Improving the quality of out-patient services in NHS hospitals: some policy considerations

One of the key objectives in the Patient's Charter was to reduce the amount of time typically spent waiting for treatment in NHS out-patient clinics, a documented source of discontent. Presents the results of a quality improvement programme instituted at Leicester General Hospital. Discusses some of the techniques and problems encountered in the measurement exercise. While the results of the monitoring exercise indicated that waiting times were being radically reduced, doubt is expressed as to whether this one simplistic indicator is sufficient to measure the overall quality of out-patient clinics. There is a danger that measurement systems have concentrated on that which is measurable rather than that which is significant. In particular, the voice of the patient is not incorporated into the league table approach to out-patient quality. Discusses several approaches to the measurement of overall quality and the problems and dangers inherent in adopting a league table approach to quality measurement.