As part of our ‘What If’ series on change in the NHS, we spoke to Governance and Risk Management Specialist Amanda Allen and asked her: “Putting all politics aside, if you could change one thing about the NHS, what would it be?”
If I could change one thing…
The NHS is steeped in history and tradition, and has a strong surrounding infrastructure to support regulatory compliance, but sometimes this can lead to compartmentalisation of roles. I would change the way we think about clinical governance and how it sometimes gets separated out from operational and financial activity.
The return on investment to be gained from the implementation of a robust governance framework can get overlooked in times of competing financial priorities and strict budgetary controls. The commercial and reputational impact of poor CQC compliance ratings is well understood, but the strategic benefits to be gained from high-end assurance activity can be less well explored.
Let’s look at the CQC Domain Effective. Many people limit the definition of ‘clinical effectiveness’ to patient outcome, and debate on this is often consigned to the clinical directorates, but an integrated approach when discussing effectiveness of a service or intervention across finance, operational and clinical departments enables this concept to be explored more holistically.
For example, business cases for introduction of new technologies frequently cite research-based outcome data to secure funding. However, this does not mean that the same outcomes might be achieved by that organisation. What is the population health profile like? What environment will the technology be deployed into? How would the patient outcomes impact be measured financially? What other innovations might need to be abandoned to enable the business case to succeed? When we think ‘clinically effective’, should we not also think what would be most ‘operationally and financially efficient’ for the patient, the healthcare organisation, and the wider population together?
Amanda is a PRINCE2 qualified Senior Healthcare Leader & Clinical Governance and Risk Management Specialist. She is expert in transforming operational processes across Healthcare to strengthen regulatory compliance and clinical effectiveness
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