Promoting good medical care.

This paper sets out the policy of the Union Europeenne des Medecins Specialistes/European Union of Medical Specialists (UEMS) on quality assurance (QA), which is defined here as the regular review against defined standards of medical care. Its aim is to provide a framework for confirming the good quality of health care in Europe and, specifically, of the contribution of specialist doctors. The paper provides guidelines that can be adopted for use in QA systems in all European countries. It will show that this can best be achieved when QA is based on valid evidence, which can also facilitate improvements in medical care and justify the provision of necessary resources. This UEMS policy paper builds upon considerable evidence of successful, well-established QA systems that are found in many parts of Europe. Fundamental features of these are that they are led by specialist doctors who control resources allocated solely for the purpose of QA. Accordingly, the UEMS recognises its responsibility to develop policy based on this experience and invites all interested parties to support this. The UEMS considers QA to be an essential component of an agenda focused on high standards of medical practice. The other parts of that agenda include continuing professional development as a form of quality improvement-covered separately in the 2001 UEMS policy document "The Basel Declaration"-and its policy being developed on regulating the medical profession. This paper is addressed to all who have an interest in the quality of health care provision: patients, doctors, medical associations, health service employers and hospitals, fund holders, regulatory authorities and national and European legislators. The UEMS considers that, in the context of the QA of medical care, all share the following agenda: The UEMS draws attention to the lack of evidence demonstrating any additional effectiveness of mandatory systems over the model described here. The following list of key points drawn from the text expands this summary. It also serves as an index to specific paragraphs of the paper. KEY POINTS: