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Systematic Narrative Review
Can routine data be used to improve
the quality of health and social care
regulation?
Abstract
Context
As part of its 2001 Programme for Government, the Northern Ireland
Executive signalled its commitment to raising the quality of public services.
This was ensued in 2002 by Ministerial agreement with those proposals set
out in 'Best Practice, Best Care', a consultative document authored and
disseminated by the Department of Health, Social Services and Public Safety
(DHSSPS). In practical terms, this progression in public policy meant that
organisations which delivered health and social care now had to fulfil a
statutory duty of care.
The subsequent legislative framework which would then form the basis for
implementing this aspiration to raising the quality of health and social care
services in Northern Ireland, was The Health and Personal Social Services
(Quality, Improvement and Regulation) (Northern Ireland) Order 2003. As an
outworking of this, the Regulation and Quality Improvement Authority (RQIA)
was established as a non-departmental public body of the DHSSPS in 2005.
The role of the RQIA as a regulator necessarily involves capturing,
processing, analysing and disseminating a huge volume of data. A significant
proportion of individual inspector's time is dedicated to prioritising and
interpreting such information when adjudicating on the quality of services or
when attempting to identify which services require proactive regulatory
involvement. The lexicon of the regulator uses the term 'intelligence' as a
synonym for the data regulators handle as they carry out risk based and
dynamic decision making. Such data, both qualitative and quantitative, is
derived from various sources including HSC Trusts, service providers,
charitable organisations, and patients/relatives themselves, to name but a few.
As such, how regulators handle the intelligence they hold is crucial; efficacious
regulation must be flexible and adaptive as it engages with such data if it is to
demonstrate credibility and integrity.
This systematic narrative review aims to examine the evidence base upon
which regulators engage with routine data as part of their regulatory activity.
The degree to which such data is converted into actionable and effective
responses is a key contributor to how RQIA and other regulators remain