Maintaining Quality In Health And Social Care Units: Perspectives And Standards

Stakeholders in Health and Social Care

It is essential for each of the health and social care units to manage quality in terms of delivering the best care to all the service users.  In order to improve efficiency and productivity, the service providers need to focus on the quality maintenance as well (Dietz et al. 2015). It is evident that, to improve the services, it is necessary to follow appropriate guidelines, principles and procedures set by the industry authority and government. For this reason, the aim of the study is to focus on the perspectives that stakeholders in various health and social care units nurture. Furthermore, the study will incorporate the standards that need to exist in social care units to measure the quality of services. This study will further encourage developing transferrable skills set beneficial to a number of roles within health and social care units.

Stakeholders in health and social care

In this particular context, the focus has been made on the Royal United Hospital, situated in Bath to improve the research. People especially all the value chain actors that are involved in health and social care units can be considered as the stakeholders in this particular environment. More specifically, the service providers along with the beneficiary of service are recognized as stakeholders. In this perspective, the statutory bodies involving Primary Care Trusts, Strategic health authorities, Practitioners and Social Services Departments fall under this category. Besides these, the third sector including charities, action groups and private service providers can also be considered as the stakeholders of this concerned unit (Valentine et al. 2015). In addition, there is an informal body that includes service users, their relatives and other carers are distinguished as the stakeholders of Royal United Hospital.

Perspectives that stakeholders in health and social care units have

Service quality can be considered as the approach to manage services in order to ensure that service users are satisfied. Therefore, it performs as an antecedent of service users’ satisfaction. This can be provided with the help of SERVQUAL model which is service quality framework aims to measure the scale of quality in case of various service sectors (Turner and Clegg, 2014). The key service dimensions under this particular model are responsiveness, assurance, tangibles, empathy and the other one is all about reliability.

Responsiveness: the willingness to provide help to the service users and deliver prompt service

Assurance: the knowledge and ability of the service providers to inspire service users (Hardyman et al. 2015).

Perspectives that stakeholders in Health and Social Care units have

Empathy: the caring and individualised attention the social care and hospitals provide to the patient

Reliability: the ability to perform all the promised services accurately

Tangibles: the presence of physical equipment, facilities and presence of personnel and communicative materials.

All these can be considered as the required services for the stakeholders. However, sometimes they become unable to fulfil all these requirements and a gap is created between what should be delivered and what is delivered to the service users. According to the viewpoint of Mossialos et al. (2015), comfortable includes dressing, showering and empowering patients. This contemplation requires taking care of customers with the help of organisation’s suppliers. Besides this, there are agents from various business divisions who are responsible not only to provide specialists at a reduced cost but to concentrate on improving group well-being, flexibility to address different advancing issues and obligations. However, in reality, people are often affected by the consequence of low-quality services.

External agencies in healthcare

An external agency influences the supports and develops social protection in the workplace environment. Besides this, the agency focuses on the interests and quality of oversight powers. For this reason, external places enhance various oversight instruments via alternative control to the state, administration and adjacent forces (Glasby, 2017). Therefore, external agencies in health and social care units include government bodies such as CQC, NICE, Health service commissioners and others.

Functions of external agencies

Care Quality Commission:

This is a free controller in the concerned health and social care in the United Kingdom. According to this body, it is necessary for the care homes to furnish service users with fantastic, compelling, sympathetic and protect the administration. As mentioned by Panagioti et al. (2014), this body empowers change of value.

Healthcare inspector:

This body inspects about the services that are delivered and help the offices to settle on their decisions about administrations (Joseph-Williams et al. 2017).

NICE:

They are responsible to recommend how different healthcare professionals should take care for service users under specific conditions. They provide information about prevention, diagnosis and long-term management.

Impact of poor service quality on stakeholders

It can often be shown that health care service providers are unable to meet all the criteria to meet the quality of services. For this reason, the stakeholders need to suffer from different perspectives. Most of the requirements in terms of care are not met in the care units and because of this, injuries occurred. Customers are unlikely to patronise the same organisation and because of this, there occurs low self-esteem and devaluation. The low-quality services impact the society as well and because of this, health and safety issues arise. According to the viewpoint of Hardyman et al. (2015), hospitals need to confront fines, prosecution and other political obstacles for not maintaining quality in the care units. Sometimes, the licenses of health care practitioners are cancelled. Sometimes, administrations need to cash spent to the government.

