An Important Step Forwards for Quality Improvement in Wales – Dr John Boulton

Earlier this month, on the 3 June 2020 the Welsh Government announced that The Health and Social Care (Quality and Engagement) (Wales) Bill had received royal assent, with the expectation that the Bill will be implemented within the coming two years. This is great news for Wales in ensuring that Health and Social care systems continue to strive to provide high quality services and outcomes for the people that they serve.

For over a decade quality improvement has been a major focus for many healthcare systems across the globe. During that time Wales has been very active in embedding the ethos of improvement into the system with, for example:

These are all great examples of a focus on quality, and support the improvement agenda. The bill very helpfully reinforces this focus on quality improvement. However, in implementing the bill it is clear that quality must be a system property, not a department or directorate. It has to be the business of the organisation. In achieving that, there will need to be a holistic approach to managing quality effectively. One that encompasses quality improvement, quality planning and quality control. And we must receive assurance that these elements are in place. I believe the Bill helpfully supports this notion.

From a Quality Improvement perspective quality has long been defined as being safe, timely, effective, efficient, equitable and person-centred. It would be hard to argue that these are not useful dimensions to defining quality, and ones that have been used for over two decades. However, they do appear to be health system focussed. Looking back through the literature, there are many definitions of quality with most not providing so much detail as above.

At the most basic those definitions are ‘meeting or exceeding customer need’. I like such a definition as it brings in the voice of the customer. The bill does just this, ensuring that the citizen voice is front and centre stage, and that we as health and social care organisations are more effectively responding to their need.

I look forward to working closely with my team and partner organisations to take this work forward as we move past the pandemic in the months to come. There’s a lot we can achieve together for the people of Wales.