Final Report > Chapter 6: Quality, Standards and Information > Attitudes and policy begin to change

Attitudes and policy begin to change

6 Attitudes and policy were not static. Whereas at the beginning of the period of the Inquiry's Terms of Reference, there was no active engagement on the part of any tier of management with the quality of clinical care, by 1995, quality had come to take on importance. A national policy on medical and later clinical audit, introduced in 1989, was beginning to have an impact by 1995. Quality of clinical care had also come to be on the agenda of management within the NHS. District health authorities (DHAs), which by 1995 had mostly given up managing hospitals directly and had become purchasers of healthcare, were showing an increasing interest in the quality of the clinical care provided by the trusts with whom they had contracts. There are four inter-related strands to the developing interest and activity in improving the quality of healthcare: audit; other quality initiatives; information; and monitoring. We deal with each in turn in the paragraphs which follow.