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Wednesday, March 31, 1999 Published at 12:57 GMT 13:57 UK


Mechanisms to maintain standards

The mechanisms will force doctors to acknowledge guidance

Standards will be monitored in the "new NHS" through three new mechanisms.

These are:

  • A Commission for Health Improvement
  • A national framework for assessing performance
  • An annual national patient survey .
The mechanisms aim to ensure high standards set by the National Institute for Clinical Excellence are met throughout the NHS. Findings will be published so patients are informed about the quality of local services and doctors can see if they are performing below par.

The Commission for Health Improvement (CHI) will be a new statutory body providing an independent assessment of local action to improve quality.

The new NHS
Its role has been compared to that of Ofsted in regulating the education system and Oftel in the telecommunications industry.

As such, it has been christened "Ofsick" in some quarters.

Headed by a new Director of Health Improvement, the commission will visit all trusts in a rolling review programme to ensure that robust clinical governance arrangements are in place locally and that NICE guidance is consistently implemented throughout the NHS.

BBC Health Correspondent Richard Hannaford: The commission's task is vast
The commission will also provide a check on the implementation of National Service Frameworks.

It will oversee a range of national external clinical audits which, for the first time, all hospital doctors will be required to participate in.

The commission will also act as a 'troubleshooter' in tackling serious difficulties.

Where there is failure to act to put local problems right or where public confidence in services has been seriously compromised, the health secretary can send the commission into a hospital to take urgent action and report to ministers on remedial action needed.

A National Framework for Assessing Performance will judge how well each part of the NHS delivers quality services.

It will focus on six key areas:

  • Health improvement
  • Fair access to services
  • Effective delivery of health care
  • Efficiency
  • Patient and carer experience
  • Health outcomes of NHS care

Its findings will be published to allow hospitals - and the public - to compare performance.

Ministers also plan to publish progressively more detailed clinical information comparing hospital performance for a range of conditions.

The National Survey of Patient and User Experience will provide annual feedback on the public's view of the service provided.

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