PHEM curriculum unit C.8 · Cross-cutting theme C: Clinical Governance
The DipIMC is blueprinted against phase 1 of the UK Pre-hospital Emergency Medicine (PHEM) curriculum. This page covers unit C.8, Understand and apply quality management processes.
Below are 2 free practice questions from the DipIMC.Ninja bank, in the Part A single best answer format. Every answer names the textbook page, guideline or statute it was written from, so you can check it rather than take it on trust. The bank holds 10 questions on this unit.
Question 1 · Law, Ethics & Human Factors · Easy
An independent ambulance provider that supplies event medical cover and patient transport under NHS contracts is preparing for assessment by the Care Quality Commission. Its clinical lead asks which five key questions the CQC asks of every service it regulates. Which option lists them?
ASafe, effective, caring, responsive and well-led
BSafe, timely, efficient, equitable and patient-centred
CStructure, process, outcome, experience and leadership
DPerson-centred care, dignity, consent, safety, governance
EQuality, safety, value, culture and sustainability
Show answer
Answer: A
Safe, effective, caring, responsive and well-led
CQC's assessment framework is built on five key questions that it asks of all health and social care services: are they safe, effective, caring, responsive to people's needs, and well-led. Under each key question sits a set of quality statements; learn the five questions, and do not rely on the detail or number of the statements beneath them for an examination. The person-centred care, dignity, consent, safety and governance option lists topics of fundamental standards in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 — for example regulation 11, need for consent — which are regulations, not the key questions. The other lists are quality frameworks from elsewhere, not CQC's. An independent provider carrying on a regulated activity is assessed against the same five key questions as an NHS ambulance trust.
Question 2 · