Palliative Care Nursing: Principles and Evidence for Practice

By Sheila Payne; Jane Seymour et al. | Go to book overview

37
Policy, audit, evaluation and
clinical governance
Liz Barker and Sue Hawkett
Introduction
In this chapter, we outline recent UK government policy linking audit, evaluation and clinical governance. We demonstrate how this has shaped specialist palliative care services and the implications for professional practice. Most of the material is drawn from the NHS Plan (Department of Health 2000d), the NHS Cancer Plan (Department of Health 2000c) and subsequent documents. Although these deal with services in England, there are similar policy directions in other UK countries. European developments have not been addressed.Where do we begin? What are the connections between policy and clinical practice? Does policy make any difference? And how can clinical nurses influence the process? These are some of the questions we should consider. It is important to see how clinical practice is informed and directed by policy and how practice influences policy. The National Health Service (NHS) for the UK established some 50 years ago was, and continues to be, founded on the principle of health care provision for all irrespective of condition or ability to pay. In 1997, the incoming government signalled a new direction for health care. The New NHS: Modern Dependable (Department of Health 1997) set out a 10-year plan focusing on improving the quality of care, proposing a new model which brought together responsibility for quality at local level with clear national standards. The aim was to reduce variations in outcomes of, and access to, services, as well as to ensure that clinical decisions were made based on the most up-to-date evidence and were known to be effective. There are three main elements to the 10-year plan.
Setting clear national quality standards through national service frameworks (NSFs) and the establishment of an independent National Institute for Clinical Excellence (NICE).
Mechanisms for ensuring local delivery of quality clinical services

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