scholarly journals Are inspectors’ assessments reliable? Ratings of NHS acute hospital trust services in England

2016 ◽  
Vol 22 (1) ◽  
pp. 28-36 ◽  
Author(s):  
Alan Boyd ◽  
Rachael Addicott ◽  
Ruth Robertson ◽  
Shilpa Ross ◽  
Kieran Walshe
Keyword(s):  
Service Provision ◽  
Online Survey ◽  
Health Care Organizations ◽  
Care Quality ◽  
Service Information ◽  
Acute Hospitals ◽  
Care Quality Commission ◽  
Regulatory Model ◽  
The Impact ◽  
Published Research

The credibility of a regulator could be threatened if stakeholders perceive that assessments of performance made by its inspectors are unreliable. Yet there is little published research on the reliability of inspectors’ assessments of health care organizations’ services. Objectives We investigated the inter-rater reliability of assessments made by inspectors inspecting acute hospitals in England during the piloting of a new regulatory model implemented by the Care Quality Commission (CQC) during 2013 and 2014. Multi-professional teams of inspectors rated service provision on a four-point scale for each of five domains: safety; effectiveness; caring; responsiveness; and leadership. Methods In an online survey, we asked individual inspectors to assign a domain and a rating to each of 10 vignettes of service information extracted from CQC inspection reports. We used these data to simulate the ratings that might be produced by teams of inspectors. We also observed inspection teams in action, and interviewed inspectors and staff from hospitals that had been inspected. Results Levels of agreement varied substantially from vignette to vignette. Characteristics such as professional background explained only a very small part of the variation. Overall, agreement was higher on ratings than on domains, and for groups of inspectors compared with individual inspectors. A number of potential causes of disagreement were identified, such as differences regarding the weight that should be given to contextual factors and general uncertainty about interpreting the rating and domain categories. Conclusion Groups of inspectors produced more reliable assessments than individual inspectors, and there is evidence to support the utility of appropriate discussions between inspectors in improving reliability. The reliability of domain allocations was lower than for ratings. It is important to define categories and rating levels clearly, and to train inspectors in their use. Further research is needed to replicate these results now that the model has been fully implemented, and to understand better the impact that inspector uncertainty and disagreement may have on published CQC ratings.

PP26  Knowledge, attitudes and practices of UK paramedics regarding pharmacology and the legal, management and administration aspects of medicines: a cross-sectional online quantitative survey

2020 ◽  
Vol 37 (10) ◽  
pp. e12.2-e12
Author(s):  
Samantha Laws ◽  
Mary Halter ◽  
Chao Wang
Keyword(s):  
Online Survey ◽  
Care Quality ◽  
Further Education ◽  
Medicines Management ◽  
Cross Sectional Survey ◽  
Perceived Knowledge ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
The Impact ◽  
Knowledge Attitudes And Practices

BackgroundChanges in the paramedic profession have seen an increased range of medicines available within UK ambulances services. However, poor practice in medicines management has been identified by the Care Quality Commission. Literature in this area is sparse. This study aimed to determine the perceived knowledge, attitudes and practices of paramedics regarding pharmacology and the legal and regulatory issues of medicines management and administration.MethodsThe study utilised a cross-sectional survey design, administering an anonymous online survey to all (approximately 1000) paramedics within one UK NHS ambulance trust. The survey focused on paramedic knowledge on pharmacology, legal supply and administration; self-assessment of knowledge and confidence related to medicine management and administration; and personal characteristics. The primary outcome was percentage of (pre-determined) correct answers.Results251 responses were received. The mean percentage of correct answers was 79.0% (SD 10.0), with variation by question observed, from 34.7 to 97.2% correct responses. A higher correct knowledge was associated with: higher self-rated confidence, lower self-reported knowledge, being less likely to report errors and higher education-based initial route into the paramedic profession.ConclusionThis single-site UK-based survey highlighted variation in medicines knowledge amongst self-selecting paramedic respondents. The results indicate a need for medicines-specific further education for all paramedics, particularly those who have not experienced longer formal education entry routes, integrating a focus on confidence and self-perceived knowledge, and enhancing and embedding integrated improvement strategies. Further research is required with larger, multi-site samples, and to evaluate the impact of education packages developed.

