Nursing Law and Ethics

. restoring working balances;
. prevention and control of communicable disease especially:
± hospital acquired infection
± reduction in anti-microbial resistance
± meeting immunisation targets.

11.9.4 The National Framework for Assessing Performance

In line with the service framework a consultation document on the use of clinical
indicators in the NHS was issued in July 1997. The indicators attempt to make the
best possible use of existing data and focus on six areas: health improvement, fair
access to services, effective delivery of appropriate health care, efficiency, patient
and care experiences and health outcomes of NHS care. Mature and responsible
use of the information could support clinical governance, leading to improvements
in quality of care where local investigation highlights any shortcomings.
The performance assessment framework [7] results will be published annually.
As a first step the UK Department of Health plan to publish a range of clinical
indicators on a named hospital basis at least annually. NHS Trusts are expected to
develop effective performance management approaches to meet local and national
health care targets, financial and quality controls, implementation of service fra-
meworks and systems for tackling serious or persistent clinical problems. Criteria
will be set nationally with assessments by the regional offices. CH Iwill carry out
independent verification of the assessments. Many of these processes are included
within service and financial frameworks, annual agreements, business plans and
performance reviews. These performance management reviews need to include
having the right people in the right place, at the right time, with the right skills and
competencies to deal with effective patient care delivery. Each Trust board within
the organisation should be asking the following questions:

. Are there robust standards of the registration and up-to-date practices of all
health care providers?
. Are there clear standards of good practice, usage of clinical indicators and
outcome measurements?
. Does the organisation have a framework with demonstrable fitness to practice
for all health care providers?
. Are there effective, supportive and fair procedures to remove unfit health care
providers while further training, skills analysis and competency reviews are
undertaken?
. Is there a corporate approach with managers and clinicians working together to
provide safe risk management, high quality and effective systems to meet the
organisational needs and targets?

NHS organisations will be publicly classified as green',yellow' or `red'
organisations:

`Red organisations will be those who are failing to meet a number of core

national targets. Green organisations will be meeting all core national targets

and will score in the top 25% of organisations on the Performance Assessment

234 Nursing Law and Ethics