare services to the patients. Longtin, et. al. (2010) had mentioned in their study that in the modern healthcare sector the involvement of the patients in their care and the decision making process related to their treatment had gained a lot of importance. The authors had mentioned that there are chances that the patients involved in their treatment collaborate more and this can help the services providers in proving the patient centered care to their patients in an effective manner.World Health Organisation had defined the patient empowerment as the process which can help the healthcare service providers in involving the patients in their decision making and this also help the healthcare service providers in motivating the patients to get involved in the actions that can have positive impact on the health of the patient.
NHS had included that the patient empowerment and involvement in their working practices, in decision making process and had started focusing on the supporting the patients with right knowledge and right service which can help them in empowering and involving the patients. Florix and Dixon had defined the process of patient involvement as the process by which the patients get involved with their health care professionals in the decision making process that can help them more comfortable with the treatment which is being provided to them and that they also cooperate with the professional which can lead to fast recovery.
Vahdat, et. al, (2014) had argued that better relationships between the healthcare professional and their patients can be developed through patient participation and it is important for making the treatment more effective. Also the patients involvement is having an positive impact on the service outcomes so all the healthcare service providing organisations should focus on developing better strategies and programs which can help them in involving the patients and empowering them as well. Moreover the report had mentioned the different factors which are important to be considered for patient involvement are recognition of the patients knowledge to the treatment which is being provided to them, allocating proper time for each and every patient and building better doctor-patient relationships between service providers and patients.
Positive impact of greater patient participation and empowerment in the decision making process and getting informed concern before treatment is having an impact on the treatment outcomes. If the patients is having better knowledge related to the treatment which is being provided to them than it will help them in focusing on fast recovery and also have an positive impact on the patient satisfaction and their psychological wellbeing which promotes better outcomes of the treatment which is being provided to the patients. Also NHS believe that involving the patients in their care can help the organisations in supporting the individuals in managing and maintaining a healthy life and will also ensure their wellbeing at the time of treatment.
Patients involvement is also important for the making improvement in the quality of the care which is being offered by the healthcare professionals. It is important for the healthcare service providers to get continues feedbacks from their patients which can promote constant learning for service improvement and will have an positive impact on the quality of the care. Bergerum, et. al., (2019) had mentioned in their study that the active involvement of the patients in the care which is being provided to them is having an significant positive impact on the quality improvement for the cited company. It can be said that for improving the quality of the care which is being provided to the patients it is important to involve them in decision making, empowering and involving them in the healthcare services which is being offered to them.
Staff Management
Staff management is referred as the management of the employees of the company in such a way that it should have positive impact on the productivity and performance of the company. Human resource is considered to be one of the most important resource for all the different business offering diverse products and services to their customers. When this comes to healthcare sector than this factor becomes more essential as the human resource of the healthcare service provider is the one who is responsible for the quality of the care delivered to the patient. It is important for the healthcare to manage the staff in an effective manner so that they can deliver best services to their patients. Kabene, et. al. (2014) had mentioned in their study that the different health care systems across the world had started focusing on the human resource management as it is one of the important inputs of the healthcare service providers. Both the clinical and non-clinical staff are important to be managed in the an effective manner so that all the operation can be managed effectively and better services can be offered to the customers. The study mentioned that highly skilled and well managed workforce is important for the healthcare sector for improving the quality of the services and satisfying the patients with the services which are being offered by them.
Pillai, et.al. (2019) had argued in their study that human resource management is important task for the healthcare service providers as it helps them in managing their operations in an effective manner. The study mentioned that the human resource management department of the healthcare service firm should focus on motivating the employees, satisfying them with their jobs, rewarding them on the basis of their services and appraising them for better performance is important for managing the workforce effectively. McDermott, et. al., (2013) had mentioned in their study that NHS is having an large workforce and they are implementing better strategies for managing the workforce in an effective manner so that better services can be provided to their patients. For managing the staff in the effective manner the NHS is focusing on appraisals, personal development plans, offering better training, developing better team work and creating an positive organisational culture and positive employee behaviour towards the company.
