Agency goals and models
| Agency | Documentary data | Interview data | Agency model |
|---|---|---|---|
| HIS | “We are the national healthcare improvement organisation for Scotland, established to advance improvement in healthcare” (Healthcare Improvement Scotland, 2014) | “[…] a blend of approaches: so we have the scrutiny, assurance, we have the clinical expertise […] independent fair and objective assessment […] [and] […] support improvement efforts” (Interviewee G, HIS) “[we] […] help providers in Scotland to improve their improvement capability (Interviewee A, HIS) | Hybrid |
| HIW | “Our purpose is to provide independent and objective assurance on the quality, safety and effectiveness of healthcare services, making recommendations to healthcare organisations to promote improvements” (Healthcare Inspectorate Wales, 2014) | “we go out and inspect and we find […] an organisation is meeting the standards […] then we wouldn’t seek improvement […] beyond that (Interviewee B, HIW) “we are not an improvement agency, but we should be operating in a way which supports improvement” (Interviewee D, HIW) | Compliance |
| RQIA | “The most important priority for RQIA is to make sure that our inspection systems and processes convey clearly to the public how well a service is performing in respect of the […] minimum standards” (Regulation and Quality Improvement Authority, 2015a, b) | “We provide assurance […] about the quality of services” (Interviewee D, RQIA) “our primary role is to question them, to challenge them early, and then they can then start making […] improvements” (Interviewee A, RQIA) | Compliance |
| CQC | “We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve” (Care Quality Commission, 2013) | “We monitor, we inspect and we regulate and make sure that these services meet the fundamental standards” (Interviewee CQC D) “it’s very clear in the CQC that we’re not improvement facilitators, we’re regulators” (Interviewee C, CQC) | Compliance |
| Monitor | “[We set] a required standard that all NHS providers must meet […] [We] control the risk that foundation trusts, once authorised, fall back below the required standard. If they do, we take remedial action […] We will focus in particular on the capabilities that drive long-term performance” (Monitor, 2014) | “where trusts fail to deliver certain minimum standards […] [we] work with those trusts to ensure that they improve their position and restore themselves to […] that minimum standard” (Interviewee A, Monitor) “[Our] mandate is basically to improve the capability of FTs” (Interviewee G, Monitor) | Hybrid |
| TDA | “The TDA oversees NHS trusts and holds them to account […] while providing them with support to improve” (Trust Development Authority, 2014) | “[Trusts] know that they are being held to account for their performance but they also know that they will get support and help and development rather than just being criticised” (Interviewee G, TDA) “[Our role is] supporting oversight of our Trusts, […] [and] that have asked for some support because they feel that they need to make some improvements” (Interviewee E, TDA) | Hybrid |
| Agency | Documentary data | Interview data | Agency model |
|---|---|---|---|
| HIS | “We are the national healthcare improvement organisation for Scotland, established to advance improvement in healthcare” ( | “[…] a blend of approaches: so we have the scrutiny, assurance, we have the clinical expertise […] independent fair and objective assessment […] [and] […] support improvement efforts” (Interviewee G, HIS) | Hybrid |
| HIW | “Our purpose is to provide independent and objective assurance on the quality, safety and effectiveness of healthcare services, making recommendations to healthcare organisations to promote improvements” (Healthcare Inspectorate Wales, 2014) | “we go out and inspect and we find […] an organisation is meeting the standards […] then we wouldn’t seek improvement […] beyond that (Interviewee B, HIW) | Compliance |
| RQIA | “The most important priority for RQIA is to make sure that our inspection systems and processes convey clearly to the public how well a service is performing in respect of the […] minimum standards” ( | “We provide assurance […] about the quality of services” (Interviewee D, RQIA) | Compliance |
| CQC | “We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve” ( | “We monitor, we inspect and we regulate and make sure that these services meet the fundamental standards” (Interviewee CQC D) | Compliance |
| Monitor | “[We set] a required standard that all NHS providers must meet […] [We] control the risk that foundation trusts, once authorised, fall back below the required standard. If they do, we take remedial action […] We will focus in particular on the capabilities that drive long-term performance” ( | “where trusts fail to deliver certain minimum standards […] [we] work with those trusts to ensure that they improve their position and restore themselves to […] that minimum standard” (Interviewee A, Monitor) | Hybrid |
| TDA | “The TDA oversees NHS trusts and holds them to account […] while providing them with support to improve” ( | “[Trusts] know that they are being held to account for their performance but they also know that they will get support and help and development rather than just being criticised” (Interviewee G, TDA) | Hybrid |
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