Learning from regulatory interventions in healthcare The Commission for Health Improvement and its clinical governance review process
Purpose - This paper aims to present the findings from research commissioned by the Commission for Health Improvement (CHI), which set out to examine the impact of CHI's clinical governance reviews on NHS trusts in England. Design/methodology/approach - This paper, giving a stratified random sa...
Saved in:
Published in | Clinical governance Vol. 11; no. 3; pp. 213 - 224 |
---|---|
Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Bradford
Emerald Group Publishing Limited
2006
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | Purpose - This paper aims to present the findings from research commissioned by the Commission for Health Improvement (CHI), which set out to examine the impact of CHI's clinical governance reviews on NHS trusts in England. Design/methodology/approach - This paper, giving a stratified random sample of 30 NHS trusts, was taken from a set of 75 trusts reviewed by CHI during a period from 2001 to 2003. Documents from these trusts'reviews were analysed. A postal questionnaire was sent to key stakeholders with an involvement or direct interest in each trust's review. Semi- structured telephone interviews were held with five to six people from each of four trusts selected as case studies. Findings - In this paper the clinical governance review process was characterized by wide variability in methods, application and effects, in the initial CHI visit and report, and the subsequent NHS trust action plan and SHA progress review. The recommendations made by reviews for change in an NHS trust were often of a nature or expressed in terms, which made measuring their subsequent implementation and impact problematic. CHI recommendations concentrated on management and support processes rather than on direct patient care and outcomes. Trusts were generally willing to accept and then enact CHI review recommendations. Practical implications - The paper concluded that a more focused and controlled review process would support greater change and improvement. There was evidence to suggest that this kind of regulatory intervention can have largely positive impacts on the organisational performance of NHS trusts, although these positive effects were mainly indirectly related to the delivery of patient care and health improvement. Any future review or inspection processes should place a greater focus upon patient outcomes if such reviews are to demonstrate their value in making a contribution to improving health. Originality/value - The paper shows that, internationally, there have been few empirical studies analysing the work of health care regulators and their impact on the organisations they regulate. While the work of CHI has been examined by others, this study is the first empirical and largely quantitative analysis of CHI's regulatory regime and its impact within the English NHS. The article is also published at a time when there is much debate about regulatory functions and forms for health and social care. |
---|---|
AbstractList | Purpose
This paper aims to present the findings from research commissioned by the Commission for Health Improvement (CHI), which set out to examine the impact of CHI's clinical governance reviews on NHS trusts in England.
Design/methodology/approach
This paper, giving a stratified random sample of 30 NHS trusts, was taken from a set of 75 trusts reviewed by CHI during a period from 2001 to 2003. Documents from these trusts' reviews were analysed. A postal questionnaire was sent to key stakeholders with an involvement or direct interest in each trust's review. Semi‐ structured telephone interviews were held with five to six people from each of four trusts selected as case studies.
Findings
In this paper the clinical governance review process was characterized by wide variability in methods, application and effects, in the initial CHI visit and report, and the subsequent NHS trust action plan and SHA progress review. The recommendations made by reviews for change in an NHS trust were often of a nature or expressed in terms, which made measuring their subsequent implementation and impact problematic. CHI recommendations concentrated on management and support processes rather than on direct patient care and outcomes. Trusts were generally willing to accept and then enact CHI review recommendations.
Practical implications
The paper concluded that a more focused and controlled review process would support greater change and improvement. There was evidence to suggest that this kind of regulatory intervention can have largely positive impacts on the organisational performance of NHS trusts, although these positive effects were mainly indirectly related to the delivery of patient care and health improvement. Any future review or inspection processes should place a greater focus upon patient outcomes if such reviews are to demonstrate their value in making a contribution to improving health.
