Managing Quality In Health And Social Care

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Introduction to  Managing Quality In Health And Social Care

Quality is an essential component of Health and Social Care (HSC) services as it is a concept with different interpretations and perspectives. Improvement of service quality requires both the empowerment and involvement of service users as well as addressing the requirements of external regulatory bodies. The present research study has been made on Royal United Hospital Bath NHS Trust which provides acute treatment and care for a population of around 5, 00,000 people in Bath. This trust provides huge number of services to the patients and for that it has employed more than 4600 staff members all around the units. Thus, the study has stated role of external agencies and stakeholders in setting service standards and along with that impact of poor service quality on HSC stakeholders are also discussed in the present study. Moreover, the subsequent study has also mentioned approaches which can be taken into account for implementing quality systems. 

LO 1

1.1 Explain the perspectives that stakeholders in health and social care have regarding quality

The major three stakeholders of Royal United Hospital Bath NHS Trust are its service users, providers and the inspection committee that analyzes service provision of the care unit. Care Quality Commission carries inspection procedure to check if Royal United Hospital Bath NHS Trust is able to enhance the service provision and standards for better customer service. Service providers deliver different types of services to the care users as per their needs and demands which allows them to interact more with the clients and at the same time, it also promotes availability of different services to the public (Desombre, 2007). Apart from this, service users also play a crucial role in service provision since they acquire services from the care unit for different purposes which in turn help them to recover their condition with effective care and concern. Stakeholders of Royal United Hospital Bath NHS Trust are extremely concerned about quality related issues and aspects since through that only, the value of service provision can be boosted.

Stakeholders need to reflect concern towards the services so that they can also get maximum value from the services. At the same time, it is also seen that in the present case issues related to waiting lines are increasing as patients do not have much time to wait for acquiring services. This is also affecting service quality of Royal United Hospital Bath NHS Trust and this is also showcasing that there should be prominent facets for managing quality aspects in the services (Glasgow, Lichtenstein and Marcus, 2003). Thus for the same purpose, the care unit has taken various initiatives in terms of applying changes. To satiate the needs to service users, it is essential for Royal United Hospital Bath NHS Trust to shift cultural aspects so that social care practitioners can deliver prominent services to the customers

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1.2 Analyze the role of external agencies in setting standards

External agencies are the entities that aids Royal United Hospital Bath NHS Trust to enhance the value of services by creating more changes in service aspects. National Institute for Health and Clinical and Health care Excellence is the chief external agencies that inspects the value of services by regulating their own standards (NHS Staff Management and Health Service Quality, n.d). The care unit has determined much standards through which Royal United Hospital Bath NHS Trust can give additional benefits to the patients. Suppliers that provides services to the care home for meeting the needs and demands of the patients are also called as members of external agencies. Hence it can be said that external agencies are essential so as to set desired standards for service provision and as per that the care unit should manage their roles and responsibilities in effective manner. Hence for such purpose, CQC is also termed as the external agency which has yet maintained number of standards for improving the quality of services. 

Health Service Commission is the another entity that also aids Royal United Hospital Bath NHS Trust to increase the standards of services which maximizes the value of care unit. Families, carers and support workers also play crucial role in the same sector since they assist the care unit to identify the areas where improvements are required and as a result, maximum number of patients can be satiated towards the care provision (Nolan, 2006). CQC has also established several guidelines so that better care can be delivered and thereafter the commission also ensures that Royal United Hospital Bath NHS Trust is managing all the standards while practicing different cases. Thus to maintain the same, all such external agencies conducts regular inspection processes. 

1.3 Assess the impact of poor service quality on health and social care stakeholders

Poor service quality always impacts patient's health and at the same time it also changes the mindset of patients and as a result they switch to different care homes for acquiring better services. Hence it can be said that poor service quality is the only aspect that also reduces the value of services at Royal United Hospital Bath NHS Trust and similarly it also impedes the value of user and provider relationships (Kim and Ahn, 2002). In terms of poor service quality, patients and their families looses interest in the care unit which not only demotivates them but also affects their mental condition. As mentioned in the case scenario, the trust had faced significant challenges in the past year which affects service provision of the care unit. The patients have been complaining that they have to wait for longer period as staff members are least concerned about the pre-defined standards. 

Patient complaints have been increasing since staff members are not delivering proper services to the patients. Thus in terms of consequences, patients are unable to acquire services on timely basis. This up to some extent is also increasing mortality ratio and as a result, people are loosing their immediate family members. The case study has also revealed that due to poor quality services, patients are complaining more for better services which also leads to dissatisfaction among the service users (Desombre, 2007).  This could also reduce the value of services and service providers may also loose interest in delivering prominent care to the patients. Staff members remain busy in other aspects which in turn impacts the care facets and thus most of the time they are unaware about the facets and criticality of patients. Hence close and direct monitoring is required in subsequent unit so that the areas that produces least quality outcomes can be ascertained.

