Driving quality implementation in the context of the Francis report

| | Principle four: respect
regulation, inspection
and accountability as
supporting care
‘When we trained, life beyond being a full-time clinician was tightly defined. You became a
researcher, devoted yourself to teaching or disappeared upstairs into management. Those
three paths describe fewer than 5% of psychiatrists. What about becoming an even better
clinician, facilitating better interventions from other disciplines, and measuring outcomes that
really matter to our patients? We can’t achieve this without working with the best people,
external regulators included, to learn as much about our services as possible. I have learned
more from external evaluation and honest feedback on what we do than from endless internal
reflection. Bring it on’ (College member).
The shape of regulatory and statutory frameworks
for healthcare provision and regulation, new forms
of regulatory control, service innovations and
quality assurance of organisational performance
have the power to change the context in which
healthcare systems work. It will be important, for
example, for the new CQC mental health inspections
to consider the whole patient pathway – that
is, to look at provision of community care as well
as of acute care.
There must be due diligence in gathering patient
and colleague feedback for GMC revalidation,
with information acted on and used to improve
practice with remedial action when appropriate.
Professional responsibility, checked through the
triad of appraiser, appraisee and responsible
officer, is crucial for good practice.
It is appropriate for psychiatrists to have a role in
accreditation and hospital visits to ensure quality
standards are maintained in education, training and
service provision. These visits empower trainees
and provide them with the opportunity to speak
openly and in confidence with assessors.
The Francis report makes clear that education and
training are closely linked with clinical standards.
We need to strengthen the weakened links in some
parts of the UK between strong university departments
and clinical services. Standards are driven
higher when research, teaching and clinical activity
go hand in hand.
College actions
1 The College will continue to issue clear standards
on good psychiatric practice in a range
of specialised areas.
2 As a member of the Academy of Medical Royal
Colleges, the Royal College of Psychiatrists
will lobby for doctors as leaders to be given
sufficient time in their work schedules to be
able to take part in other valuable work that
will lead to improving standards and outcomes
in clinical care. For example, the College will
encourage psychiatrists to become involved
as skilled advisors in the mental health inspections
that will commence in 2014, recognising
Principle four: respect regulation, inspection and accountability as supporting care 17