A focus on quality : improving health care in Scotland / [Scottish Executive Health Department].

  • Scotland. Health Department
Date:
2001
Catalogue details

Licence: Open Government Licence

Credit: A focus on quality : improving health care in Scotland / [Scottish Executive Health Department]. Source: Wellcome Collection.

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    Introduction The Clinical Resource and Audit Group (CRAG) provides leadership and a focus for integrating clinical effectiveness activity into clinical services across Scotland. Clinical effectiveness is an umbrella term describing a range of activities that support clinicians to examine and improve the quality of their care. Probably the best known example is audit but effectiveness stretches beyond this to include standards, guidelines, integrated care pathways, clinical performance indicators and a range of mechanisms to measure and assess quality of care through new information systems and automatic data capture. Scotland has made great progress in many of these areas and further details on specific initiatives are included in later sections of this report. This first section describes the approach to co-ordination and strategic development of clinical effectiveness, setting this in the context of clinical governance with clear accountability to the public for the quality of care delivered in the NHS in Scotland. Origins of CRAG Scotland took a strategic overview of how best to support the effective and efficient use of health care resources as early as 1985, when a group was set up to examine clinical services from a clinical and economic standpoint. In 1989, this became what we now know as the Clinical Resource and Audit Group (CRAG) with an initial remit to act as a national forum for the planning and assessment of clinical resources and a focus for the development of audit (then largely medical audit) across Scotland. Between 1989-95, there was a major drive to stimulate audit in all clinical disciplines through national audit committees and ring-fenced funding. By 1995, over 120 audits had been funded by CRAG's national projects committee and over £26 million allocated to support this developing activity across Scotland. In partnership with the Scottish Health Management Efficiency Group (SCOTMEG), CRAG also examined and reported on four key care areas: maternity services mental illness accident and emergency services for elderly people. In 1993, CRAG published Clinical Guidelines, confirming the importance of guidelines and protocols in developing evidenced-based practice and high quality clinical care. CRAG supported the establishment of an innovative and collaborative initiative by the joint Scottish Colleges (clinical professional organisations) and in 1993, the Scottish Intercollegiate Guidelines Network (SIGN) began work as a pilot project (see Section 2). Today, CRAG
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