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NICE

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NICE Launches Quality Standards for UK's National Health Service

The first set of quality standards sets out a vision of what high-quality care should look like for patients on the NHS.

Published: Tuesday, July 6, 2010 - 13:01

(NICE: London) -- Some 150 clinical areas will eventually have their own set of quality standards, with the first three standards published on June 30 covering the treatment and care of stroke, dementia, and venous-thromboembolism (VTE) prevention. The new quality standards are a series of concise statements that show what high-quality care should look like for these conditions, and are sourced from the best available evidence such as  National Institute for Health and Clinical Excellence as (NICE) guidance, or information accredited by National Health Service (NHS) Evidence, which provides free access to the quality-assured, best-practice information required to inform evidence-based decision making quickly and easily.

“Arriving at these quality standards is an absolutely critical thing to do,” says Health Secretary Andrew Lansley, in Brighton. “I want the NHS to focus on better health outcomes, providing a service that better reflects what is important to patients, and builds upon clinical evidence. Quality standards give an authoritative statement on what high quality NHS health care should look like in relation to dementia, stroke, and VTE prevention. It will, in [the] future, support a service which is focused on outcomes and looks for the evidence on how to achieve continuously improving outcomes.

“This advice will be used by the NHS to commission and provide high-quality and cost-effective services. It will increasingly, with other quality standards in [the] future, be a basis for commissioning, for designing incentives for quality, and relate to quality inspection. Whilst these standards identify processes, they will not be seen as processes in isolation from each other, or from the outcomes achieved. With clinical sign-up, they are a basis for supporting clinical judgment, not distorting it,” adds Lansley.

“What we have been able to do is to express really concisely in a limited number of statements what constituents a really high standard of care for patients,” says Sir Andrew Dillon, chief executive of NICE. “If those who are providing the services are performing well against these standards then they can be confident, and we can be confident, that we are going to get that high quality care, and that we are going to end up with the outcomes we expect from the NHS.

“But they are not just designed for the NHS. They are as much for the public and they have been written in a way that, we believe, will allow the public to get an understanding of what they can get as an individual if they need support on the NHS. It’s a way that they can hold the NHS to account for the delivering of high quality care,” Dillon adds.

Sir David Nicholson, chief executive of the NHS, adds that the development of the quality standards would benefit from the huge experience of NICE and the methodologies that they use.

Dr. Tim Kendall, who led development of the dementia standard, says that it would help transform the experience of dementia patients but also support caregivers. “Some [caregivers] suffer far more than they should. People with dementia effectively die while the person caring for them watches them disappear,” he says.

The dementia quality standard would also help to reduce the number of patients on antipsychotic drugs. “When someone’s behavior becomes challenging, those who are caring for them should look for the factors that might be causing this and address those problems,” adds Kendall. “They should also be trained so that they can deal with challenging behavior so that they do not need to offer antipsychotics. If people with dementia are given good quality care, then the use of antipsychotic drugs should drop.”

“These quality standards distill the key elements of stoke care that every patient should receive,” says Dr. Tony Rudd, who chaired the Stroke Topic Expert Group. “I’m very excited about the quality statement based around offering patients active therapy. At the moment, some patients are not receiving any therapy and are just doing nothing. But driving up the amount of therapy that people get has a huge impact on outcomes.”

Professor Gerard Stansby, chair of the VTE prevention Topic Expert Group, says that the standard would be central to the care of patients with VTE, a condition that kills more than 20,000 people a year.

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About The Author

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NICE

The National Institute for Health and Clinical Excellence (NICE) is an NHS organization based in London and Manchester. NICE provides guidance, sets quality standards, and manages a national database to improve people’s health and prevent and treat ill health. NICE was set up in April 1999 to ensure everyone has equal access to medical treatments and high quality care from the NHS regardless of where they live in England and Wales.