About the strategy
High-quality care should be the standard for everyone who uses the NHS. This strategy sets out how we will deliver that consistently over the next decade.
It provides a structured approach to making quality the organising principle of NHS-funded care in England.
What we mean by high-quality care
High-quality care is defined through 3 core domains:
- safety – reducing the risk of unintended or unexpected harm to patients arising from the provision of healthcare
- effectiveness – providing evidence-based care that improves outcomes for people
- experience – delivering co-ordinated, compassionate and responsive care that meets people’s needs
All 3 must improve together. Focusing on one alone will not deliver consistently high-quality care.
What the strategy aims to achieve
The strategy focuses on:
- improving health outcomes and healthy life expectancy
- reducing healthcare inequalities
- improving satisfaction with NHS services
Why this matters now
High-quality care is delivered across the NHS every day, but recent reviews and data still show a mixed picture of care quality.
Some encouraging gains have emerged – for example, continued improvement in early lung cancer diagnosis and a partial recovery in the timeliness of cancer treatment. Yet, outcomes and experiences remain uneven, and healthy life expectancy at birth in the UK has fallen to its lowest level since 2011.
To address these challenges, this strategy aligns with:
- the 10 Year Health Plan, which sets a system-wide commitment to high-quality care and transparency, based on a new operating model and moving care from hospital to community, analogue to digital and sickness to prevention
- the Dash Review, which calls for a more co-ordinated, value-based approach to quality to make the best use of NHS resources by focusing on interventions that deliver the greatest overall health benefit and improved productivity
- a strengthened role for the National Quality Board (NQB) in overseeing progress and improving accountability
Read more about the context behind the strategy.
Priorities for this strategy
This strategy does not introduce new requirements. It focuses on applying proven approaches more consistently, where this will deliver the greatest improvements in outcomes, equity and value.
Initial priorities focus on:
- improving outcomes and reducing unwarranted variation across major conditions and priority groups through implementation of the National Cancer Plan and modern service frameworks
- making sustained improvements in maternity and neonatal services
- strengthening patient safety across all settings
- improving experience of care and restoring trust in NHS services
- reducing inequalities across safety, effectiveness and experience
- monitoring clinical and population health outcomes
These priorities will evolve over time, reflecting progress, emerging risks and changing population need.
Read more about the strategy’s priorities.
How this will be delivered
The strategy sets out 10 enablers to create the conditions for improvement across the system. Each enabler links to further detail on how it will be delivered:
- clarifying who is responsible and accountable for quality at every level of the healthcare system
- setting clear priorities to improve the quality of care while adopting a transparent, co-ordinated and value-based approach
- strengthening leadership and management capability to create the right culture and conditions for improvement
- listening to and working with people and communities on what matters to them
- using data to manage quality, inform decisions and support accountability at all levels
- increasing transparency, making the NHS the world’s leading healthcare system for public access to information on care quality
- developing and embedding technology to underpin quality management and improvement
- aligning incentives and rewards with accessible, high-quality and productive care
- promoting research and innovation to support continuous improvement in clinical care and how the NHS operates
- creating a more co-ordinated and improvement-focused approach to regulation
Building on the 10 enablers, the strategy also outlines how quality management systems provide local organisations with a structured way to plan, deliver, monitor and improve quality.
A shared responsibility
This strategy asks every member of staff, both clinical and non-clinical, to see quality improvement as their responsibility, not someone else’s.
It also asks the system as a whole to be honest about where care is falling short and what it will take to put things right.
The prize is significant: fewer avoidable deaths, longer healthier lives and care that people can trust. Working together, we can create a system that delivers high-quality care everywhere and for everyone.