Q member, Mirek Skrypak has recently started in a new role as Director of Quality Improvement at NELFT NHS Foundation Trust – and helping to embed a Quality Management System (QMS) is a key task for him.
In this session he discussed his ‘Quality’ challenge with QMS experts, including Dr Tom Rose.
Is a full ISO 9001-based QMS a realistic and appropriate goal in trusts?
ISO 9001 is defined as the international standard that specifies requirements for a QMS.
Dr Tom Rose argues that the ‘Quality’ of NHS services is already reasonably well defined nationally through regulations, NHS England Specifications, NICE Guidance, GIRFT publications, CCG ITTs, University research and even the World Health Organization publications. So the targeted Quality Standard is available, but what is most clearly missing is not Quality Improvement (QI) but good service design, good implementation and efficient and effective Continuous Improvement (CI) of the service delivery processes. The NHS Long Term Plan (LTP) itself calls for service re-design, and infers that this service re-design will emerge as a result of QI activity. This approach is not consistent with Quality Management principles and is not the most effective and efficient way of achieving the aims of the LTP.
Some departments, like Pathology and Radiography have, and will always have, their long-standing QMS but large areas of the NHS have never done any Quality Management, eg clinics and wards etc.
Trusts or Integrated Care Systems (ICSs) for example, usually have no joined-up QMS, but could create a trust-wide Quality Manual (to include policy and the structure of the QMS) with each department having a Process Management Manual, which details that department’s key processes ie ‘how you do it’ (preferably in a process map format, with supporting procedural documentation including quality control aspects). It may take 15-20 years for a trust to get all departments up to ISO 9001 requirements level, meaning that a long-term plan is needed. A top-down and bottom-up approach may work, suggests Tom, with a Quality Management Department at the top and establishing a Process Management System at the bottom.
Other expert panellists will present their own differing views on how to implement Quality Management and the pros and cons of aiming for an ISO 9001-based QMS. There is no suggestion here that the QMS should be certified to the full scope of ISO 9001 nor that external certification bodies should be used.
This session is organised by Q’s Quality Management in Healthcare Special Interest Group – join the group.
Bio
Dr Tom Rose
Tom, a Chartered Engineer (MIET) and Chartered Quality professional (MCQI), has been associated with Quality Managements Systems since the days of BS5750 in the 1980s. He has designed and implemented Quality Management Systems, including the requirement for TickIT, the software design quality standard, for a number of design and manufacturing organizations, and is a qualified ISO9001 external auditor, including the TickIT standard. He has taught and Assessed the Business Improvement Techniques NVQ.
He gained a PhD from Cranfield University with research into Business Development in 2003. Since joining the University of Birmingham as a Research Fellow six years ago he has been researching Process Management in the NHS and also doing a bit of lecturing in healthcare improvement.
Jem Ramazanoglu
Jem joined the NHS in 2008 as a Graduate Management Trainee. He joined the NHS Institute for Innovation and Improvement in 2010, delivering QI training and improvement support as part of the Productives, ThinkGlucose and Organising For Quality and Value (now QSIR) teams. He joined CLCH in 2012 to support the development of improvement capacity and capability and has led the Trust’s Quality Improvement workstream since 2014. During this time, Jem has helped grow the Trust’s interest and ambition to embed continuous improvement. Having spent the last year piloting the introduction of a Quality Management System within the QI function, he is currently supporting the development of a CLCH Quality Management System. Jem is also a co-convener of a QMS Implementation Leads network, bringing together people responsible for QMS implementation to share learning and provide mutual support.
Emma Adams
Emma is an improvement consultant and coach, specialising in the strategic development and management of quality within health and social care. Emma supports organisations to develop their strategic approaches to improvement – through deployment and execution of strategy, embedding of daily continuous improvement, and through structured improvement projects. She also coaches and trains staff in quality improvement and delivers hands-on improvement across many healthcare settings using a variety of techniques and approaches.