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Our newly launched Quality Review Scheme is an accreditation scheme aimed at improving the quality of rheumatology services throughout the UK. Dr Liz Price tells us more about what it involves, why it’s so important and her hopes for the future of the scheme.


What is the Quality Review Scheme (QRS)?

It’s a voluntary accreditation scheme to drive up standards and improve patient care across the whole of the UK. It builds on the foundations of our successful and long-standing peer review scheme but goes a step further. We’ll be undertaking a summative assessment against set standards, while involving patients and the whole multi-disciplinary team.


QRS uses acknowledged best practice standards for rheumatology and supports units to develop by benchmarking against set criteria. It provides external validation and a quality mark for rheumatology services.


Why is it important?

The aim is to improve rheumatology care uniformly across the UK. We know there are pockets where rheumatology is struggling and that’s usually because of a lack of resource and investment, and issues with recruitment. We want to help services address these and ensure consistency across the board.


What does it involve?

The process is clinically led and involves patients and the whole MDT. There’s a robust application to assess your policies and procedures, then there’s an inspection. As part of the process, we’ll speak to patients and get their views. A report is written up by the assessing team with a recommendation and, before this is released, it goes through a verification process overseen by a separate accreditation panel.


The panel is made up of external representatives of the MDT and patients, and they assess it against set standards. You then get notified within 10 working days, validating your strengths, and giving you a powerful quality mark. The whole process is on a three-year cycle and there’s an annual light touch review that encourages you to maintain the standards you’ve achieved.


What are you looking for?

You don’t have to be an all singing, all dancing unit. We’re looking at the way you work within your resources in the most efficient way to deliver good care to your patients.



How has COVID-19 affected the scheme?

We’ve adapted the scheme to take some of it online. For instance, the patient interviews are done via video calls. The pre-questionnaire is online and we’re also limiting the number of people who do the site visit, as we recognise it’s more difficult at the moment.


What can units gain from being part of it?

It gives you external recognition and that all important stamp of validation. It gives units a chance to reflect, look at what you’re delivering and ensure you’re doing it in the best possible way. It gives reassurance to the units, patients, the public and CQC that services are doing things right. Research looking at services going through the accreditation process in other fields confirms that standards rise during the process and remain up afterwards.


How did the pilots go?

I learn so much when visiting other units and I’m always impressed by the dedication of people and how hard they’re all working. Some of the pilot sites told us that because the process involves managers and senior managers, they were able to showcase all the hard work going on and demonstrate how invested teams are in improvement.


It could also help in gaining extra resource and championing the specialty with commissioners and providers. By preparing for the review, pilot sites told us it helped improve standards because they updated policies or changed processes in readiness for inspection.


What are your hopes for the future of the scheme?

In the long-term, I’d love QRS to be something that everybody aspires to. If all units got involved, we’d be able to increase standards across the whole of the UK. It would be lovely if no unit was left behind.


What’s your key message to members?

Let’s embrace it. In many respects rheumatology is ahead of the game as we’re a multidisciplinary specialty and patient-focused. QRS allows us to demonstrate our strengths and I’d like to show the whole medical world how cohesive we are and how we are driving up standards for patients.