Education And Debate

Health service accreditation: report of a pilot programme for community hospitals

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6982.781 (Published 25 March 1995) Cite this as: BMJ 1995;310:781
  1. Charles D Shaw, director, hospital accreditation programmea,
  2. Charles D Collins, medical directorb
  1. a CASPE Research, London SE1 1LL
  2. b Taunton and Somerset NHS Trust, Musgrove Park Hospital, Taunton, Somerset TA1 5DA
  1. Correspondence to: Dr Shaw.
  • Accepted 7 February 1995

Voluntary accreditation in the United Kingdom is being used by health care providers to improve and market their services and by commissioners to define and monitor service contracts. In a three year pilot scheme in the south west of England, 43 out of 57 eligible community hospitals volunteered to be surveyed; 37 of them were ultimately accredited for up to two years by the hospital accreditation programme. The main causes for non-accreditation related to safety, clinical records, and medical organisation. Follow up visits in 10 hospitals showed that, overall, 69% of recommendations were implemented. An independent survey of participating hospitals showed the perceived benefits to include team building, review of operational policies, improvement of data systems, and the generation of local prestige. Purchasers are increasingly influenced by accreditation status but are mostly unwilling to finance the process directly. None the less, the concept may become an important factor moderating the quality of service in the new NHS.

The concept of accrediting hospitals as suitable environments for training was developed by the American College of Surgeons from 1917, and accreditation became a national yardstick for the organisation of hospitals for many other purposes. Accreditation has subsequently been adapted and adopted in Canada and Australia and, particularly over the past five years, in many other countries, including the United Kingdom.

All accreditation systems have explicit standards for organisation against which the participating hospital assesses itself before a structured visit by outside surveyors, who submit a written report to the hospital with commendations and recommendations for development before a follow up survey.1 Accreditation may be awarded for a fixed term or may be withheld by an independent assessment board if the hospital does not meet a defined threshold of standards. Functioning national schemes in the United Kingdom include the King's Fund organisational …

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