Originality/value
The paper shows that, internationally, there have been few empirical studies analysing the work of health care regulators and their impact on the organisations they regulate. While the work of CHI has been examined by others, this study is the first empirical and largely quantitative analysis of CHI's regulatory regime and its impact within the English NHS. The article is also published at a time when there is much debate about regulatory functions and forms for health and social care. This paper aims to present the findings from research commissioned by the Commission for Health Improvement (CHI), which set out to examine the impact of CHI's clinical governance reviews on NHS trusts in England. This paper, giving a stratified random sample of 30 NHS trusts, was taken from a set of 75 trusts reviewed by CHI during a period from 2001 to 2003. Documents from these trusts' reviews were analysed. A postal questionnaire was sent to key stakeholders with an involvement or direct interest in each trust's review. Semi-structured telephone interviews were held with five to six people from each of four trusts selected as case studies. In this paper the clinical governance review process was characterized by wide variability in methods, application and effects, in the initial CHI visit and report, and the subsequent NHS trust action plan and SHA progress review. Purpose - This paper aims to present the findings from research commissioned by the Commission for Health Improvement (CHI), which set out to examine the impact of CHI's clinical governance reviews on NHS trusts in England. Design/methodology/approach - This paper, giving a stratified random sample of 30 NHS trusts, was taken from a set of 75 trusts reviewed by CHI during a period from 2001 to 2003. Documents from these trusts'reviews were analysed. A postal questionnaire was sent to key stakeholders with an involvement or direct interest in each trust's review. Semi- structured telephone interviews were held with five to six people from each of four trusts selected as case studies. Findings - In this paper the clinical governance review process was characterized by wide variability in methods, application and effects, in the initial CHI visit and report, and the subsequent NHS trust action plan and SHA progress review. The recommendations made by reviews for change in an NHS trust were often of a nature or expressed in terms, which made measuring their subsequent implementation and impact problematic. CHI recommendations concentrated on management and support processes rather than on direct patient care and outcomes. Trusts were generally willing to accept and then enact CHI review recommendations. Practical implications - The paper concluded that a more focused and controlled review process would support greater change and improvement. There was evidence to suggest that this kind of regulatory intervention can have largely positive impacts on the organisational performance of NHS trusts, although these positive effects were mainly indirectly related to the delivery of patient care and health improvement. Any future review or inspection processes should place a greater focus upon patient outcomes if such reviews are to demonstrate their value in making a contribution to improving health. Originality/value - The paper shows that, internationally, there have been few empirical studies analysing