PRU Quality, Safety and Outcomes of Health and Social Care

Project Description

Having a high quality, safe NHS and care system is more important than ever. The Government is committed to ensuring that the health and care system puts patient safety and quality at the heart of everything it does. Research can help to work out the best ways to deliver these aims.

This proposal brings together researchers from Universities of Kent and Oxford and the London School of Hygiene & Tropical Medicine with experience of research into quality (including patient safety, how well treatments work, and people’s experiences of their care).
Our aim will be to use research to help guide health and care policy so that it can deliver improvements for patients, service users and their families, prioritising their views in the research. We will use robust scientific methods and draw on a range of perspectives.
The NHS is becoming more integrated across hospital, ambulance, general practice and social care services. It is increasingly putting patients and people at the heart of the system, with services working to people rather than people adapting services. Recognising these changes will be at the core of our research.

Key questions
Our proposed research programme is based around five policy questions - First, are appropriate measures being used to monitor quality? We will review and assess whether existing quality indicators work as the system becomes more integrated, and also propose new ways to ensure we understand whether NHS/social care are producing high quality care. Second, what can we learn from specific incidents of poor quality (especially safety)? Failings will occur but are the mechanisms in place to learn from those incidents? We will analyse new arrangements for reviewing deaths in hospital, and assess what the data on patient safety can tell us. Third, what can we learn from the variation we see in quality indicators across England? We will analyse the causes of these variations, accounting for differences in the health and affluence of populations. The answers will help us make recommendations to reduce the unwarranted variation. Fourth, can we identify effective approaches to improve quality? Approaches have been developed to improve the effectiveness of care (e.g. auditing clinical effectiveness) and safety (e.g. infection control, surgical procedures, understanding of ‘human error’). We will gather evidence of how well they work, and assess how far they are actually used in practice. Fifth, what are the best ways of dealing with the consequences of poor quality? When adverse events occur we need sound policy to deal with the consequences, particularly for patients. We will review policies for ‘resolution after harmful events’ that seek to minimise the need for litigation.

How we work - We will develop a comprehensive programme that also has the facility to respond to short-term policy needs. We will: use a well-developed strategy for public involvement in the research, consider fairness and inequality issues, and work closely with policy-makers. We propose a collaboration of experts with different scientific backgrounds, building on past experience to ensure the Unit works in a timely and effective way.