Disappearing teaspoons: Spoon solutions

Le résumé fourni par la source

Good quality monitoring is crucial for informed choiceEditor-In accordance with the patient choice scheme, all 303 primary care trusts in England were obliged from January 2005 to offer patients a choice of at least two providers for cataract surgery. 1 The scheme allows patients to be involved in how, where, and when they are treated.Providers can be NHS trusts, diagnostic and treatment centres, or independent sector providers from the UK or overseas.By February 2005 13 000 extra operations had already been performed under the independent sector treatment programme. 2However, concern was raised about variations in clinical safety between different providers. 3 We sent a postal questionnaire to the leaders of patient choice for each of the primary care trusts in England asking how they monitor the quality of care from their providers.The table shows the replies from 125 trusts.The quality monitoring of providers by primary care trusts is poorly structured and variable.Who then should monitor standards and what variables should they use?Traditionally, NHS providers have used audit and clinical governance to measure their performance.Should it now be the role of the Strategic Health Authority, the provider, or the purchaser in the form of primary care trusts to monitor the product offered to the patient?Information technology exists to collect accurate data about adverse events in addition to visual acuity and refractive outcomes.The public expect that safe cataract care should be commissioned for them, 4 and robust methods of monitoring need to be agreed and implemented so that patients can make a truly informed choice.These decisions need to be made not only for cataract surgery but also for other elective procedures that will increasingly be made available to patients through the patient choice scheme.

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