Quality matters – even when no one is looking

Clenton Farquharson MBE, is chair of Think Local Act Personal,

Clenton Farquharson MBE, is chair of Think Local Act Personal, and a disabled person. He is a member of the NHS Assembly, current chair of Quality Matters, trustee of the Race Equality Foundation, and ambassador for Disability Rights UK.

“The thing people really care about is the quality of the care that they receive,” said Matt Hancock, the health and social care secretary, at a recent Local Government Association conference.

But what is quality? Can we define it, can it be measured and, most importantly, how do you provide it?

These are questions I asked a couple of Think Local Act Personal (TLAP) colleagues the other day. TLAP’s view is that quality should be defined more by people than the system. Understanding the quality of care is all about understanding how people are made to feel, and above all it’s about people rather than things.

An example from my own experience was a time when I was in hospital for an eye condition, unable to see, and worried that I was going blind. The doctors did a brilliant job on the eye, and I couldn’t fault them for that, but they missed the personal touch. It took a health care assistant who could see that I was terrified to demonstrate the kindness and compassion that is the real hallmark of quality. He just put his hand over mine, and told me he was there for me if I needed him.

Keeping people at the centre 

As well as being chair of Think Local Act Personal, or TLAP for short, I am currently chair of the Quality Matters board, a government project designed to inspire high quality adult social care across England. I think it’s really important that people with lived experience are front and centre of this important initiative. The focus of my tenure will be to remind people that quality is fundamentally about people, relationships and lives, rather than key performance indicators. That’s not to say KPI’s aren’t important, but it shouldn’t be a choice between one and the other. Quality for me is about keeping people at the centre.

My ambition is to ensure that quality is fundamentally grounded in people’s experience, so that their experience directly informs practice. In other words, the sector needs to recognise the need for co-production as a pre-requisite for embedding quality.

Co-production leads to better outcomes for people

Co-production is based on the premise that the people who use services are best placed to help design them. Done well, it represents a shift in the relationship between services and people, transforming people from passive recipients to equal partners in design and delivery of services. It focusses on what matters to people.

One way to make sure that we are hearing what matters to people is through TLAP’s Making it Real. This sets out what good care and support looks like, both from perspective of people who access services and those who work in them. Making it Real is for organisations and individuals, to help you think about what’s happening locally and what needs to change. Co-production runs as a thread through Making it Real, to ensure that people’s own experiences can support improved planning and decision making at the strategic level. People’s lived experience should inform policy and practice – and result in better quality.

When Quality Matters was being developed, TLAP organised an event for people with lived experience to build a consensus on quality and how we can work together to improve it. The graphic shown here illustrates the conclusions we came to on that occasion. So much of this still resonates with me today – and is the inspiration for this article’s title.


Edel Harris





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