Coiera(2006) had mentioned that for delivering the high quality care to the patients it is important that the healthcare service providers should focus on developing better team and effective communication among the employees which can be achieved by proper human resource management. The study mentioned that better communication among all the different healthcare professionals and the team of clinical and non-clinical errors is important for reducing the chances of errors and sharing patients information in an effective manner and delivering the best possible service to them. It is important for the organisations to develop better communication among the employees and managing the staff in an effective manner as it is having an impact on the performance of the employee which affects the overall performance of the firm.
Cullen and Gerada, (2004) had mentioned that managing the staff is an important component of the clinical governance and all the private or government owned organisations offering healthcare services to the patients are required to manage their staff in an effective manner. The study mentions that better management is having an positive impact on the job satisfaction of the professionals which is important for the maintaining the quality of care offered to the patients. Also the study had mentioned the benefits of better staff management for the company such as developing better team work, helping the professionals on reflecting their own work, developing better cooperation and belonginess. Moreover it can be said that staff management is crucial as it help the healthcare sectors and their employees in ensuring that high quality services are being delivered by them and it also promotes proper maintenance and improvement in the quality care.
Clinical effectiveness is referred as the effectiveness of the services which are being offered by the health care service providers.According to NHS clinical effectiveness is being defined as the referred as the right person doing the right things in the correct manner at the right time in the right place and getting the right results. The healthcare service providers should focus on assuring their clinical effectiveness and this can be done by evidence based practices. As the public concern for high quality healthcare service is increasing the demand for accountability and standardisation is also increasing by the professional regulatory bodies, government and the public as well. Now the healthcare professionals and the organisations offering health care services needs to focus on the clinical guidelines for addressing the issues of the clinical effectiveness. Clinical practice guidelines are important for ensuring the quality of the services which are being offered by the healthcare professionals and also helps them in measuring that how these practices are.
Graham, et. al., (2003) had described that the clinical practice guidelines are very effective at helping the healthcare professions and guiding them to work effectively and take better decision for their patients for the specific clinical circumstances. Also the clinical practice guidelines are having greater potential to help the healthcare professionals in improving the quality of care delivered by them and patients outcomes as well. It also helps the healthcare professionals in creating a proper pathway for developing proper plan, monitoring effectively, delivering the services and documenting the care in an effective and well disciplinary manner. The clinical pathway is being referred as the multidisciplinary tool which is based on the evidence based practice for a particular group of patients with a particular clinical course. It helps the healthcare professional reducing the wastage of time and using the resources in an effective manner so that better care can be delivered to the patients. Several studies had revealed that the implementation of clinical pathway is having an positive impact on both quality of the care provided and patients outcomes as well.
Evaluating the clinical effectiveness and improvement had become important so that better care can be delivered to the patients. There are different tools which can be used by the healthcare service providers for analysing the effectiveness of the clinical care. Clinical audit is also an important tool which can help the healthcare service providers in working effectively on ensuring the effectiveness of the clinical services provided. Esposito and Canton, (2014) had mentioned in their study that clinical audit is an quality improvement process which help the healthcare service providers in improving the quality of the care and patients outcomes withn the help of systematic review of care against the explicit criteria. The clinical audit process needs to be done in an effective manner and it is important that the healthcare organisations should focus on all the different stages of the clinical audit process. The major steps of this clinical audit is choosing the audit topic, setting criteria and standards, collecting data, analysing the data and implementing the changes and checking the improvements and maintaining them. According to National Institute for clinical excellence had mentioned clinical audit as an important element of the clinical governance and had also mentioned that it can help the healthcare organisations in identifying the risk factors, using the resources in an effective manner, improving the quality of the services, reducing the wastage and making effective changes which are required for delivering high quality care.
Clinical indicator is referred as the object measures which are being taken by organisations so that the effectiveness of the quality of the care can be analysed. These indicators can be defined for identifying different things such as indicators related to the safety, clinical effectiveness and also helps in identifying the quality of the care which is being offered to the patients. Along with this different other programs such as accountability to the public and offer transparency also helps the organisations in understanding the customers views which develops better opportunities for the improvements in the services offered and clinical care as well.
Conclusion
Healthcare organisations are responsible for providing best care to their patients and ensuring that they get better treatment for all the different diseases. In this report the researcher had mentioned that how the healthcare sectors are affected due to the social and political environment of the country in which they are operating. The report had described regarding the clinical governance which is being developed by NHS and is also considered in all the different healthcare service providing organisations operating across the globe. NHS is the healthcare service providing firm which is offering the best and high-quality healthcare services to all the citizens of UK. The study mentioned that due to the Brexit the political stability and the entire political environment is highly affected, and the healthcare service providers are also facing several changes and challenges because of brexit which are explained in detail in this report.