the work of health care regulators and their impact on the organisations they regulate. While the work of CHI has been examined by others, this study is the first empirical and largely quantitative analysis of CHI's regulatory regime and its impact within the English NHS. The article is also published at a time when there is much debate about regulatory functions and forms for health and social care. Purpose -- This paper aims to present the findings from research commissioned by the Commission for Health Improvement (CHI), which set out to examine the impact of CHI's clinical governance reviews on NHS trusts in England. Design/methodology/approach -- This paper, giving a stratified random sample of 30 NHS trusts, was taken from a set of 75 trusts reviewed by CHI during a period from 2001 to 2003. Documents from these trusts' reviews were analysed. A postal questionnaire was sent to key stakeholders with an involvement or direct interest in each trust's review. Semi- structured telephone interviews were held with five to six people from each of four trusts selected as case studies. Findings -- In this paper the clinical governance review process was characterized by wide variability in methods, application and effects, in the initial CHI visit and report, and the subsequent NHS trust action plan and SHA progress review. The recommendations made by reviews for change in an NHS trust were often of a nature or expressed in terms, which made measuring their subsequent implementation and impact problematic. CHI recommendations concentrated on management and support processes rather than on direct patient care and outcomes. Trusts were generally willing to accept and then enact CHI review recommendations. Practical implications -- The paper concluded that a more focused and controlled review process would support greater change and improvement. There was evidence to suggest that this kind of regulatory intervention can have largely positive impacts on the organisational performance of NHS trusts, although these positive effects were mainly indirectly related to the delivery of patient care and health improvement. Any future review or inspection processes should place a greater focus upon patient outcomes if such reviews are to demonstrate their value in making a contribution to improving health. Originality/value -- The paper shows that, internationally, there have been few empirical studies analysing the work of health care regulators and their impact on the organisations they regulate. While the work of CHI has been examined by others, this study is the first empirical and largely quantitative analysis of CHI's regulatory regime and its impact within the English NHS. The article is also published at a time when there is much debate about regulatory functions and forms for health and social care. Adapted from the source document. |
Author | Benson, L A Boyd, A Walshe, K |
Author_xml | – sequence: 1 givenname: L surname: Benson middlename: A fullname: Benson, L A – sequence: 2 givenname: A surname: Boyd fullname: Boyd, A – sequence: 3 givenname: K surname: Walshe fullname: Walshe, K |
BookMark | eNqF0UtLw0AQB_BFKthWP4C34MFbdPaRfRyl-IKAFwVvYbuZtCnpbt1NhH57U-pJDz0Nw_yYYfjPyMQHj4RcU7ijFPQ9FUoppkBSkJpTIc_IlEFhciHF54RMD_N8BOKCzFLaADAQAFMiSrTRt36VNTFss4irobN9iPus9T3Gb_R9G3wau2yNtuvXzka8JOeN7RJe_dY5-Xh6fF-85OXb8-viocwd46zPDau1s0pyJ5qaLrEGzpYKgXPDJVhjikbXhbaNrI1yRjrtOHWIaKmgDCifk9vj3l0MXwOmvtq2yWHXWY9hSFWhKJWcsZOQF6LQbDx7EoLRQgkY4c0fuAlD9OO3FQMtCsW0HBE9IhdDShGbahfbrY37ikJ1iKX6Fwv_AfPAf-A |
