Learn News Opinion

Regulation now – regulation tomorrow

Alan Rosenbach Sector Commentator

“We will develop new fundamental standards that focus on these five areas. We will work with the public, people who use services, providers and professionals, and our partners to do this. We have a real opportunity to make a difference and will work with pace, passion and determination to do so”.

 “We received widespread support for our plans, which are organised around our five priorities for improving quality of care and outcomes for people who use services…This gives us a unique opportunity to make a real difference for people, by working with a range of organisations in these sectors to drive improvement in local care services and in how well they work together”.

These are two extractions from Care Quality Commission statements of intent although separated by a number of years. Can you work out which CEO and Chair made these statements and when?

The point is not to judge this system regulator but simply to point out that there is a paucity of imagination and creativity in health and care regulation.  It is like Hollywood making endless remakes of classics because of lack of talent.

The field of health and care quality, safety and improvement covering both organisational and individual practice is cluttered (see diagram below

Quality Safety & Improvement Players

In an era where data and information is transforming everything we do, the world of organisational and professional regulation is ripe for this kind of modernisation and imagination.

The NHS is drowning in data. It suffers from the affliction that it is data rich and information poor. What is needed is an organisation with the staff that have the skills and capability to analyse and interpret quality and safety data. The capacity to do this in real time and feed it back to staff in hospitals, community services and general practice is the answer. It should also be packaged up for the public. Such an approach provides an up to date moving picture rather than a static picture taken at a moment in time. It ensures a vibrant approach to quality, safety and improvements.

The care sector on the other hand is data poor and information poor although there are some organisational exceptions. Many providers have recognised that capturing data to drive quality, safety and improvement is vital. There should be a mandated minimum data set that all care providers must collect that is flexed to take account of size of service. It will be proportionate. As with the NHS an agency will be responsible for analysis and interpretation and real time feedback.

On top of these developments the need to develop the Artificial Intelligence offer is crucial. The capacity to analyse big data for predictive purposes linked to risk for both health and care is the obvious benefit.  Additionally AI capability will allow for linkages between need and staffing allocations.

The role of professional regulators would also be restructured as real time data and information about staff behaviours linked to quality and safety patterns.  Professional regulators would be forced to act in a more timely way.

If you revisit the diagram and consider the complexity of the system engaged in quality, safety and improvement it is only reasonable to assume we should be handling these issues in a more coherent way that is fit for this and future stages of the 21st century.


Edel Harris





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