LO 2

2.1 Explain the standards that exist in health and social care for measuring quality

Quality is the major aspect that aids Royal United Hospital Bath NHS Trust to improve the level of services and this is also essential in terms of retaining patients for longer period. Thus in order to augment the value of services, the subsequent care unit has been using different approaches for managing quality aspects in service provision (Quality improvement in the NHS, 2012). The main purpose of quality facet is to increase customer satisfaction and also to promote the care unit in different places. In the below part, certain standards have been mentioned embodied with quality facets. 

  • With the help of quality standards, regulatory bodies can compare the efficiency of services and they are also required to assess the areas of improvements. 
  • Service users can also get distinct type of services as per their specific needs. Hence this also showcases how much the care unit is concerned about valuable aspects in services (Moss, 2012). 
  • The quality concerned bodies like CQC also determine rights and obligations of patients and up to what level care unit is considered it in service delivery.
  • The subsequent care unit also determines if the care providers are considering legal standards and all regulations.
  • With the help of such care practices, it has been seen that Royal United Hospital Bath NHS Trust has been managing resource allocation process in adequate manner and through this, the care unit can also develop the standards of service provision (Petch, 2012).

All the social care practitioners are required to inspect each and every thing about the service type so that continuous quality changes can take place. External agencies have also determined many standards to ensure that quality methods are being undertaken by the health care organization. In respect to that, NSF and National Institute for Health care Excellence have determined numerous measures for management of work processes. Therefore these quality standards can change the value of services and as a result, better outcomes can be accomplished.

2.2 Evaluate different approaches to implementing quality systems

There are various approaches that can be taken into account for managing quality systems consistently in service aspects.

Total Quality Management: Total Quality Management is the major facet through which Royal United Hospital Bath NHS Trust is able to maintain quality standards and they are also required to analyze the aspects through which areas of improvements can be diagnosed (Burau and Blank, 2006). Through such facet, the processes can be managed with zero defects. Here as per the approach, the care unit is required to set some benchmarks so that so that according to that, the level of services can be augmented. 

Benchmarking: Benchmarking is the method through which Royal United Hospital Bath NHS Trust can measure and compare the level of services it provides to the clients and specific service users. 

Continuous Quality Improvement: CQI is the commission through which care unit can inspect the quality of services through diversified approaches. Hence considering the significance of CQI, Royal Unit could acquire better outcomes by delivering prominent services (Desombre, 2007).  

In the present case, the care unit could execute Total Quality Management technique so that customer satisfaction can be acquired and quality service can be delivered. The approach should be applied on all the cases so that constraints and service errors can be eradicated from the service category. 

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2.3 Analyze potential barriers to delivery of quality health and social care services

It has been observed that Royal United Hospital Bath NHS Trust has been trying to deliver proper care and services to the patients; however there are certain barriers that affects service delivery. Here is the list of external barriers that has been impacting the delivery of service quality:

Inter-agency interactions: Interaction between different agencies can also impact the value of services as all emphasizes on different views and facets (Glasgow, Lichtenstein and Marcus, 2003).  

Inter-agency interactions: Interaction between different agencies can also impact the value of services as all emphasizes on different views and facets (Glasgow, Lichtenstein and Marcus, 2003).  

Social policy: Social policy is one of the core factors that impedes quality aspects and alongside that also changes service delivery and care facets.
Internal barriers

Interaction between people: Lack of adequate interaction between care practitioners and clients is also the another factor which impacts quality of health and social care services. 

Resources: The efficacy of service delivery is getting impacted since the care unit is not having appropriate amount of resources which in turn can also change the level of service provision. 

Organizational structure: Sometimes changes in organizational structure can also affect service quality as improper delegation of authority can change the scenario of services (Culture and behaviour in the English National Health Service: overview of lessons from a large multimethod study, 2013). 

LO 3

3.1 Evaluate the effectiveness of systems, policies and procedures used in a health and social care setting in achieving quality in the services offered

There are many systems in place for patients to have basic care needs embodied with planned, assessed and delivered services. NICE has developed range of guidelines so that different and specific needs of the care providers can be fulfilled. This is also useful in terms of managing client interest by delivering prominent services to the clients. Royal United Hospital Bath NHS Trust is also following Mental Capacity Act so that the patients of dementia and mental disorder can  be treated in effectual manner (Haskell and et. al., 2007). This allows the care unit to deliver prominent services to the patients and and as a result, service care entities are able to take suitable decision for the service provisions. This was also initiated for the purpose of reducing risk factor from the service aspect which sometimes affects service care. Proper management and leadership aspects have been taken into account so that proper services can be rendered to the patients and this is also useful in facilitating continuous improvement in service facets. Quality circles are also the essential ways which aids subsequent care unit to consider patient interest to higher extent. 

3.2 Analyze other factors that influence the achievement of quality in the health and social care services

While achieving quality aspects, Royal United Hospital Bath NHS Trust is getting impacted through  several forces among which some are being mentioned in the below study:

Funding: Apparently it is essential for every care entity to arrange funding systems so that quality aspects can be improved. Similarly in the present case also, if Royal United Hospital Bath NHS Trust has adequate amount of funds, then the care entity could achieve all the purposes of quality measures (Marriner and Raile, 2005). 