External Agencies in Healthcare

Quality issues at Royal United Hospital, Bath

In the concerned hospital, there are some quality issues that need to resolve by the higher authority of that care unit. As mentioned by Aveyard (2014), super visioning is essential at Royal United Hospital in order to bolster the required quality management. The care unit needs to concentrate on store usage and mastery to different partners outside the organisation. Further, they need to focus on the observing quality that will set up effective game plans for quality change.

It is worth saying that, there are some of the standards that exist in health and social care units in the United Kingdom to measure the quality. The principles of NICE, Code of Practice, CQC all are providing some set of standards to improve the service user’s ability to stay safe. According to the viewpoint of Bowling (2014), there are London quality standards for improving the quality and safety of maternity services and preventing people from dying prematurely. Scope of the London quality standards include

Adult emergency services	Paediatric emergency services	Maternity services
· Emergency departments · Acute medicine · Critical care · Fractured neck of femur · Emergency general surgery	· Emergency departments · Emergency inpatient · medicine · emergency general · surgery	· specialist acute care labour immediate postnatal Birth · care

Table 1: London Quality Standards

(Source: Bowling, 2014)

NHS performance framework

As mentioned by Makai et al. (2014), NHS performance framework sets out different departmental approaches in order to identify underperforming NHS organisations. Along with this, it stipulates when intervention should take place or occur in such care units. There are public health outcomes framework, adult social care outcomes framework, health education outcomes framework and some other to measure the quality of services.

NHS outcome frameworks	Attributes
Public health outcomes framework	Sets to increase healthy life expectancy Reduce differences in healthy life expectancy and life expectancy between communities
Health education outcomes framework	Sets to develop education, workforce and training in care units Impact on the safety and quality services for service users
Adult social care outcomes framework	Measures how well support and care units achieve the outcomes.

Table 2: NHS outcome frameworks

(Source: Cameron et al. 2014)

Besides these,  there are other standards set by quality protects programme, Equality Act of the year 2010, benchmarking, charter marks and key performance indicators that help to measure the improvement in quality services that are provided to the service users to improve the health of the society.

Different approaches to implement quality systems in care units

The health and social care setting can implement the quality services by evaluating a number of approaches. There are different personal, professional and social approaches which have that potential to implement quality systems within the workplace environment of the hospitals and trusts. According to the viewpoint of Millarand Hall (2013), various personal approaches include reflective practice, target setting, personal development plans, appraisal, learning plans and skills audit that significantly enhance the implementation process. Aside from this, with the help of SWOT analysis and by providing external and internal training to the service providers, the health acre authority can improve the process successfully.

Functions of External Agencies

Analysing potential barriers to delivery of quality

As mentioned by Munn-Giddings and Winter (2013), there is a number of potential barriers in health and social care units that act as obstacles to reach to the quality of services and because of these, many of the organisations need to face a number of political issues for failing to reach to the quality of services.  These potential barriers include social, professional and personal obstacles.

Personal barriers

It can often be shown that, barriers arise from the internal structure of the care units. According to the viewpoint of Munn-Giddings and Winter (2013), staffs in health care units show reluctance towards change work pattern and because of these, the National Health services find it difficult to change the regular work pattern. Besides this, the higher authority needs to provide costs on additional senior staffs to introduce changes to maintain the quality of services. Sometimes, the charge becomes a little high and performs as one of the barriers to meet the objective. As mentioned by Rimmer (2017), the organisations practice Rota management which is the most significant barrier to reach the ultimate goal in providing quality services to the service users.

Social barriers

Along with the personal barriers, there are some of the social barriers that make it difficult for the healthcare services to reach their expectations. This includes communication and interpersonal relationship. As opined by Rimmer (2017), there is lack of communication among each of the stakeholders of these care units and therefore, no recommendations ultimately reach to each of the health care providers and because of this, they become aware of the facts and measurements to provide quality services to the patients. Another barrier is all about the interpersonal relationship and this performs as one of the major obstacles to meet the requirements.

