1. © Nuffield Trust and Health Foundation © Nuffield Trust
The QualityWatch Programme
Dr Martin Bardsley

2. © Nuffield Trust and Health Foundation
Website QualityWatch.org.uk

3. © Nuffield Trust and Health Foundation
Challenge of assessing quality…
Quality is multidimensional – does not easily fall into a handful
of simple indicators.
Quality will vary between areas where services are provided,
and vary over time
Danger of focussing in what's measured and missing the point
Time lag for change to work through the systems –good quality
care may not be immediately visible
Our ability to use information improving – look forward to new
and better metrics

4. © Nuffield Trust and Health Foundation
Hiding behind the mean? Patients' responses to the question "Overall,
did you feel you were treated with respect and dignity while you were in the
hospital?" (2002 to 2012)
Mrs H’s Story
We found evidence that the care given
to Mrs H fell significantly below the
applicable standard in relation to
meeting her cultural and linguistic
needs, maintaining her comfort and
wellbeing and safeguarding her
property and clothing..
http://www.ombudsman.org.uk/care-
and-compassion/case-studies/mrs-as-
story5#sthash.vo4hqXq9.dpuf

5. © Nuffield Trust and Health Foundation
Trends and blips. Diagnostic waiting times.
Proportion of tests on the waiting list over 6 or 13 weeks (January 2006 to April 2013)
0%
10%
20%
30%
40%
50%
60%
6+ weeks 13+ weeks

6. © Nuffield Trust and Health Foundation
Areas of continued improvement for a range of
specific quality markers

7. © Nuffield Trust and Health Foundation
Urgent Care
Emergency admissions continuing to rise from some
patient groups
Increased pressure on A&E with longer waits and more
breaches
Ambulance responses slowly falling
‘Unprecedented’ cuts in social care spending by 15%
2009/10 to 2012/3
Acute sector productivity increasing (12-15% over 5
years) from same beds and similar/less levels of nursing
staff

8. © Nuffield Trust and Health Foundation
Continuing challenge of prevention and inequalities
Though survival following a hip
fractures has improved significantly
The incidence of hip fracture has not
changed and the pattern of lower
survival in more deprived areas
continues.

9. © Nuffield Trust and Health Foundation
Changes in cervical cancer screening

10. © Nuffield Trust and Health Foundation
Future programme
Looking to refine both our indicators and approaches to
measurement including asking what are the best
indicators?
How do we improve measurement? Can we harness the
potential of linked data sets to describe the quality of
patient care?
How do we make judgements on what is good or bad?
What are the best benchmarks/yardsticks
What are the best early indicators of strains in the
system?
How do we support an informed debate on quality?

11. © Nuffield Trust and Health Foundation
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© Nuffield Trust and Health Foundation
12 March 2014