Why quality of care reviews for care assurance are a priority

Quality of care (QoC) reviews are essential for ensuring that people in receipt of healthcare receive high-quality, safe, and effective person-centred care. These reviews help determine if patients’ needs and outcomes are being met. The Excellence in Care (EiC) programme provides a structured approach to QoC reviews, promoting continuous learning and improvement at a local level. By using the tools and resources provided, local teams can better understand care standards, identify factors impacting care delivery, and determine where support is needed. This process ultimately leads to improved experiences and outcomes for patients, their families, and the healthcare workforce.

A Quality of Care (QoC) review may be needed in the following situations:

1. Scheduled Proactive Reviews: These are planned reviews conducted regularly to ensure ongoing quality and safety in care delivery.
2. Responsive Reviews: These are initiated in response to specific triggers, such as:
   • Positive quality and safety indicators, like sustained quality improvement activities or positive feedback from service users.
   • Patient safety issues where the quality of care has been or may be compromised.

These reviews help identify areas for improvement and ensure that high standards of care are maintained.

As the national care assurance programme, Excellence in Care (EiC) has provided a structure to inform a consistent approach to QoC reviews at a local level, in order to drive continuous learning and improvement (For further information see EiC framework in supporting resources). The tools and resources within the sections will support local teams to gain a deeper understanding of the standards and quality of care being delivered, the factors impacting on care delivery and where support might be required, while taking account of the need to make effective and efficient use of the workforce and resources. Ultimately this will result in improved experiences and outcomes for patients, their families and the workforce.

The sections have been written with the expectation that a multi-professional approach will be used when undertaking a QoC review, in recognition of the fact that care is delivered by multi-professional teams and to ensure a supportive and collaborative organisational culture. The local sponsor of the QoC review should identify staff with the appropriate knowledge and skills, as required by the scope and complexity of the QoC review, to lead the process. The scope will determine if a care assurance visit (CAV) is part of a wider QoC review or whether it is undertaken as a standalone process.

The frequency and format of QoC reviews can be determined locally within boards, who might consider a scheduled proactive programme of QoC reviews alongside a programme of responsive QoC reviews. Responsive QoC reviews might be undertaken to learn from clinical areas with a range of positive quality and safety indicators such as sustained quality improvement activities and positive feedback from people using a service or in response to patient safety issues, where quality of care has, or may become compromised.

A small number of key quality and safety indicators have been identified for each element of the EiC framework, along with possible sources of information to inform these care assurance processes. Using local knowledge and expertise, a number of other relevant speciality specific quality and safety indicators may need to be considered for inclusion. The number and combination of elements to be included is determined by the professional judgement of those undertaking the QoC review and as indicated by the scope of the QoC review.

While it is recognised that boards may have developed their own templates to capture information for a QoC review, this guidance identifies a standardised approach and key considerations when planning and undertaking a QoC review by detailing the approach, method and tools to be used.