The National Health Service in the United Kingdom takes health care quality seriously and makes great effort to be a system that learns. The current NHS Outcomes Framework is entirely built around quality and patient-centredness is the system’s focal point. The drive to provide high quality care means that the United Kingdom has internationally pioneered many initiatives, including clinical guidelines, continuing professional development and use of patient surveys and patient-reported outcomes. Professionalism was for many years the trusted base upon which quality monitoring and improvement activities rested. In recent years, though, this governance model has progressively shifted toward a quality management approach, more reliant upon regulation and control. There has been a proliferation of national agencies, reviews and policies that address quality, leading to a somewhat congested and fragmented field of actors, particularly in the fields of inspection and performance monitoring. A tension, perhaps more pronounced than in other OECD health systems, is now evident between top-down quality management approaches and bottom-up quality improvement techniques. What should the United Kingdom do to resolve this tension and ensure that its quality architecture remains one that is studied and emulated by other OECD health systems? This report recommends three key actions. First, greater emphasis on professionalism should be reinstated as a key driver of excellence. As the same time there is scope to simplify the range of institutions and policies regulating health care quality. Finally, renewed focus on the quality at the interfaces of care, as well as on community-based services, is needed.
The challenge before us is clear. It is no longer possible for us to think about inequalites and growth separately. We need to promote more Inclusive Growth to ensure the recovery and lay the foundations for a shared and affluent future.
The global economic crisis has had a profound impact on people’s well-being, reaching far beyond the loss of jobs and income, and affecting citizens’ satisfaction with their lives and their trust in governments, according to a new OECD report.
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Gains in female education attainment have contributed to a worldwide increase in women’s participation in the labour force, but considerable gaps remain in working hours, conditions of employment and earnings. More specific data for the United Kingdom are available in this country note.
Governments should invest more money on children in the first six years of their lives to reduce social inequality and help all children, especially the most vulnerable, have happier lives, according to the OECD’s first ever report on child well-being in its 30 member countries.