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What impact does an inspection regime have on the quality of public service delivery
This assignment will look at the impact inspection has on the quality of public services delivery using the five step model for public services delivery improvement. Public services provide individuals with a service, which is provided by a public body and free at the point of delivery. On some occasion there might be nominal charge payable for example charges for prescription. The main responsibility of the governments to its citizens is the provision of public services such as healthcare and education Alford and O’flynn (2012). The manner in which governs institutions through the delivery of public services is a key factor in the attitudes to which citizens will have towards the regime. Better services translate to content individuals who are willing to cooperate with the initiatives of the government and vice versa (Foster 2011, p.74). Therefore, the services provided should be conversant and fit for purpose to meet with the needs of the public, especially the most vulnerable and should further be delivered with utmost veracity. The Health Foundation (2017) states that the UK currently spends over £140 billion a year on public provision on health and over £20 billion on social care. These structures form the largest expenditure of the total revenue retrieved by the government (Brandsen, and Pestoff 2006, p.439).
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The Care Quality Commission is an inspection regime in England that is affiliated with both public health and social care delivery services; which ensures the safety, effectiveness, compassion and quality of care given to individuals using these services was fit for purpose. The structure regulates a vast range of sectors such as the ambulance services; healthcare dispensed, care homes, hospitals dental services GP surgeries and other affiliated organisations. The system contains well elaborated policies, which apply ratings to the sectors which are regulated by law which is vital in the successful execution of its set objectives whist also encouraging improvement to be made (GOV.UK 2018).However, despite the escalation of the income the government gets, there is evidence of slow progress in the delivery of public services in both the health and social care sector. Some factors affect such outcomes like occurrences of corruption and misallocation of funds (Martin et al. 2016, p. 132). As to counter such issues, the inspection of public organisations was developed to ensure that services are delivered according to the stipulated terms (Ozolins 2010, p.198).
The forum has had major effects on service delivery as many organisations have shaped themselves in a manner that they would pass the scheduled inspections. Comprehension of the impact of inspection regime on the quality of public service delivery in the UK is aided by elaboration of associated theories and ideas. Generally, the regime aids in improving the quality of service provided as it makes the public organisations provide account for all their actions.
Various literatures suggest that the quality of services dispensed in public sectors is determined by interrelationships between all stakeholders (Löffler 2015, p.239). The hierarchical positions of the parties associated with the organisations influence the manner of message conveyance and allocation of its resources (Halstead 2014, p.7). Theories that describe the functionality of public service delivery are divided into two parts, which entail descriptive and analytical structures (De Jong et al. 2017, p.606).
The former consists of discussions that elaborate on the stakeholders involved and their segmentations but are deficient of elucidations of their interactions whereas the latter entails clarifications of the relationships and strategies employed by the actors in public organisations. The analytical theories are further equipped with mechanisms that foretell the trends in the associated establishments. Based on the two sections, the theories of public service delivery are categorised into three parts; health, education, and infrastructure.
Theories related to education argue that the main stakeholders in the system are the student, their guardians or parents, and the general public such as explained by Mansoor and Williams (2018, p.12). They are the personnel who are directly affected by the system through the merits provide. Additional players constitute of the regime in the country and the directives that govern the system (Bajorek, and Bevan 2015, p.96). The government plays a fundamental role in the public services organisations as it is responsible for the provision of resources that are employed and it also dictates the policies that guide the system.
The educators further form important actors as they are the service providers and determine the quality of the service rendered in collaboration with the establishments. The theory further suggests that the teachers and all the stakeholders only productively act when they are held accountable for their conduct (Davis and Martin 2008, p.55). As per the theory, the devised and implemented accountability mechanisms over concentrate on the number of individuals admitted in schools rather than the quality of the education dispensed.
Health theories consist of both analytical and descriptive frameworks. An example of a descriptive health structure is the World Health Organisation (WHO) bodywork. It entails elaborations of what constitutes the health structure and the factors that can be utilised in buttressing the organisation. According to the framework, the health care system consists of six fundamental segments that contribute to its strengthening. They include; service dispensing, data, actors associated healthcare labour force, monetary funding, governance, and medical equipment consisting of both technology and medication (Ferlie et al. 2005, p.97). Effectual integration and interaction between the six elements are aimed at increasing the quality of services through an increment of equity, safeguarding of social and financial threats, and escalated efficiency. Another type of theoretical framework of the healthcare service delivery identifies different key players in the organisation. They entail the patients, the citizens who pay tax, and all other customers of health care services (Rowe and Michelle 2013, p.13).
The structure argues that since the three stakeholders are the main source of monetary resources for the organisation, they are the most important and the whole structure is dependent on them. Another theory, which is more analytical, suggests that the quality dispensed in the healthcare services is dependent on three actors entailing of the state of the establishment, the general populace, and the personnel who specialise in health caregiving (Tummers et al. 2015, p.1104). The interactions between the three are interconnected for instance, the populace and the caregivers associate aided by the organisation as it acts as the interface. Consequently, the state of the healthcare facilities is the determining factor on the other relationships and the corresponding quality dispensed.