User of service expectation: Sometimes, service user expexts too much things from the care entities which is unusual to provide. Hence it can be said that the type of service is the major aspect that probably aids Royal United Hospital Bath NHS Trust to manage consistent improvement in health and social care services. 

The media: Media also influences quality dimensions in health and social care services as they are directly entitled in promoting the care services from several grounds. Irrelevant sources of media influences the patterns of services and as a result, it impedes the level of care and quality services.

Hence from the discussion, it is clear that achieving quality things is not an easy task since it requires funds and other necessary aspects for retaining the same standards (Kim and Ahn, 2002). 

3.3 Suggest ways in which the health and social care service could improve its quality

Royal United Hospital Bath NHS Trust has been facing varied problems such as long waiting lines, low level of staff engagement and regular complaints from the patients about the inability of staff members in meeting the requirements (NHS staff management and health service quality, 2011). Thus as per the prevailing problems, it is essential for Royal United Hospital Bath NHS Trust to undertake necessary measures.

First and foremost it is required for the staff members tog get involved in different services so that better services can be delivered and this is also necessary in terms of managing client interest. The staff members are also required to conduct meetings and seminars so that to acquire knowledge on innovative service types. 

Apart from this, the problem of waiting line should also be solved by creating more concerns towards the queue management (Moss, 2012).

Proper feedbacks should be provided to the patients as per their complaints so as to maintain their interest in the care unit. 

LO 4

4.1 Evaluate methods for evaluating  health and social care service quality with regard to external and internal perspectives

The procedure of quality assessment in health and social care must be non-stop so that providers and regulatory authorities can have better learning and better information regarding  future betterments. An crucial prospect is measuring the quality degree of both health and social care and public health participations. The employment and the facilities can be assessed through exploitation of Donabedian framework. It includes actions like Structure-Process-Outcome. It has been identified that the organization can focus on three components to render an effective quality assessment.

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 Structure - It find out the provision, facilities and employees that are accesing within organization. It includes -

  • The total volume of beds available in the hospital
  • The number of employees in hospital including doctors, nurses to each patient.
  • The availability of staff members at day and night hours (Nolan, 2006)

Process - This focuses on treatment and care which is provided to service user.

  • The record system and maintenance of service user information and also detail of injury
  • The procedure of diagnosing
  • Credibility and dependability of diagnosis
  • The time consumption in diagnosis
  • The degree of patient involvement and relation among user or professional.

Outcomes - This find out the skilfulness of attention that is rendered to service users in way of  advancement in health -

  • Betterment in patient status
  • Number of complications
  • Service user satisfaction degree
  • Expense effectiveness over care

The number of authorities are having focus on better evaluation and in the support of this, organization has formulated various regulations and standards that can provide better assessment. Other than this, the feedbacks from patients is also helpful to measure the applicability of correct standards in health care organization (Petch, 2012). The authorities also collect data regarding attachment of quality programs which provided by organization top management. It collects information about diligent guard, health result from attentions.

4.2 Discuss the impact that involving users of services in the evaluation process has on service quality

It has been identified that the involvement of service user in organization evaluation process have great impact on working and development of quality services. In the support of this, it can also be said that the involvement of service users in the assessment procedure might create contrastive outcomes as compare to other assessment process. It may because the persons are services users that attain the treatment as they are more clear about the needs (Watson, 2007). If organization will have proper involvement of service user in process then the organization will attain proper need identification. It has identified that the better need identification can facilitate in quality improvement. For example, the patient visit the hospital for treatment he failed to get proper treatment. If in this case, the organization will user involvement then organization will able to know the need and that will improve the quality of service. 

It is necessary for organization to have involvement of  service users for better improvement of quality services. It is because the service users are receivers of treatment so they can render better explanation regarding issues and needs. 


The service provision of Royal United Hospital Bath NHS Trust is getting impacted through number of aspects amid which some are being mentioned in the study. Hence, lastly researcher has discussed several suggestions through which Royal United Hospital Bath NHS Trust could improve the level of service quality. 


  • Burau, V. and Blank, R., 2006. Setting health priorities across nations: More convergence than divergence. Journal of Public Health. 27(3).
  • Desombre, T., 2007. Healthcare Management. International Journal of Pharmaceutical and Healthcare Marketing. 1(1).
  • Glasgow, R. E., Lichtenstein, E., and Marcus, A. C. 2003. Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261-1267.
  • Haskell, W. L., and et. al., 2007. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation.116(9).
  • Kim, N. S., and Ahn, W., 2002. Clinical psychologists’ theory-based representations of mental disorders predict their diagnostic reasoning and memory. Journal of Experimental Psychology: General. 131.
  • Marriner, T.A., and Raile, A.M., 2005. Nursing theorists and their work. 5th ed. St Louis: Mosby.
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