Cites_doi | 10.1136/qshc.2002.005108 10.1080/00420980220135563 |
ContentType | Journal Article |
Copyright | Copyright Emerald Group Publishing Limited 2006 |
Copyright_xml | – notice: Copyright Emerald Group Publishing Limited 2006 |
DBID | AAYXX CITATION 0U~ 1-H 7QJ 7RV 7TA 7WY 7WZ 7X7 7XB 8AO 8FD 8FI AFKRA AN0 ASE AXJJW BENPR BEZIV CCPQU DWQXO FPQ FYUFA F~G JG9 K6X K6~ L.- L.0 M0C M0Q M0T NAPCQ PQBIZ PQEST PQQKQ PQUKI PYYUZ Q9U |
DOI | 10.1108/14777270610683146 |
DatabaseName | CrossRef Global News & ABI/Inform Professional Trade PRO Applied Social Sciences Index & Abstracts (ASSIA) ProQuest Nursing and Allied Health Journals Materials Business File ABI/INFORM Collection ABI/INFORM Global (PDF only) ProQuest Health & Medical Collection ProQuest Central (purchase pre-March 2016) ProQuest Pharma Collection Technology Research Database Hospital Premium Collection ProQuest Central UK/Ireland British Nursing Database British Nursing Index Asian & European Business Collection AUTh Library subscriptions: ProQuest Central Business Premium Collection ProQuest One Community College ProQuest Central Korea British Nursing Index (BNI) (1985 to Present) Health Research Premium Collection ABI/INFORM Global (Corporate) Materials Research Database British Nursing Index ProQuest Business Collection ABI/INFORM Professional Advanced ABI/INFORM Professional Standard ABI/INFORM Global European Business Database Healthcare Administration Database Nursing & Allied Health Premium ProQuest One Business ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Academic ProQuest One Academic UKI Edition ABI/INFORM Collection China ProQuest Central Basic |
DatabaseTitle | CrossRef Materials Research Database ABI/INFORM Global (Corporate) ProQuest One Business ProQuest European Business Technology Research Database Asian & European Business Collection ProQuest One Community College Trade PRO ProQuest Pharma Collection Applied Social Sciences Index and Abstracts (ASSIA) ABI/INFORM Complete Materials Business File ProQuest Central Global News & ABI/Inform Professional ABI/INFORM Professional Advanced Health Research Premium Collection ABI/INFORM Professional Standard ProQuest Central Korea Business Premium Collection ABI/INFORM Global ProQuest Central Basic ProQuest One Academic Eastern Edition British Nursing Index with Full Text ProQuest Health Management British Nursing Index ABI/INFORM China ProQuest Nursing & Allied Health Source ProQuest Hospital Collection ProQuest Business Collection Nursing & Allied Health Premium ProQuest Health & Medical Complete ProQuest One Academic UKI Edition ProQuest One Academic |
DatabaseTitleList | CrossRef Materials Research Database Materials Research Database Materials Research Database Applied Social Sciences Index and Abstracts (ASSIA) |
Database_xml | – sequence: 1 dbid: BENPR name: AUTh Library subscriptions: ProQuest Central url: https://www.proquest.com/central sourceTypes: Aggregation Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 2059-464X |
EndPage | 224 |
ExternalDocumentID | 1143423381 10_1108_14777270610683146 |
Genre | Feature |
GeographicLocations | United Kingdom--UK |
GeographicLocations_xml | – name: United Kingdom--UK |