Regulation of intellectual disability services

2015 ◽  
Vol 9 (3) ◽  
pp. 101-107
Author(s):  
Afra Kelsall ◽  
John Devapriam
Keyword(s):  
Intellectual Disability ◽  
Design Methodology ◽  
Care Quality ◽  
Regulatory Process ◽  
Disability Services ◽  
Content Type ◽  
Care Quality Commission ◽  
Ongoing Development ◽  
Regulatory Model ◽  
Future Work

Purpose – Winterbourne and Mid-Staffordshire scandals have had a significant impact on how Care Quality Commission inspects and regulates intellectual disability services (IDS). The purpose of this paper is to describe the changes and development of regulation of these services and future work. Design/methodology/approach – The paper is a descriptive paper. Findings – A new regulatory model is currently implemented for IDS. It has been developed in consultation with patients, carers, providers and other stakeholders. There will be ongoing development and refinement of the inspection methodology. Originality/value – This is an original descriptive paper which will provide useful information to readers on how the regulatory process works in IDS.

scholarly journals The role of the clinical professions in the regulation of healthcare in England: walking the tightrope

2009 ◽  
Vol 33 (9) ◽  
pp. 321-324
Author(s):  
Paul Lelliott
Keyword(s):  
Ad Hoc ◽  
Healthcare Services ◽  
Care Quality ◽  
Clinical Expertise ◽  
Delivery Of Care ◽  
Care Quality Commission ◽  
The Impact ◽  
Ownership Of Information

SummaryThe Royal Colleges and other professional bodies could use their clinical expertise, authority and influence with clinicians to improve the quality of regulation of healthcare services. At present, their contribution to regulation in England is ad hoc and informal. Better engagement could increase the impact that professional bodies have on patient care and create a new role for them as arbiters of quality in the organisation and delivery of care. the requirement for healthcare provider organisations to register with the Care Quality Commission from April 2010 and the National Health Service Next Stage Review have created an opportunity for closer collaboration. However, there are problems that must be overcome. These include the ownership of information about the quality of care and the uses to which this is put. It would be self-defeating if closer working with the regulator undermined the trust that clinicians have in quality improvement work led by the professional bodies.

scholarly journals Knowledge, attitudes and practices of UK paramedics regarding pharmacology and the legal, management and administration aspects of medicines: a cross-sectional online quantitative survey

2020 ◽  
Vol 5 (2) ◽  
pp. 1-9
Author(s):  
Samantha Laws ◽  
Chao Wang ◽  
Mary Halter
Keyword(s):  
Online Survey ◽  
Care Quality ◽  
Further Education ◽  
Medicines Management ◽  
Cross Sectional Survey ◽  
Perceived Knowledge ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
The Impact ◽  
Knowledge Attitudes And Practices

Introduction: Changes in the paramedic profession have seen an increased range of medicines available within UK ambulances services. However, poor practice in medicines management has been identified by the Care Quality Commission. Literature in this area is sparse. This study aimed to determine the perceived knowledge, attitudes and practices of paramedics regarding pharmacology and the legal and regulatory issues of medicines management and administration.Methods: The study utilised a cross-sectional survey design, administering an anonymous online survey to all (approximately 1000) paramedics within one UK NHS ambulance trust. The survey focused on paramedic knowledge on pharmacology, legal supply and administration; self-assessment of knowledge and confidence related to medicine management and administration; and personal characteristics. The primary outcome was percentage of (pre-determined) correct answers.Results: 251 responses were received. The mean percentage of correct answers was 79.0% (SD 10.0), with variation by question observed, from 34.7 to 97.2% correct responses. A higher correct knowledge was associated with: higher self-rated confidence, lower self-reported knowledge, being less likely to report errors and higher education-based initial route into the paramedic profession.Conclusion: This single-site UK-based survey highlighted variation in medicines knowledge among self-selecting paramedic respondents. The results indicate a need for medicines-specific further education for all paramedics, particularly those who have not experienced longer formal education entry routes, integrating a focus on confidence and self-perceived knowledge, and enhancing and embedding integrated improvement strategies. Further research is required with larger, multi-site samples, and to evaluate the impact of education packages developed.