Infrastructure provision in any country cost a vast number of taxpayers’ monetary resources. Therefore, they need to be carefully decided to avoid wastage or unequal distribution (Greener 2013, p.21). The theories affiliated with infrastructure suggest that the quality dispensed in the sector is determined by interaction among different players who are interdependent. They consist of the public whose perception about the implemented procedures is affected the most, the policies that govern the structure such as supervision and manner of execution of pre-planned strategies, data conveyance, and the raw material required in the process. Additionally, the location of the transmission of the inputs of infrastructural development is an actor in the factors affecting the quality of infrastructure rendered. Effective application of interrelationships among the determinants of quality in infrastructures leads to positive implication on the public service dispensed.
Public service delivery is associated with the investments of a large part of government revenue. However, without strict scrutiny on the manner in which it is utilised, it is susceptible to be misused or underutilised for the benefits of a small percentage of the whole population (Pierson et al. 2014, p.27). Therefore, it requires frequent supervisions to enable the personnel associated to be held accountable for all utilisation of the funding, which should adhere to the set standards in the structure (Marr 2009, p.14).
The inspection regime in the UK is geared towards ensuring efficiency in service provision in public sectors, which is achieved through the implementation of user concentrated supervisions (Donetto et al. 2015, p.228). The aim of the systems in the countries affiliated is to ensure maximisation of utility dispensed to the public through optimisation of the delivery process. The structure also purposes to assure the public that their interests are taken into account through building up of enhancement of public service delivery. Scrutiny of an inspecting regime such as the Care Quality Commission (CQC) by execution of the five-step policy which are identification of the goals of the policies of the regime, policy devising, espousing the best resolution, execution, and assessment of the set policies. Review enables the deciphering of the intentions and implications of inspection in quality of public service delivery.
The goals of CQC are driven by the prevailing issues in the healthcare and social sector, which enable prioritisation of measures effectively. The main challenge facing the sector is the increasing degree of insufficient funds needed to keep up with the rising demand for the resources. Research carried out for Panorama found that 69 home care companies have closed in the last three months and one in four of the UK’s 2,500 home care firms are at risk of collapse (BBC News, 2016).
The conventional strategies employed in the industry have proven to be no longer effective in mitigating the problem. Such techniques involved injecting more investments in healthcare delivery, leaving the prices to be determined by the forces of the free market, which are dependent on the status of supply and demand, and economic utilisation of government revenue. In light of such issues, the purposes of CQC include ensuring that the healthcare services dispensed to the public is effective, of heightened quality, and promote increment of the services to the general public. Additionally, it aims to safeguard the services rendered to the public and ascertain that they are compassionate.
There is a high necessity for the formulation of efficacious models in the provision of the public services, which should involve participation from all the stakeholders associated, that is, the public, the health care centres and professionals, and the policy devisers (Parsons and Greenwood 1996, p.337). For instance, the new structures can be strategized in a manner that they deal with the prevailing demands effectively and concentrate more on the interests of the patients and the general public (Van Dooren, Bouckaert, and Halligan 2015, p.49). As such, they should be geared towards increment of quality such as through formulation of methodologies that would enable prevention of ailments, and altering policies to incorporate related sectors that conventional policies did not consider such as transport and advertising (Osborne, Radnor, and Strokosch 2016, p.672).
CQC formulated various standards, which it uses to measure the quality of services provided by varied institutions such as care homes. For instance, its policies are geared towards ensuring that the healthcare provided to the public is conversant with the prevailing laws and contains sufficient proof to ascertain that they are carried out in the most efficacious way possible to mitigate the issue of reduced funds. As such, the technology deployed in the institutions is necessitated to be utilised effectively to ensure eradication of underutilisation of resources (Gardini, Mattei, and Orelli 2012, p.126). The technologies should also be beneficial to the consumers and back their autonomy. Additionally, the standards set require that there be no form of discrimination to any individual based on the equality act in the UK, especially during the resolution making procedure. The regime has also well formulated ethical standards that are necessitated to be followed by all institutions associated to enhance protection of the customers.
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The decisions on the policies to be implemented by CQC are achieved by evaluation of the needs of all the stakeholders in the healthcare sector. The patients are also involved in the inspection process since they are directly affiliated with the public service delivered. For instance, in medication supervision, the regime scrutinises the state of the drugs, their transmission processes such as transportation mechanisms, their storage, and prescription to the patients moreover, the structure analyses whether the consumers are effectively guided on the utilisation of the medication as per the stipulated directives to ensure that they are not misused. The policies also ensure that the medications used are in line with the needs of the individual and that the healthcare personnel do not wrongly prescribe drugs for personal incentives.
