Intended for healthcare professionals


An inspectorate for the health service?

BMJ 1997; 315 doi: (Published 11 October 1997) Cite this as: BMJ 1997;315:896

Ofsthealth may be inevitable, but it needs to observe the science of quality improvement

  1. John Oldham, General practitionera
  1. a Manor House Doctors' Surgery, Glossop, Derbyshire SK13 8PS

    Imagine yourself being listed for a day case procedure, organising work and home around the date, arriving anxiously at the ward only to be turned away. The reason? Your body mass index does not meet that hospital's criteria. This happened last week to one of our patients. The clinical decision may have been correct but the process of care failed. It is the cumulative effect of such instances together with knowledge of the wide variation that exists in clinical outcomes for similar cohorts of patients1 2 that has led to political demands for an office of standards in health (Ofsthealth)—an inspectorate of health services linked to the development of national standards, similar to that which exists for education.3

    Inequalities in access to care, the experience of that care, and the outcomes associated with it are just as unacceptable as inequalities in resource distribution. The cost of poor quality is a haemorrhage of scarce resources, largely untracked and ignored in the cry for more money for the NHS. The ambition to place quality at …

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