analyse how organisational system and processes are managed to promote participation and independence of users of health and social care
Clinical governance is a key strategy of evaluating patient care within the United Kingdom health and social care system. Organisational systems such as the Care Quality Commission (2016) and the National Institute of Clinical and Health Excellence (2016) set the standards of patient care, which health and social care providers must attain to demonstrate accountability and professionalism (Royal College of General Practitioners, 2007). With a shift to patient involvement and person-centred care (Rogers, 2012), organisational processes such as clinical audits, patient feedback surveys, and complaint processes are utilised to ensure that the care delivered, is consistently meeting expected patient outcomes, national guidelines and patients’ expectations (Dixon and Quest, 2010). Through involving service users in clinical governance systems and processes, the aim is that health and social care practice can be determined by the service users’ needs, choices and experiences; fostering greater independence and inclusion of service users in decision making processes (Darzi, 2008; Department of Health, 2013).
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High profile inquiries such as the Shipman inquiry (Smith, 2004) and the Bristol hospital case (Weik and Sutcliffe, 2003) reveal however, that organisational processes – such as the effective sharing of information – do not always ensure patient safety and service users’ best interests. However, through engaging in processes such as critical event analysis and multi-disciplinary case reviews, service users can participate in decision making processes, which can facilitate an audit of the timeline of events, to ensure accountability and to reduce the risk of similar care failings occurring in future practice (Smith, 2004; HMSO, 2007: Grol, 2008).
Care Quality Commission (2016) CQC. Retrieved from: http://www.cqc.org.uk/ (Accessed 2nd June, 2016).
Darzi, A., (2008). High quality care for all: NHS next stage review final report (Vol. 7432). London: The Stationery Office.
Department of Health (2013) NHS Constitution. London: DoH.
Dixon, N. and Quest, H.Q., (2010). Guide to involving junior doctors in clinical audit. HQIP, Healthcare Quality Improvement Partnership.
Grol, R., Berwick, D.M. and Wensing, M., (2008). On the trail of quality and safety in health care. British Medical Journal, 7635, 74.
Her Majesty’s Stationary Office (2007) Learning from tragedy, keeping patients safe Overview of the Government’s action programme in response to the recommendations of the Shipman Inquiry. London: HMSO.
National Health Service England (2015) NHS services England complaints procedure. London: NHS England.
National Institute of Health and Clinical Excellence (2016). NICE. Retrieved form: https://www.nice.org.uk/ (Accessed 2nd June, 2016).
Rogers, C., (2012). On becoming a person: A therapist’s view of psychotherapy. Boston: Houghton Mifflin Harcourt.
Royal College of General Practitioners (2007) Clinical Governance. London: RCGP.
Smith, D.J., (2004) The Shipman Inquiry, Fifth Report – Safeguarding Patients: lessons from the past – proposals for the future. Norwich: HMSO.
Weick, K.E. and Sutcliffe, K.M., (2003). Hospitals as cultures of entrapment: a re-analysis of the Bristol Royal Infirmary. California Management Review,45(2), 73-84.
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