Final Report > Chapter 27: Care of an Appropriate Standard > Monitoring of performance > Informing the public and the professional

Informing the public and the professional

55 Information arising from audit and review must be disseminated so that those in a position to do so may take appropriate action. This clearly includes the relevant healthcare professionals and the trust chief executive. Does this mean that the information should also be made public? We recall that our central concern here, as elsewhere, is with the creation of a culture within the hospital and beyond which is patient-centred. If this is the aim, then the question of publication admits of only one answer. The public, who are patients in another guise, should have access to the analysed data. We believe that the data which are put into the public domain should relate not only to the performance of the trust as a whole, but should also describe the performance at the level of a specialty and of the consultant unit. [26] Performance at the level of a specialty or a department is important. It is an intermediate point between the trust as a whole and a consultant unit. Further, it offers an opportunity to address the performance of a service from the patient's perspective, and should include the contribution to care not only of doctors but also a cross-section of healthcare professionals.

56 It will be objected that audit data are complex and hard to understand. The public will be misled and draw unwarranted conclusions. Healthcare professionals will be unfairly criticised. All of these are, of course, real risks. But they are risks that must be faced and resolved. The alternative, of continued secrecy and anonymity, is no longer a real option. A new compact between the community and its hospitals must be forged in which the public must accept that the price of information is a considered and responsible reaction to it.

57 This new compact is much more likely to be forged when the next stage in improving quality through information is taken. Systems must be put in place within the hospital to take account of and, crucially, to respond to what the data describe. In a flexible organisation, all those involved in the hospital, at whatever level, should have a part to play in determining the appropriate responses. But also patients and the general public must be involved. (We will consider later how best this can be achieved.) By involving the public, not only does the hospital show that it is listening, but the public gains a degree of ownership and understanding of what can and should be done.

58 We said earlier that a concern for safety must be embedded in the organisation. We repeat this in relation to quality. It must be seen as the concern of all, not merely the responsibility of the chief executive. We are seeking in our approach to create a continuing and continuous interaction between on the one hand safety, the standards of clinical care and the standards of professional competence, and, on the other, the validation of hospitals to provide healthcare services. And, by involving patients and the public, a network of support is created as well as a collective will to sustain and improve the quality of care.

Footnotes

[26] We take the term `consultant unit' to mean a consultant and the team of doctors who work under his or her supervision