Current Topic:
Practice Development – Part 1 – Developing a practice initiative in Oncology and Palliative Care
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Abstract
Healthcare services have been changing at an amazing speed over recent years, in part due to demands from society for improvements in clinical care and equality in provision. In the United Kingdom, some serious clinical failings, such as variations in breast cancer treatment, have been publicised widely, helping clinical quality to evolve into a public confidence issue.
Quality first arrived on the UK government agenda in 1990 in two white papers; Working with patients, (Department of Health 1989) and Care of people, (Department of health 1989). Both of these papers addressed care in the community, and were released under the previous government where a market economy approach was prominent.
With a change in government in the UK from the Conservative to the Labour party, came major changes in the National Health Service, described as the ‘Modernisation Agenda’. The internal market, which had been established by the previous government, was abolished and plans to modernise the NHS – with the emphasis on quality care for the patient, were laid down. The consultation paper A First Class Service; Quality in the new NHS (Department of Health 1998) detailed proposals to support the delivery of consistent, higher quality care for patients. Four further papers followed, which addressed local issues within each of the four countries comprising the UK. These were: The New NHS, Modern and Dependable (Department of Health, 1998) in England, Designed Care (Secretary of State for Scotland 1997) in Scotland, Putting Patients First (Secretary of State for Wales 1998) and Fit for the future (Department of Health for Northern Ireland).
At the same time as changes in the NHS, modernisation within social services was addressed within the white paper Modernising Social Services (Secretary of State for Health 1998), through which vulnerable people in society would be better protected, and standards of care raised.
In your own practice there will have been changes driven by this agenda for change, but perhaps the most influential to those in Oncology is the introduction of National Service Frameworks outlined in The New NHS: Modern and Dependable, which has resulted in defining the standards for the delivery of care. The same white paper introduced accountability for maintaining these standards through Clinical and Research Governance policies, and evaluation of outcome through the Commission for Health Improvements, now called the Healthcare Commission.
Clearly, much of this influence on the development of clinical services has been political and the political influences outside of the UK may be different, the underlying principles will be recognised and applicable to most countries.
The main aim of this module is to provide you with knowledge and understanding of the history, process and development of a practice initiative. Upon completion of the module you will be able to critically review these influencing factors within the context of oncology / palliative care, and more specifically, within your own clinical area. Furthermore, we hope that you will have the knowledge to implement a change in your practice and part 2 of this series considers evaluation of its effectiveness through audit.
Discussion
Comment Submitted By: Ms Pat Webb
Date: 22nd May 2007
This is a very helpful discussion board site. I hope many people will contribute so that we can have a lively discussion about this topic. Thank you!
