New standards for safer better healthcare

Healthcare managers will have a central role to play in successfully implementing the new HIQA National Standards for Safer Better Healthcare, writes Dr. Deirdre Mullholland.

Following the recent launch of the National Standards by the Health Information and Quality Authority (HIQA), attended by over 200 health service managers, staff, and patient representatives, HIQA plans to meet with and talk to healthcare providers on how to meet the new requirements.

Deirdre Mullholland
Dr. Deirdre Mullholland

The Standards will form the basis for future licensing of all healthcare facilities in Ireland, both public and private, and are aimed at substantially improving healthcare services for patients, but they recognise the challenges faced by those providing services, including management.

The National Standards aim to empower managers to lead, and require every service provider to have a designated and clearly identified individual with overall executive accountability. Where a service provider has a governing board, the board has ultimate accountability for the quality and safety of the services provided and, consequently, the implementation of the National Standards.

Scope of National Standards

The National Standards take immediate effect for Health Service Executive (HSE) funded and provided services. While HIQA’s remit does not currently cover private healthcare, representatives of the independent hospital sector were involved in developing the National Standards and HIQA acknowledges the desire from this sector to be involved in the implementation of these Standards. It is anticipated that private providers will adopt these National Standards voluntarily in advance of proposed statutory licensing.

Healthcare managers will have a central role to play in successfully implementing the new National Standards for Safer Better Healthcare.

Later this year, HIQA will begin a phased monitoring process against the Standards, and in the middle of next year will began a substantive monitoring process, initially in HSE acute hospitals and the National Ambulance Service.

Implications for managers

There are 45 standards in the National Standards for Safer Better Healthcare. These are organised into eight key themes which reflect the most important themes in the context of Irish health services, ranging from person-centred care and support to workforce and use of information.

Managers will play a key role in demonstrating compliance with the National Standards. Given that the National Standards are new to the healthcare system in this country, in the near future HIQA will launch an awareness and education campaign with key healthcare providers and will develop and publish guidance on how managers and health service staff can implement the Standards.

To illustrate what is expected of services under the new National Standards, some examples of the themes are discussed here.

The National Standards aim to empower managers to lead, and require every service provider to have a designated and clearly identified individual with overall executive accountability.

HIQA has on a number of occasions found that good leadership, governance and management makes a crucial difference to standards of care, and ultimately the experience of patients. Therefore, under Theme 5, Leadership, Governance and Management, clear executive responsibility, planning and management from the top to the bottom in each service are among the requirements set out.

Theme 5 contains 11 standards and calls for support for all staff to raise concerns about safety and quality, and that staff at all levels are enabled to exercise their personal and professional responsibility for the quality and safety of services provided.

One of the fundamental principles of Theme 2 of the Standards, Effective Care and Support, is that services consistently deliver the best achievable outcomes for people using a service within the context of that service, and within the finite resources available to it. Theme 2 emphasises the need to plan and deliver care to meet the individual patient’s healthcare needs, while considering the needs of other patients.

Conclusion

The National Standards do not presume that the way services are organised and provided currently will necessarily be capable of meeting the National Standards. Meeting these National Standards will require service providers to align their resources appropriately to ensure the delivery of safe services while applying evidence of what works best.

The National Standards take immediate effect for Health Service Executive (HSE) funded and provided services.

As well as the Standards monitoring process, HIQA will continue to act on any information that it receives that may raise concerns about the quality and safety of services being provided. HIQA will also review the role and application of all existing standards developed under its auspices in light of the implementation of the new National Standards.

The National Standards for Safer Better Healthcare provide a national and consistent approach to improving safety, quality and reliability in our health service. HIQA looks forward to working with healthcare managers on the journey to make our shared vision for safer, better healthcare in Ireland a reality.

 Deirdre Mulholland is Head of Standards and Methodology, Health Information and Quality Authority