Consensus on quality

The QualityWatch programme uses a framework that views quality through six domains.


Published: 18/12/2015

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‘Quality’ in health care is a complex concept to define. The QualityWatch programme uses a framework that views quality through six domains in order to draw as broad an understanding of the state of health and care as possible.

However, different people – including professionals, care users, their friends and relatives and policy-makers/influencers – may have different and conflicting opinions on what should be measured in order to understand quality.

At the end of 2014, Solutions for Public Health (SPH) was commissioned by QualityWatch to conduct a study to gather consensus from a range of stakeholder groups on what they felt was important to measure in order to understand the quality of healthcare. Participants were asked to rate the importance, on a five-point scale, of a set of 73 statements about the quality of care that people receive, and to comment on the suitability of these statements for assessing healthcare quality.

This report is a summary of the findings of the work. It also provides further context and highlights the impact of the results.

Key findings were as follows:

  • All 73 statements were rated very highly on the scale of importance. Over 90 per cent of the statements were scored as ‘very important’ or ‘important’.
  • Statements that related to safety scored relatively highly and the domain contained six of the ten highest scoring statements. In contrast to safety, the domain that related to access to care contained four of the lowest scoring statements.
  • Broadly, there was little variation in how the different stakeholder groups scored the statements. Over 60 per cent of the scores given by each respondent group fell within the ‘very important’ category.
  • As no statements came out as scoring particularly low on the importance scale, it highlights the need to continue to use many different measures to understand the quality of care. It also suggests that using indicators is a good approach for covering the ‘many things to many people’ nature of quality.

Suggested citation

Dorning H (2015) Consensus on quality. QualityWatch briefing. Nuffield Trust and The Health Foundation.