If you don’t understand what Quality Planning, Quality Improvement and Quality Control are then you will never close the Quality Gap. This is NOT the same Quality Improvement as the QI undertaken by the NHS. The NHS have NO Quality Planning and NO Quality Control as described by Juran.

I’m loving these conversations! I’m pretty new to healthcare QMS coming from a frustrated former risk manager, i’m learning a lot form these posts and just ordered my Juran Quality Handbook.

Really enjoyed the quality gap model graphic @peterdudgeon thank you

Hi Both. Tom, If there is no gap between patient need/service expectation and service delivery/perception of delivery, we can all pack up and go home (have I understood you correctly?) Of course that gap exists, that gap is a universal truth. The issue is that – without QMS – we cannot understand that gap or seek to close it. When you say Juran’s Trilogy is non-existent in the NHS, that is largely true. It’s also true to say that in some pockets (e.g. some of the regulated and accredited areas you mentioned – support services in Moorfields is a good example) there are strong illustrations of ‘say what you do and do what you say’. In terms of the Juran Trilogy, where these areas tend to be less strong is in understanding needs and designing for those needs. That said, if the wider NHS ‘said what it did and did what it said’, that would be a great start to building towards robust quality management systems. I fear that good design requires skilled people, who – in political terms – are ‘not front line’ and therefore not valued by the general public. Investing in these people, will be quite the sell! I’m hopeful but realistic about that. All the best.

This is a very interesting discussion to follow. While discussing various management systems, such as QMS, IMS, or ISO 7101, it’s noteworthy that Denmark abandoned accreditation nearly 10 years ago. This decision offers valuable insights for the UK Government and the NHS. The challenge lies in the complexity of these systems, and there is no one-size-fits-all solution. A broader perspective, beyond departmental, specialty, and organizational levels, is necessary.All management systems are designed with the best intentions, but how do we ensure we are interpreting the standards correctly to foster learning and continual improvement, rather than merely engaging in a compliance exercise? As George Box said, “All models are wrong, but some are useful.” This provides much food for thought.For further details, you can refer to the discussion on quality and safety in Denmark below:

Quality & safety in Denmark: 7 years after the end of accreditation