CQC regime further necessitates that the professionals in the healthcare sectors possess the needed and effective skill sets to cater to the health needs of the individual. As such the regime scrutinises how the performance of labour force is managed in the institutions and whether the methodologies used are in line with legislative associated. The policies further entail that the institutions be a mirror of the prevailing needs of the citizens to ensure that the services provided meet the increasing demand for health care systems (Walker and Boyne 2006, p.374). Moreover, governors in health institutions are required to have sufficient integrity and expertise when they are hired and throughout their working period.
The execution stage focuses on implementing the policies pre-set by CQC. The regime inspects health care delivery often and involves all stakeholders. The process involves questioning the patients and the healthcare personnel and management and evaluating the evidence presented and the state of the facilities. Before commencement of any service provided by facilities that are necessitated to be regulated by CQC, they are required to be registered with the regime (“Care Quality Commission” 2016, p.4).
The structure safeguards the rights of all individuals including the marginalised such as people with mental challenges. The data retrieved from the patients are treated with the utmost importance to ensure that the healthcare institutions dispense services as per the stipulated standards. Therefore, the execution process involves partnering with the consumers of the services and also other groups who are more in touch with citizens such as Health watch England. However if the healthcare institutions do not meet the standards set, the regime imposes strict actions such as but not limited to fining the organisations, inhibiting the actions of the health care facilities for a specified duration, prosecuting the establishments (Slapper and Kelly 2003, p.3). Additionally, CQC can caution the institutions and compel them to act accordingly whether it’s to make improvements and in some cases shut the services providers down.
After the execution of the policies, CQC publishes its findings, which are prone to review requests from the health care institutions. They can follow different paths such as before publications where the institutions can project their perceptions and elucidate on the accuracy of the data (“Requesting a review of ratings” 2018). If they share a contrary opinion, they are required to provide sufficient evidence, which refutes the information the CQC has. Similarly, when CQC gives the establishments a warning announcement, they are given the opportunity to evaluate the findings of the regime and project any claims they may have supported by evidence. Healthcare institutions can also seek reviews after the publication of CQC inspection results.
CQC has fundamental impact on the quality of services dispensed by healthcare organisations such as care homes. The impacts caused leads to stimulation of varied actions from the personnel and management of the care homes (Goodman et al. 2015, p.428). Because they anticipate the inspections, they modify their conducts and structures to be conversant with the standards of CQC after which they do not adhere to them (De Bruijn 2003, p.11). However, the inspections compel them to reflect on their organisational structures, especially intrinsic environment, which motivates them to practice better standards. Various issues raised by the CQC on the care homes have prompted them to regulate their conduct, which has led to an improvement in the quality dispensed. Many consumers of health care provided in care homes rely on the information published by CQC, and when they find the situation contrary to what they read, they project their concerns, which compel the inspection regime to take action and the concerned establishments to review their activities and align them with the standards of CQC (Ferguson and Lavalette 2014, p.45).
The interactions between inspectors and the staff in the care homes have the corresponding effect of catalysing improved interactions among personnel in the institutions. Consequently, they are better equipped with a conducive environment to brainstorm and discover better ways of carrying out their activities in manners that are user focused. Hence, the CQC have substantial impacts on the care homes, which extends to more than the set directives (Smithson et al. 2018, p.3).
They stimulate other productive response that enhances the quality of care dispensed. To further enhance beneficial impacts, CQC can employ measures that equip inspecting personnel with effective expertise to better relate with different organisations, and ensure that the cultivated interactions have corresponding merits the entire establishments. Additionally, the inspection regime should foster productive interrelationships with the healthcare providers in care homes and all other associated organisations where they support the caregivers to enable increment of the degree of quality dispensed. There is also the need for the health caregivers to work collaboratively with the regulating bodies to ensure effective delivery of services. For instance, the personnel in the sector should be inspired to be more accommodating to CQC and other inspection bodies and be open to any suggestions projected. They should adhere to the standards stipulated and practice them during and also after supervision to ascertain improvement of quality dispensed.
In conclusion Inspection regimes enhance the delivery of public services as they ensure that the public organisations adhere to the set standards in the country. Despite the flaws in the inspection regime in the UK there has been increased self-awareness which encourages a more focuses outward looking approached. Such findings are exemplified by CQC and its inspection on establishment in the public sector. Because public organisations take up the largest percentage of taxpayers’ money, they ought to be carefully scrutinised to ensure that the service the consumers derive is of high quality as the corresponding attitudes determine their contentment in the government. As per the theories associated with public services, the stakeholders in the organisations are the determining factors of the effectiveness of quality delivered, which also constitutes of governing policies that encompass inspection regimes. Even though most public organisations only modify their activities during inspections to avoid negative repercussions, they are also influenced positively by inspecting bodies.
For such structures to further improve positive impact, they should interact more with public organisations ensure that they foster productive interactions in the organisations. Similarly the public service deliverers should be more accommodating to inspection bodies and work collaboratively with them.
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