Professional:

As mentioned by Joseph-Williams et al. (2014), health and service providers are unable to reach the ultimate objective because of the lack of resources. However, there is lack of funds and because of this; it becomes difficult for the healthcare provides to maintain the quality of the workplace environment. Inadequate health record systems and unavailability of transport act as a potential barrier to support integrated care management across the care continuum. Professional uncertainty and lack of skills and training to consider new roles and responsibilities also fall under this particular category.

As mentioned by Ham et al. (2015), continuous monitoring plays a pivotal role in delivering quality services to the service users. This is because, the continuous monitoring has that potential to provide that extent of caring to a service user so that, the person can return to the regular life. There are a number of policies that include clinical governance, total quality management, the leadership of change, ISO9000 and other organisational policies and procedures that a healthcare setting uses in order to achieve the quality in the services.

Impact of Poor Service Quality on Stakeholders

It is worth saying that, there are some of the policies and procedures that are mentioned in the chosen hospital so that, it becomes possible for them to achieve the quality of the services. In this scenario, it can be stated that the concerned hospital the health care providers use the leadership of change and they provide medical and other social care to the service users. Along with this, the service providers utilize therapeutic considerations to the patients so that, they can easily get in all the policies and procedures of the centre. According to the viewpoint of Osborne (2017), the caregivers provide considerations to the service users along with a paediatric palliative consideration in the form of group social work. The main strength of the hospital is that it uses teamwork so that, communication among the team members is a strong point of the concerned hospital. Along with this, for critical cases, the hospital appoint additional staff so that, it becomes possible for them to provide special care to the critical cases.  According to the viewpoint of Osborne (2017), many healthcare settings offer services; however, Royal United Hospital offers best services that help to improve the health condition of service users. With the help of ISO 9000, this healthcare setting becomes able to identify the root of the issue and thereby, they become able to find a solution. Further, this healthcare home uses health and safety policy, waste disposal policies and procedures for fatuities, infection control policy and some other so that, it becomes possible for them to become of the most renowned NHS Foundation Trust.

In accordance with the aforementioned factors, there are some other factors that influence the achievement of the quality of services in the selected healthcare. These include perception and skills of health and social care service providers of the care unit. The practitioners are highly skilled and so that, they provide improved quality services to the patients (Makai et al. 2014). Aside from this, the inner framework plays a vital role in influencing the achievement. Therefore, the concerned hospital practices an improved inner framework that promotes the low quality into higher one. Another factor is all about keeping a track record of quantifiable and positive outcomes. Besides this, availability of resources can be considered as another major factor in this situation. From this perspective, the hospital encompasses a huge storage of resources to provide quality services to the service users. As mentioned by Middleton et al. (2013), the concerned care setting seeks to provide value for money and therefore, it becomes possible for all service users to reach this place. Further, the firm becomes able to coordinate secondary and primary care and therefore, the practitioners replicate these lessons in some other field in the quest for quality development.

Quality Issues at Royal United Hospital, Bath

As mentioned by Littlejohn et al. (2017), all the factors that are patronized by the hospital are important in reaching the goals and objectives of the group social work. It is worth saying that, Royal United Hospital provides enhanced credibility to the stakeholders in the quest for quality achievement. Therefore, it can be stated that this NHS foundation trust is able to provide a quality service to the patient by setting up all these powerful quality frameworks. As a rule, the healthcare without considerable quality models is unable to promote the quality. Therefore, it can be stated that these frameworks are important that influence the achievement of quality care standards in the workplace environment.   

Recommendations to improve the quality of service

Issues:

One of the issues faced by the hospital authority is the congestion. This is because, the hospital provides value for money and therefore, it becomes possible for all service users to afford the services. Another issue is all about the understaffing and because of this; the patients have to wait a long. This can be considered as the major issue in this selected hospital. Coupled with staff deficit and congestion, it makes difficult for the hospital to reach the desired goals and objectives (Brownson et al. 2017). For this reason, the researcher provides a number of improvement measures that can develop the quality of services and the hospital becomes able to reach the desired outcome.

