Final Report > Chapter 6: Quality, Standards and Information > Other initiatives concerned with quality > Poor co-ordination of systems for assuring quality

Poor co-ordination of systems for assuring quality

20 While interest in quality assurance and the quality of clinical care certainly grew between 1984 and 1995, the development of mechanisms for assessing and improving quality (setting standards, gathering data, recording and reporting performance, and making improvements) was haphazard. Each strand, audit, quality assurance activity, the `Patient's Charter', and other initiatives, developed along separate lines. The mechanisms were not co-ordinated. Numerous organisations became involved. Their involvement was not co-ordinated. Their roles and responsibilities were ill defined. Over time, this led to a situation of increasing confusion as to who was responsible for what as between the various parties (the DoH, the regional and district health authorities, the trusts and the various bodies outside the NHS, such as the Royal Colleges, and healthcare professionals themselves).