State of Care and Quality Improvement: a national perspective Jeremy Cox, Director of Quality Improvement

What do you see?

CQC’s Purpose We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve “…adherence to the process frequently becomes the objective, as opposed to achieving the objective that the process was put in place to achieve.” David Marquet

The CQC system

Four Strategic Priorities 1. Encourage improvement, innovation and sustainability in care We will work with others to support improvement, adapt our approach as new care models develop, and publish new ratings of NHS trusts' and foundation trusts' use of resources. 2. Deliver an intelligence-driven approach to regulation We will use information from the public and providers more effectively to target resources where the risk to the quality of care is greatest and to check where quality is improving, and introduce a more proportionate approach to registration. 3. Promote a single shared view of quality We will work with others to agree a consistent approach to defining and measuring quality, collecting information from providers, and delivering a single vision of high-quality care. 4. Improve our efficiency and effectiveness We will work more efficiently, achieving savings each year, and improving how we work with the public and providers.

Independent Voice

State of Care 2017/18 Most people in England receive a good quality of care. But quality is not consistent, and access to good care increasingly depends on where in the country you live and the type of support you need. Despite the continuing challenges that providers face, this quality of care has been largely maintained, and in some cases improved. Some people can easily access good care. Others cannot access the services they need, they experience disjointed care, or only have access to providers with poor services. People’s experiences are often determined by how well different parts of local systems work together.

Links to QI Inconsistent quality Inconsistent access Disjointed provision Extent of effective working across local systems Pressure on resources

Quality Improvement in Hospital Trusts 2017/18 “Demand on health and social care services is increasing year-on-year. This increased workload puts quality of care at risk but, despite these pressures, we have found that hospital trusts that put a focus on continuous quality improvement have demonstrated that they can deliver high-quality care. In those trusts we have rated as outstanding, we have found a culture of quality improvement embedded throughout the organisation.” Systems view Strategic intent for QI Building a QI culture at all levels Leadership for QI Patients at the centre of QI Building QI skills at all levels

Implications for QI Part of CQC’s regulatory approach “We would expect that a hospital trust committed to delivering high-quality care should be embedding a systematic and effective approach to QI. However, we recognise that it is not easy. Rather than a quick fix, this is a challenging endeavour, changing behaviour in complex organisations and developing an effective leadership and organisational culture.” Professor Ted Baker Chief Inspector of Hospitals Encouraging Improvement – part of CQC Purpose CQC’s internal QI Programme – strategic priority for CQC

Encouraging Improvement: some key collaborations DPIC Health Foundation Q Network NHSI approach to supporting QI New models of care, Place, pathways

Encouraging Improvement “The more efficient you are at doing the wrong thing, the wronger you become. It is much better to do the right thing wrong than to do the wrong thing righter. If you do the right thing wrong and correct it, you get better.”

Thank You !