The Government has shared a new Quality Strategy for NHS-funded Care in England. Developed by the National Quality Board, the strategy aims to put quality at the centre of the NHS’s work, providing a new structured approach to making quality the organising principle for all NHS activity in England over the next decade.
It applies to system-wide, guiding national bodies, NHS leaders, the wider healthcare workforce and partners whose actions impact the quality of care in local communities.
The strategy’s definition of high-quality care is based on the following principles:
- Safety: Reducing the risk of unintended or unexpected harm to patients arising from the provision of healthcare.
- Effectiveness: Delivering evidence-based care that optimises the outcomes that matter to people using services.
- Experience: Coordinated, compassionate and responsive care, delivered by staff who are skilled, supported and able to do their job well.
Drawing on the 10‑Year Health Plan and the Dash Review, the strategy sets out 10 enablers that support quality improvement across the whole healthcare system:
- clarifying who is responsible and accountable for quality at every level of the healthcare system
- setting clear priorities to improve the quality of care while adopting a transparent, co-ordinated and value-based approach
- strengthening leadership and management capability to create the right culture and conditions for improvement
- listening to and working with people and communities on what matters to them
- using data to manage quality, inform decisions and support accountability at all levels
- increasing transparency, making the NHS the world’s leading healthcare system for public access to information on care quality
- developing and embedding technology to underpin quality management and improvement
- aligning incentives and rewards with accessible, high-quality and productive care
- promoting innovation and research to support continuous improvement in both clinical care and how the NHS operates
- creating a more co-ordinated and improvement-focused approach to regulation
Responding to the Quality Strategy, Dr Rosie Benneyworth, Interim Chief Executive Officer at the Health Services Safety Investigations Body (HSSIB): "We welcome the publication of the Quality Strategy and its recognition that safety is the foundation of high-quality care. The important role that the National Quality Board now has in providing strategic leadership, improving coordination across the system and creating a more coherent approach to quality and safety provides a significant opportunity to improve patient care. Strong national leadership, combined with a culture of learning and psychological safety, will be critical if the NHS is to move from reacting to harm to anticipating and preventing it.
"While we welcome the strategy’s vision of a quality management system for the NHS, our investigations continue to identify that too often, risks are recognised too late, warning signs are missed, and opportunities to learn are lost. If we are to make a meaningful improvement in patient safety, we must move beyond reacting to harm and strengthen how safety is managed across the system. There remain opportunities available for a safety management system to offer a practical way of achieving this to help organisations understand risk, put effective controls in place, strengthen accountability and support continuous learning and improvement.
"HSSIB looks forward to the publication of the Quality Management Systems Framework. However, given the Quality Strategy’s recognition that safety is the foundation of high-quality care, we are disappointed that it does not set out the need for an integrated management system.
"As the Strategy acknowledges, quality management and safety management require different but connected approaches, which should be brought together. HSSIB therefore welcomes the intention to review the NHS Patient Safety Strategy following publication of the Quality Strategy, particularly in its aims to enable real-time monitoring and management of risks as patients move through the system. These components should form part of an integrated quality and safety management system.
"We support the strategy’s ambition to improve clinical outcomes, reduce unwarranted variation and tackle health inequalities. We also support its emphasis on openness, learning and improvement. Creating the conditions where staff can speak up, share concerns and learn without fear of blame is essential to delivering safer care.
"For patients, families and NHS staff, this is about more than processes or structures. It is about creating a healthcare system that identifies risks earlier, listens when concerns are raised, learns when things go wrong, and acts before harm occurs. By improving outcomes, reducing inequalities and strengthening how safety is managed, we have an opportunity to deliver safer, more effective care and better experiences for everyone who relies on NHS services."
Healthwatch welcomed the strategy's focus on patient experience, saying: “It is welcome that the National Quality Strategy focuses on patient experience, which it considers equally important to quality as safety and effective healthcare. For too long, components such as clear communication and feeling listened to have been overlooked despite their importance to patients.
“The strategy sets out almost 40 metrics for patient experience. Some of these cover the top priorities reported to us by the public, including how easy it is to get through to their GP surgery on the phone. However, with so many metrics on improving experience there is a risk that providers of NHS services aren’t clear on which to prioritise. The Oversight Framework will be a key mechanism for focusing providers and commissioners on a core set of priorities. We would like to see this include metrics on communication and experiences of waiting for care, such as the standards recently announced for waiting for elective care.
“It will be key that as data is collected on quality over the coming years we are able to break it down by demographics. We know that some demographic groups report poorer experiences of care, notably including the financially disadvantaged, ethnic minority groups and those who are neurodivergent.
“Finally, it will be important that the NHS continues to value patient stories, and not simply rely on survey answers. People value being able to describe their experiences in their own words, and one story can be more powerful than a sea of stats.”
Visit: NHS England » Quality strategy for NHS-funded care in England
