Can Clinical Quality be Taught?
One of a series of positive recommendations from recent weeks was the commitment from the Keogh Review to invest time and effort into clinical leaders in the NHS and build capability for quality. As the academy designs specific interventions, we think there are 2 specific areas that need to be part of their development programme.
The first is to develop the skill of navigation and prioritisation. Although everyone agrees quality is paramount, the assurance framework in the NHS is complex and fiercely prone to fragmentation and risk.
How would you coach a clinical leader to prioritise interventions and actions against this assurance framework and more importantly build relationships across this continuum? This should be the first topic for the NHS Leadership academy’s Clinical Leadership Programme.
“Navigate Complexity, Inspire Confidence and Influence”
The second key development area is how clinical leaders can inspire confidence and influencetheir general management peer group and work on their decision making. Many of the 14 hospitals in the Keogh Review had made salami slice cut backs to clinical and administrative staff without adequate reference to impact upon quality and continuity of care. Many of the 14 had been negatively influenced by one dimensional and enforced professional services advice over a sustained period of time.
“A quality impact assessment is more than a tick box exercise and many clinicians did not have the influence to combat transactional cost improvement processes that did not improve clinical quality or value.”
Many general managers and financial leaders struggle with the concept that high quality services are more valuable, endure reduced levels of clinical variation and can cost less.
The leadership development programme must ensure that clinical leaders can influence Boards topromote the fact that if they pursue quality and access, efficiency will improve. Not the other way round.
In fact when strong hospitals are considered, their key features are evident and universally understood by the majority of clinical leaders.
So our question to the first intake of clinical leaders could be:
What skills do you need to ensure that you influence your organisation to:
……….understand that cost reduction should be the consequence of its efforts and not its primary goal?
………foster a shared philosophy that quality and patient care comes first?
……….systematically benchmark clinical quality against external benchmarks and report the data in a meaningful way consistently prosper?
………..put greater emphasis on and makes investments in changing processes to reduce clinical variation, hasten patient flow, match staffing need and reduce mistakes and errors improve clinical performance?
………….promote better outcomes that will lead to lower costs for the hospital and better value for commissioners?