Recommendations:

Familiarity with clinical aspects is essential for the hospitals and care settings. The situation is not different in this particular hospital. It is necessary for the hospital to maintain familiarity with the prolonged care administration to reach the ultimate goal. From this perspective, it is essential for the concerned hospital to provide a holistic approach to the palliative care provision.  

Another recommendation is all about the availability of staffing. The healthcare faces issues regarding insufficient staffing. Therefore, it is essential for the hospital to appoint more health and service providers with proper training so that, it becomes possible for the hospital to reach the desired outcome.

The healthcare settings need to improve the entire management system by applying the total quality management. This is because, with the help of this approach, the hospital can provide an improved environment to the service users.

Methods for evaluating health and social care service quality

Higher authority of health and social care setting can measure the quality of services with the help of different methodologies. It is worth saying that, evaluation of the care services is required so that, it becomes possible to improve the quality of the services. As mentioned by Drummond et al. (2015), it is the responsibility of the hospital authority to look after all the departments so that, it becomes possible to improve the care environment for the patients. Therefore, with the help of these services, service users can get better services from the healthcare professionals to improve their health quality. There are a number of methodologies with the help which, the health and social care unit can evaluate quality. One of these methodologies includes inspection report. From this perspective, the hospital authority and the NHS are solely responsible to have a survey method so that, they can inspect about the entire procedure of the hospital. In this situation, they need to keep a record of the gathered data for future use. This is because; the hospital authority can criticize their improvements (Gavin et al. 2014). On the other hand, there is service user’s feedback that can be performed as one of the methodologies to evaluate the quality of services. Without having knowledge about the service user’s perspective towards the quality of service, the service providers cannot be able to improve the care environment. Besides service user’s feedback, practitioner’s feedback is also required to evaluate the service quality. As mentioned by Anhang et al. (2014), the only practitioner can state what is required to improve the services and what is not. Therefore, to improve the quality environment, the higher authority needs to incorporate these methodologies.

Task 2

Discuss the impact that involving users of services

By focusing on the community-oriented work, the considered Royal United Hospital incorporates servicer users in the decision making process. This is because, the authority of the concerned trust believe that, the participation of service users has that potential to develop the working pattern of the health and social care service providers. According to the viewpoint of Dewing and Littlejohn et al. (2017), the feedback from service users influences the evaluation process. Service user’s involvement has become a key policy driver in health and social care setting in the United Kingdom. Health and social care settings involve service users in a range of projects especially on the level of collaboration and consultation. Because of this, it becomes possible for the healthcare units to gain knowledge about the service user’s perspectives and experiences. All these have that potential to develop a sense of well-being, confidence and self-esteem of the concerned authority of Royal United Hospital. As mentioned by Dewing and Dijk (2016), the benefit of this trust is in having service user’s focus and perspective. Furthermore, the involvement of service users in the evaluation process makes the healthcare setting to develop the client-centred care. It is evident that the service user’s participation can develop the quality of health activities of the public. For example, service users with the long-term illness have insights regarding their care that policymakers and health care providers do not have often. As opined by Drummond et al. (2015), there is a declaration of W.H.O and it states that people have a duty and right to participate collectively and individually in the planning of their health care. Nevertheless, there is a tendency of the Royal United Hospital to omit the service users from setting priorities and planning. Therefore, it can be stated that the service user’s participation is required in order to improve the planning and services of the service providers. Further, the tendency of the health care providers to involve service users empowers the patients and because of this, it becomes possible for them to improve the quality of services.

Conclusion

In the most awaited conclusion part, it can be concluded that a health and social care unit involves a number of activities to manage and maintain quality. Healthcare settings need to select the most appropriate procedure to set the quality services. Based on the selection, it is necessary for the care units to prepare quality manual which consists various action items that need to implement in order to improve the quality level of the services. The considered hospital needs to focus on retaining services in comparison to other hospitals and in this condition; they might get help from the Care Quality Commission. Further, the study has derived various standards of quality so that, it becomes possible for the researcher to understand the issues faced by the hospital in delivering quality services to the service users. For this reason, the researcher has provided effective recommendation so those, the concerned hospital can improve and manage the quality of services

Table 1: London Quality Standards

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