Patrick Keady

NHS National Quality Board – interim report

HSJ reported today that there is lack of information on the safety and effectiveness of much NHS care and that this has been spelled out in an interim report from members of the NHS National Quality Board.

One of the NHS’s prevailing beliefs seems to be, that individuals will perform better and their organisations will flourish …. when we reward the behaviours that we seek … and punish the behaviours that we dislike. This approach works well for simple, routine, rule-based work.


But NHS workers undertake other types of work, where non-routine creative and conceptual capabilities are also required.


I believe that Quality in the NHS will improve significantly when PCTs and Trusts demonstrate to their staff, that they understand what it is that really motivates their employees – the motivation of making progress in their work, improving quality and the simple satisfaction of getting better at what matters.


We know that businesses with transcendent purposes survive and continue to deliver excellent services to their customers. Too bad that ICI, Boeing and some of the large banks focussed too much on targets, and too little on purpose.


NHS targets are good. They continue to challenge clinical teams and Trusts. They have played a key role in improving the NHS. But more and more we are seeing that targets, potent as they are, can be an insufficient impetus for NHS staff and organisations. They do not get everyone leaping out of bed in the morning and racing to the wards, patients homes, theatres and meetings …. to do deliver excellent patient care.


The BBC’s Panorama team discovered earlier this year, that Trusts were incorrectly assessing performance, potentially distorting their standing in the CQC’s Annual Health Check. 17 out of the 28 Trusts visited by the CQC in 2009, made incorrect assessments. Did Mid-Staffs and Maidstone & Tunbridge Wells focus too much on targets, and too little on purpose?


While much has been written on aspects of Quality in the NHS, I would like the outputs from the NHS Quality Board to be short and to the point. To focus on Quality outcomes from the perspectives of the Treasury/National Insurance contributors, patients and employees.


And while the NHS focuses on purpose, that its satisfied employees will be racing to the wards, peoples homes, theatres and meetings …. to continue doing what motivates them best – making progress in their work, improving quality and the simple satisfaction of getting better at what matters.



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