Clinical focus and public accountability in English NHS Trust Board meetings
Clinical focus and public accountability in English NHS Trust Board meetings
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DOI：
10.1258/jhsrp.2012.011154
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发表时间：
2013-01-01
影响因子：
2.4
通讯作者：
Woodward, Valerie
中科院分区：
文献类型：
--
作者：
Endacott, Ruth;Sheaff, Rod;Woodward, Valerie
背景资料：以前的研究表明，在NHS专员和提供者信托委员会会议上更多地关注临床问题可能会改善临床护理的范围，质量或成本。本研究报告的程度，临床重点在董事会会议上的三种类型的NHS信托，并认为对公众accountability.Methods的影响：（1）内容分析，从105个随机选择的NHS信托在2008/09年的董事会会议记录。(2)在2008/09年度，在上述信托中的8个信托的定性子样本中，对24次董事会会议进行了结构化观察。结果：NHS信托委员会讨论的项目中，临床项目的百分比从0%到51%不等，但没有因信托类型而异。初级保健信托基金（PCT）记录了比NHS信托基金和NHS基金会信托基金更多的项目，因为PCT作为服务提供者和专员的双重角色。有显着差异之间的信托董事会会议的临床项目的数量有关的服务设计，临床成果和活动水平。NHS基金会信托委员会会议的公开会议记录的可用性和可获得性有时是有问题的。对会议的观察揭示了会议记录中没有体现的一些动态。董事会会议一般由主席领导（根据主席的自由裁量权进行）;合议;非执行董事的讨论水平和范围相似，重点是当前的政策举措。董事会在公众质疑的程度、他们如何对病人护理的提供和质量行使内部治理以及董事会会议前的预先规划程度方面存在差异。发表的会议记录并不总是准确的记录meets.Conclusions：调查结果照亮了重要的透明度问题，应给予仔细考虑，在英国国民保健服务。(C)SAGE Publications Ltd
Background: Previous studies have suggested that greater focus on clinical matters in NHS commissioner and provider Trust Board meetings might improve the range, quality or cost of clinical care. This study reports the extent of clinical focus in Board meetings in three types of NHS Trust and considers the implications for public accountability.Methods: (1) Content analysis of published minutes of Board meetings from 105 randomly selected NHS Trusts in 2008/09. (2) Structured observation of 24 Board meetings in a qualitative sub-sample of eight of the above Trusts in 2008/09.Results: The percentage of clinical items among the items discussed by NHS Trust Boards ranged from 0% to 51%, but did not differ by Trust type. Primary Care Trusts (PCTs) recorded more items than NHS Trusts and NHS Foundation Trusts because of PCTs' dual role as service providers and commissioners. There were significant differences between Trusts' board meetings in the numbers of clinical items concerning service design, clinical outcomes and activity levels. The availability and accessibility of supposedly publicly-available minutes from NHS Foundation Trust Board meetings was sometimes problematic. Observation of meetings revealed a number of dynamics not evident in the minutes. Board meetings were generally chair-led (conducted according to the chair's discretion); collegial; had similar levels and extent of discussion from the non-executive directors, with a focus on current policy initiatives. Boards differed in the extent of public questioning, how they exercised internal governance over the provision and quality of patient care, and the extent of pre-planning before the Board meeting. Published minutes were not always an accurate record of meetings.Conclusions: Findings illuminate important transparency issues which should be given careful consideration in the English NHS. (C) SAGE Publications Ltd 2013