15 The neurological patient experience survey (England)

2020 ◽  
Vol 91 (8) ◽  
pp. e13.2-e14
Author(s):  
Michael Dilley ◽  
Katharine McIntosh ◽  
Sarah Vibert ◽  
Keyword(s):  
Mental Health ◽  
Patient Experience ◽  
Service Provision ◽  
Online Survey ◽  
Mental Wellbeing ◽  
Process Data ◽  
Neurological Patient ◽  
Mental Health Support ◽  
Experience Survey ◽  
The Impact

Objectives/aimsThe Neurological Alliance’s patient experience survey 2018/19 aimed to gather relevant data of the experiences of 10,000 neurology patients across England, in order to reveal how patients are faring, and to provide insight about the impact service provision (or lack thereof) is having in people’s lives. It is the only pan- neurological national survey of neurology patients. Mental wellbeing questions were included to build our understanding of service provision and whether people’s needs are being met.MethodsAn online and in-clinic survey was conducted during the course of 2018–2019. The online survey was promoted by The Neurological Alliance’s member organisations (predominantly charities), and via social media. The in-clinic data was collected from patients attending neurology outpatient appointments at 39 clinics across England. The data underwent a rigorous cleaning process. Data regarding patient’s home postcodes was collected in order to be able to attribute responses to STPs. Results were subsequently anonymised prior to analysis.ResultsOf those to whom these questions were relevant:40% of respondents (n=2879) felt their mental wellbeing needs were not being met at all, and an additional 22% (n=1613) said their needs were only being met to a small extent 30% (n=2821) had not been referred or signposted to support for their mental wellbeing by a health professional, but would have liked this 58% (n=5593) said they were not asked about their mental wellbeing by a health or social care professional.Of those referred/signposted for mental health support, 26% (n=616) were referred to a neuropsychologist/neuropsychiatrist, 60% (n=1452) to a counsellor/therapist, 7% (n=167) to a buddying/befriending support group 62% (n=1249) said this support helped them feel better/more positive; 24% (n=481) said that this support did not make them feel better/more positive; 14% (n=270) said it was not suitable for them.The older respondents were, the less likely they were to have been signposted to support for managing their mental health: 18–24s scored 36%, 55–64s scored 26%, 65–74s scored 17%, and 75+ scored 12%. People aged 75+ were most likely (67%) to report they did not need/want signposting.ConclusionsThe data gathered enhances our understanding of the mental wellbeing of people with neurological conditions, and provides a baseline for monitoring improvement/future interventions, such as the forthcoming neuropsychiatry service specification.

scholarly journals The impact and influence of digitisation on dentistry

2015 ◽  
Vol 6 (1) ◽  
pp. 36-39 ◽  
Author(s):  
Nigel Knott
Keyword(s):  
Data Protection ◽  
Care Quality ◽  
Professional Standards ◽  
Practice Management ◽  
Freedom Of Information ◽  
Daily Routine ◽  
Freedom Of Information Act ◽  
Small Practice ◽  
Care Quality Commission ◽  
The Impact

The time when practice management was a small part of a practice principal’s daily routine has passed and the days of the small practice are numbered. It is not only a question of implementing the GDC’s professional standards but also of having to address legislation regulated by the Information Commissioner’s Office 1 (the Data Protection Act and Freedom of Information Act among others) and, of course, the Care Quality Commission (CQC).

scholarly journals Shared Decision Making in Cancer Treatment: Findings from a Large Survey of Lymphoma (LYM) Patients and Survivors

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2134-2134
Author(s):  
Kendall H Sullivan ◽  
Michael Toscani ◽  
Tayla Poretta ◽  
Ciera Patzke ◽  
Thushara Korattyil ◽  
...  
Keyword(s):  
Decision Making ◽  
Online Survey ◽  
Conflicts Of Interest ◽  
Treatment Options ◽  
Treatment Decision ◽  
Active Role ◽  
Care Quality ◽  
Actual Role ◽  
Significant Difference ◽  
The Impact