The important principles of the clinical governance which are being taken in consideration by the healthcare service providers for improving the quality of the care offered by them and raising the standards of the services are mentioned in the report. In this report the researcher had mentioned that the staff management, clinical effectiveness and importance of patient experience and involvement are mentioned in detail. Through this report is can be said that clinical governance is important for having improvements in the quality of the care which is being offered by the healthcare service providers to the patients. Also the improvement of the quality of care is based on multiple dimensions and the healthcare service providers should focus on all of them.
References
Appleby, J. and Dayan, M., 2018.Causes of concern for the NHS after Brexit. Bmj, 363, p.k4767.
Bergerum, C., Thor, J., Josefsson, K. and Wolmesjö, M., 2019. How might patient involvement in healthcare quality improvement efforts workA realist literature review. Health Expectations, 22(5), pp.952-964.
Braithwaite, J. and Travaglia, J.F., 2008. An overview of clinical governance policies, practices and initiatives. Australian Health Review, 32(1), pp.10-22.
Coiera, E., 2006. Communication systems in healthcare. Clinical Biochemist Reviews, 27(2), p.89.
Esposito, P. and Dal Canton, A., 2014. Clinical audit, a valuable tool to improve quality of care: General methodology and applications in nephrology. World journal of nephrology, 3(4), p.249.
Florin, D. and Dixon, J., 2004. Public involvement in health care. Bmj, 328(7432), pp.159-161.
Flynn, R., 2002. Clinical governance and governmentality. Health, risk & society, 4(2), pp.155-173.
Gerada, C. and Cullen, R., 2004. Clinical governance leads: roles and responsibilities. Quality in Primary Care, 12(1), pp.13-18.
Graham, I.D. and Harrison, M.B., 2005. Evaluation and adaptation of clinical practice guidelines. Evidence-based nursing, 8(3), pp.68-72.
Hensmans, M. and van Bommel, K., 2020. Brexit, the NHS and the double-edged sword of populism: Contributor to agonistic democracy or vehicle of ressentiment?. Organization, 27(3), pp.370-384.
Kabene, S.M., Orchard, C., Howard, J.M., Soriano, M.A. and Leduc, R., 2006. The importance of human resources management in health care: a global context. Human resources for health, 4(1), p.20.
Longtin, Y., Sax, H., Leape, L.L., Sheridan, S.E., Donaldson, L. and Pittet, D., 2010, January. Patient participation: current knowledge and applicability to patient safety. In Mayo Clinic Proceedings (Vol. 85, No. 1, pp. 53-62).Elsevier.
Macfarlane, A.J.R., 2019. What is clinical governance?. Bja Education, 19(6), pp.174-175.
McDermott, A.M., Keating, M.A., Hyde, P., Sparrow, P., Boaden, R. and Harris, C., 2013. High performance HRM: NHS employee perspectives. Journal of health organization and management.
McKee, M., 2016. Brexit: the NHS is far safer inside the European Union. Bmj, 353, p.i2489.
Pearson, B., 2017. The clinical governance of multidisciplinary care. International Journal of Health Governance.
Pillai, M. and Senthilraj, O., 2019. Role of Human Resources Management in Healthcare Organizations: A Review. International Journal of Health Sciences and Research, 9(1), pp.228-235.
Scally, G. and Donaldson, L.J., 1998.Clinical governance and the drive for quality improvement in the new NHS in England. Bmj, 317(7150), pp.61-65.
Simpkin, V.L. and Mossialos, E., 2017. Brexit and the NHS: challenges, uncertainties andopportunities. Health Policy, 121(5), pp.447-480.
Snowden, M., Ellwood, F., McSherry, R., Halsall, J.P. and Hough, D., 2017. Clinical governance: a friend or foe to dental care practice in the UK?. International Journal of Perceptions in Public Health, 1(2), pp.112-120.
Vahdat, S., Hamzehgardeshi, L., Hessam, S. and Hamzehgardeshi, Z., 2014. Patient involvement in health care decision making: a review. Iranian Red Crescent Medical Journal, 16(1).
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