'A first class service - quality in the NHS' consultation document

A first class service - quality in the NHS provided further detail on the government's plans to tackle quality variation.

National standards would be set out in national service frameworks (NSF), which were to be prepared by senior clinicians (sometimes called 'czars') appointed to head a committee and produce guidance on their particular specialties, such as heart or mental illness.

Additionally, the National Institute for Clinical Excellence (NICE) would produce clear guidance for clinicians and assess new drugs, treatments and devices for clinical and cost effectiveness. The NHS would quality assure clinical decisions through clinical governance and professional self-regulation.

Standards would be monitored through the new Commission for Healthcare Improvement (CHI), a national performance assessment framework and a national patient survey. CHI's main functions would be to provide national leadership to:

• develop and disseminate clinical governance principles
• scrutinise local clinical governance
• support the NHS to identify and tackle serious or persistent clinical problems.