Introduction: As the complexity of the LYM treatment landscape increases, patients (pts) have become more involved in understanding treatment options, joining advocacy organizations, and seeking information through a multitude of venues. This has increased the pts voice in the treatment decision-making (DM) process while considering several factors (i.e. route of administration, side effects, cost, access to care, quality of life, etc). There is robust evidence that establishes the importance of a collaborative relationship between pts and clinicians when making treatment related decisions. The growing evidence also suggests there is an increased need for pt oriented-research, including communication between the scientific community and cancer pts. However, despite the established need for shared DM, there are discrepancies between the extent that pts prefer to be involved vs their actual involvement. Previous studies have suggested that elderly pts and pts with lower education status prefer a passive DM role. Our objective was to facilitate a detailed survey identifying clinical characteristics and demographics that influence the preferred and actual role that LYM pts have in shared treatment DM. Methods: This study was reviewed and approved by the Rutgers IRB. A 30 question survey was developed and sent to the LYM Research Foundation (LRF) distribution list of pts and caregivers. This voluntary and anonymous survey was available through the online survey platform Qualtrics®, a Rutgers University approved survey platform, and was sent to 132,827 unique email addresses. Data collection and analysis was performed solely through the Qualtrics online platform with no additional pt identifiers or information collected. Statistical analyses were performed using non-parametric two-sided Mann Whitney U test and Fisher exact testing. Results: Of the 132,827 unique email addresses that received the survey, an estimated 12,316 recipients opened the email with a total of 1045 participants completing the survey. Among the 1045 participants, 878 were LYM pts or survivors. Of the 878 pts, 58% were current and the remaining were survivors. Among known diagnoses, the most common subtypes were follicular LYM (30%), CLL/SLL (25%), mantle cell LYM (20%), Waldenstroms macroglobulinemia (10%), & diffuse large B cell LYM (8%). At the time of diagnosis, the majority of pts (73.7%) were 60 years or older. There were slightly more female (55%) than male pts. Disease status for pts: 22% had not yet received therapy, 38% reported 1 line of therapy, and 40% 2 or more. Additionally, 49% reported receiving chemotherapy, 55% receiving immunotherapy. Considering the 878 LYM pts who were included in this analysis, 460 (52%) responded to their preferred role in treatment DM. Furthermore, 448/460 (97%) pts responded that they preferred to have an active role in the treatment DM paradigm. However, 147/448 (33%) responded they did not have a role in the DM process. We analyzed several pt demographic and disease variables for the impact on decision making (Table).There was no significant difference in the probability of pts with no role in DM for most subgroups. There was a trend for LYM pts with relapsed/refractory disease in having less of a role in DM for therapy compared with newly diagnosed pts, while there was no apparent differences based on whether immunotherapy was part of therapy or not. However, there was a prominent difference in the probability of pts when stratified by age with 27% of pts ages ≥60 years vs 50% of LYM pts ages <60 years stating that they did not have a role in DM for their treatment (Table). Conclusions: This analysis informs the perspective of LYM pts and survivors regarding their roles in treatment DM. While nearly all responding pts reported they preferred to have an active role in the treatment DM process, 1/3 of those pts stated that they did not have a role. This preference transcended most pt demographics and disease characteristics. However, there was a prominent age-based discrepancy with younger LYM pts reporting no role in treatment decisions compared with older pts. Based off of previous evidence that suggests older pts prefer a more passive role, this data suggests pts perception of their actual role in shared treatment DM can be influenced by their reported preference. Continued analyses and studies are warranted to understand the ongoing gaps and to improve the overall DM process for pts and providers. Disclosures No relevant conflicts of interest to declare.

Have CQC hospital inspections resulted in better quality care?

2019 ◽  
Vol 28 (10) ◽  
pp. 654-655 ◽  
Author(s):  
Alan Glasper
Keyword(s):  
Quality Care ◽  
Care Quality ◽  
Emeritus Professor ◽  
Care Quality Commission ◽  
The Impact

Emeritus Professor Alan Glasper, University of Southampton, discusses the impact and success of Care Quality Commission hospital inspections since publication of the report into Mid Staffordshire NHS Trust

scholarly journals Kidney Care during COVID-19 in the UK: Perspectives of Healthcare Professionals on Impacts on Care Quality and Staff Well-Being

2021 ◽  
Vol 19 (1) ◽  
pp. 188
Author(s):  
Archontissa Maria Kanavaki ◽  
Courtney Jane Lightfoot ◽  
Jared Palmer ◽  
Thomas James Wilkinson ◽  
Alice Caroline Smith ◽  
...  
Keyword(s):  
Online Survey ◽  
Healthcare Professionals ◽  
Healthcare Access ◽  
Healthcare Delivery ◽  
Well Being ◽  
Care Quality ◽  
Free Text ◽  
Structured Interviews ◽  
The Uk ◽  
The Impact

In light of the rapid changes in healthcare delivery due to COVID-19, this study explored kidney healthcare professionals’ (HCPs) perspectives on the impact of these changes on care quality and staff well-being. Fifty-nine HCPs from eight NHS Trusts across England completed an online survey and eight took part in complementary semi-structured interviews between August 2020 and January 2021. Free-text survey responses and interviews were analysed using inductive thematic analysis. Themes described the rapid adaptations, concerns about care quality, benefits from innovations, high work pressure, anxiety and mental exhaustion in staff and the team as a well-being resource. Long-term retention and integration of changes and innovations can improve healthcare access and efficiency, but specification of conditions for its use is warranted. The impact of prolonged stress on renal HCPs also needs to be accounted for in quality planning. Results are further interpreted into a theoretical socio-technical framework.

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