GroupedDBID | --- .X8 .X~ 0R~ 1WG 29B 3FY 4.4 53G 5GY 5VS 6PF 70U 7RV 7WY 7X7 8AO 8FI 8FW 8R4 8R5 AAAPP AACPQ AAGBP AAMCF AAPSD AAUDR AAWTL AAXLC AAYXX ABEAN ABIJV ABSDC ACGFS ADOMW AEBZA AEDOK AEMMR AETHF AFNZV AIAFM AJEBP AJFKA ALMA_UNASSIGNED_HOLDINGS AMLIN AODMV APPLU ASPBG ATGMP AUCOK AVWKF AXJJW AZFZN BENPR BEZIV BFQZO BKEYQ BLEHN BPHCQ BTXLY BUONS BVXVI CAG CITATION COF DWQXO EBS EJD EX3 FYUFA GEA GEB GEC GEI GMM GMN GQ. GROUPED_ABI_INFORM_COMPLETE H13 HZ~ IPNFZ J1Y JI- JL0 K6~ KLENG M0C M0T M42 O9- P2P PCD Q2X RIG ROL RWL RXW SCAQC SDURG TAE TDK TEM TET TGG TMD TMF TMT WOW X6Y Z11 Z12 Z21 0U~ 1-H 7QJ 7TA 7XB 8FD AFKRA AN0 ASE CCPQU FPQ JG9 K6X L.- L.0 M0Q NAPCQ PQBIZ PQEST PQQKQ PQUKI Q9U |
ID | FETCH-LOGICAL-c232t-92d8ca763c4fd1bed032b7e0339360a995f8d58af6d97c96c8c31ceeea1412013 |
IEDL.DBID | BENPR |
ISSN | 1477-7274 2059-4631 |
IngestDate | Fri Aug 16 04:07:57 EDT 2024 Sat Aug 17 04:14:27 EDT 2024 Fri Aug 16 08:32:10 EDT 2024 Thu Oct 10 21:07:46 EDT 2024 Fri Aug 23 01:02:33 EDT 2024 |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 3 |
Language | English |
LinkModel | DirectLink |
MergedId | FETCHMERGED-LOGICAL-c232t-92d8ca763c4fd1bed032b7e0339360a995f8d58af6d97c96c8c31ceeea1412013 |
Notes | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2 |
PQID | 208457286 |
PQPubID | 23500 |
PageCount | 12 |
ParticipantIDs | proquest_miscellaneous_57116322 proquest_miscellaneous_35458239 proquest_miscellaneous_30984740 proquest_journals_208457286 crossref_primary_10_1108_14777270610683146 |
PublicationCentury | 2000 |
PublicationDate | 2006-00-00 |
PublicationDateYYYYMMDD | 2006-01-01 |
PublicationDate_xml | – year: 2006 text: 2006-00-00 |
PublicationDecade | 2000 |
PublicationPlace | Bradford |
PublicationPlace_xml | – name: Bradford |
PublicationTitle | Clinical governance |
PublicationYear | 2006 |
Publisher | Emerald Group Publishing Limited |
Publisher_xml | – name: Emerald Group Publishing Limited |
References | key2022021320013731600_b2 key2022021320013731600_b1 key2022021320013731600_b6 key2022021320013731600_b5 key2022021320013731600_b4 key2022021320013731600_b3 key2022021320013731600_b9 key2022021320013731600_b8 key2022021320013731600_b7 key2022021320013731600_b11 key2022021320013731600_b10 key2022021320013731600_b12 key2022021320013731600_b15 key2022021320013731600_b14 key2022021320013731600_frg1 key2022021320013731600_b16 |
References_xml | – ident: key2022021320013731600_b15 – ident: key2022021320013731600_b14 – ident: key2022021320013731600_frg1 – ident: key2022021320013731600_b16 – ident: key2022021320013731600_b12 – ident: key2022021320013731600_b10 – ident: key2022021320013731600_b6 – ident: key2022021320013731600_b5 – ident: key2022021320013731600_b7 – ident: key2022021320013731600_b8 – ident: key2022021320013731600_b3 – ident: key2022021320013731600_b4 – ident: key2022021320013731600_b2 – ident: key2022021320013731600_b1 – ident: key2022021320013731600_b11 doi: 10.1136/qshc.2002.005108 – ident: key2022021320013731600_b9 doi: 10.1080/00420980220135563 |
SSID | ssj0020400 |
Score | 1.7261729 |
Snippet | Purpose
This paper aims to present the findings from research commissioned by the Commission for Health Improvement (CHI), which set out to examine the impact... This paper aims to present the findings from research commissioned by the Commission for Health Improvement (CHI), which set out to examine the impact of CHI's... Purpose - This paper aims to present the findings from research commissioned by the Commission for Health Improvement (CHI), which set out to examine the... Purpose -- This paper aims to present the findings from research commissioned by the Commission for Health Improvement (CHI), which set out to examine the... |
