There are a number of reasons for wanting to know how well a clinical service is working. A commissioning organisation or a regulatory body may want evidence of quality to inform a commissioning decision or as part of an inspection. A department may wish to know how well it is doing in comparison with another department or whether it is improving, standing still, or deteriorating over a period of time. There are many possible ways of measuring quality ranging from opinions of service users and staff to hard measures of outcome such as mortality. However, good measures of quality may be defined as ones which ask questions which discriminate accurately between a service which is serving its patients well and one which is failing its patients.
The College’s Quality Standards Group has produced a suite of simple self-assessment tools in draft form for the following clinical services: cataract, glaucoma, diabetic retinopathy, children and young adults, oculoplastics, age-related macular degeneration (AMD) and vitreoretinal surgery. The tools do not attempt to assess every aspect of each service, but focus on areas where problems are likely to show if the service is under stress. Very few clinical services will achieve a perfect score, so the questionnaires can be used as quality improvement tools as well as snapshot audit tools.