ABSTRACT
Quality management has become a key feature of health and social care policy. There is a good deal of evidence available as to what constitutes good care, and good commissioning. The aim of services should not be to provide care that is just ‘good enough’. Clearly, quality matters, therefore, to both service users and staff, and there have been many initiatives to change the behaviour of professionals and to improve the quality and efficiency of care. Quality in health and social care was historically defined by professionals, who were ‘experts’ in their particular field. The Kennedy Report drew attention to the ways in which parts of the health service were shrouded in a professional ‘mystique’ that meant members of the public were effectively in the dark. Members of the integrated health and social services learning disability team in Westminster, London, were aware that some people could not access day service provision because of their challenging behaviour.