SourceID | proquest crossref |
SourceType | Aggregation Database |
StartPage | 213 |
SubjectTerms | Clinical governance Health care Health care industry Impact analysis Inspections Ratings & rankings Regulation Studies Trusts Workforce planning |
Subtitle | The Commission for Health Improvement and its clinical governance review process |
Title | Learning from regulatory interventions in healthcare |
URI | https://www.proquest.com/docview/208457286 https://search.proquest.com/docview/30984740 https://search.proquest.com/docview/35458239 https://search.proquest.com/docview/57116322 |
Volume | 11 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV3PS8MwFH64DcSL-BPndPbgSSi0SdokJ1HZGIJDxMFupU1S9dLOdTv43_vSZXUi7lia0DZ5vO97-V7fA7hmwtIIW2Y_4xoDlNj4gpjc1wzRLeRZqPO62uc4Hk3Y4zSautycyqVVrn1i7ah1qewZOQbpgkWciPh29unbplFWXHUdNFrQISGzKm3nfjB-fmkiLmuhtrsccggfHx46WdO2vgkZR2LJEc6CWNCaAG8C02-_XIPN8AD2HUv07lbbegg7pjiC3Sengx8Dc2VR3zz7e4g3XzWUL-df3sdGDmOFV957k-B1ApPh4PVh5Lv-B75CnrPwJdFCpegAFMt1mBkdUJJxE1AqaRykUka50JFI81hLrmSshKIhgp5JcTEQ2OkptIuyMGfgUSUV1RFOinKbUWprcjNbyk2kmuDULtysPz6ZrcpcJHV4EIjkz0p1obdensRZfJU0-9OFq-YumqrVH9LClMsqoYFELGTBlhG1jEfl_yMiHiKDJOR86zv0YO_nqOQC2ov50lwieVhkfWjxKe87Q_kGB4vB-A |
link.rule.ids | 315,786,790,4043,12083,21416,27954,27955,27956,31752,31753,33777,33778,43343,43838,74100,74657 |
linkProvider | ProQuest |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV3PT8IwFH5RSNSL8WdEVHbwZLJkXbutPRk1EFQgxkDCbdnaTr0wZHDwv_d1lIkxclzWZlv78r7v9b19D-CacUMjjMx-GikMUELtcl9nrmKIbiRKicpKtc9B2B2xp3EwtrU5hS2rXPnE0lGrXJozcgzSOQsin4e300_XNI0yyVXbQWMb6kZxk9egft8evLxWEZexUNNdDjmEiw8nNq1pWt8QFiGxjBDOvJDTkgCvA9Nvv1yCTecA9i1LdO6W23oIW3pyBDt9mwc_BmZlUd8c83uIM1s2lM9nX87HWg1jgVfOe1XgdQKjTnv40HVt_wNXIs-Zu8JXXCboACTLFEm18qifRtqjVNDQS4QIMq4CnmShEpEUoeSSEgQ9nRBGENjpKdQm-USfgUOlkFQFOCnITEWp0eRmRsqNJ8rHqQ24WX18PF3KXMRleODx-M9KNaC5Wp7YWnwRV_vTgFZ1F03V5B-Sic4XRUw9gVjIvA0jyjQeFf-PCCKCDNL3zze-Qwt2u8N-L-49Dp6bsPdzbHIBtflsoS-RSMzTK2su38iPxAc |
linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV07T8MwED5BkSoWxFOUAs3AhBQRx05sTwgBVXlVDFTqFiW2AyxJadqBf885dR8I0TGKLTn26b7vfJf7AC6YsDTCttnPuMYAJTa-CE3ua4boRnhGdF53--zHvQF7HEZD11KocmWVc59YO2pdKntHjkG6YBEPRXyVu6qI17vu9ejLtwJSNtHq1DQ2YQtBMrAqDny4jL2srVqdOWQTPi6DuASnFcEhjCPF5AhsQSxoTYVXIeq3h65hp7sLO44vejezA96DDVPsQ_PFZcQPgLkGqe-e_VHEG8-k5cvxt_e5Us1Y4ZP3sSj1OoRB9_7ttuc7JQRfIeOZ-DLUQqXoChTLNcmMDmiYcRNQKmkcpFJGudCRSPNYS65krISiBOHPpIQRhHh6BI2iLMwxeFRJRXWEk6Lc1pba7tzMNnUTqQ5xagsu5x-fjGYNL5I6UAhE8menWtCeb0_ibL9KFifVgs7iLRqtzUSkhSmnVUIDiajIgjUj6oQelf-PiDhBLhmGJ2vX0IEm2kny_NB_asP28v7kFBqT8dScIaOYZOe1rfwAY63GxA |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Learning+from+regulatory+interventions+in+healthcare&rft.jtitle=Clinical+governance&rft.au=Benson%2C+L+A&rft.au=Boyd%2C+A&rft.au=Walshe%2C+K&rft.date=2006&rft.pub=Emerald+Group+Publishing+Limited&rft.issn=2059-4631&rft.eissn=2059-464X&rft.volume=11&rft.issue=3&rft.spage=213&rft_id=info:doi/10.1108%2F14777270610683146&rft.externalDBID=HAS_PDF_LINK&rft.externalDocID=1143423381 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1477-7274&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1477-7274&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1477-7274&client=summon |