The purpose of this paper is to explore the dilemma facing the health staff regarding the achievement of targets (waiting list reduction, etc.), on the one hand, and, on the other hand, the responsibility of continuously improving the healthcare quality in NHS organisations.
In‐depth interviews were conducted using a semi‐structured interview method with a heterogeneous group of 33 key persons who have important responsibilities in an NHS Hospital Trust. The case study method was adopted to understand how the health staff are coping with the dilemma of meeting targets, on the one hand, and, on the other hand, continuously improving the quality of care (a statutory duty imposed on every member of health staff under clinical governance framework).
The findings of the research suggest that clinical governance has increased the dilemma of health staff on how to meet targets while continuously improving the quality of clinical care. The departments get additional funds only when it is clearly demonstrated that funds will be used to meet targets, whereas such additional funding is not available for quality improvement activities. Consequently, meeting targets becomes a priority, while achieving continuous quality improvement takes a backseat.
In view of the mounting pressure on health staff to deliver the highest quality of clinical care more speedily, more research on a wider scale is necessary to understand what could be a practical solution for reducing the tensions of health staff and delivering the highest quality of care.
The research points out that it is almost impossible to continuously improve service quality to higher standards while meeting quantitative targets, because improving quality of healthcare would require allocation of more time to each patient and subsequent quality improvement activities. Putting too many patients through the system may reduce waiting lists but it may increase the risk of clinical errors because less time is available for individual patients.
The current literature provides little information on the above issue. The paper makes a valuable contribution by highlighting the failure of clinical governance to address some of the fundamental issues facing the NHS organisations. The managerial concepts of improving both quality and quantity at the same time may not be workable in healthcare organisations, because of the unique characteristics (i.e. the human dimension of clinical decision making) of healthcare management.
Som, C. (2009), "“Quantity” versus “quality” dilemma of health staff in NHS UK: Does clinical governance provide a solution?", Clinical Governance: An International Journal, Vol. 14 No. 4, pp. 301-314. https://doi.org/10.1108/14777270911007827Download as .RIS
Emerald Group Publishing Limited
Copyright © 2009, Emerald Group Publishing Limited