Practice 4.1 Evaluating and revising standards/criteria
Examples of notable practice:
Revisions to methodology
The Mental Health Act Commission conducted a radical review of its methodology during 2003 and 2004 and revisions were implemented in October 2004.
Applying lessons learned elsewhere
The Audit Commission applied lessons learned from the development and impact of the Comprehensive Performance Assessment (CPA) in local government, to the development of health scored judgements.
Annual review
The NHS Litigation Authority reviews its risk management standards and assessment processes on an annual basis to ensure that they remain contemporary and relevant.
The Health and Safety Executive
The 1974 Health and Safety at Work etc Act places general duties on all employers to protect the health and safety of their employees and those affected by their work activities. Its goal-setting approach makes clear that those who create the risks are best able to manage them. The need to assess risks and take appropriate action lies behind the qualification ‘so far as reasonably practicable’. This, in effect, requires that good practice should be followed whenever it is established, otherwise the duty holder needs to follow the rule of take precautions up to the point where the cost of further action would be grossly disproportionate to the health and safety benefits.
As a result, good practice standards and other forms of compliance benchmarks are regularly reviewed in light of evolving technology, risk reduction methodologies and social attitudes to risk.
Quality assurance of methodologies
The National Audit Office continuously reviews and develops its study methodologies. The approach is based on quality assessments of its work that comprise:
- feedback from the Department of Health
- evaluation of media reaction and coverage
- a cold review by the London School of Economics or Oxford University
- a team review
As an office, the NAO’s health team is required to save 8 times what it costs. Some studies are selected on the basis that they should lead to quantified financial benefits. These benefits are then agreed with the Department of Health prior to being confirmed as a financial or non-financial impacts etc. The NAO’s recent report on Stroke services identifies a number of quantified savings that ought to be realised through improvements in the management of stroke care.
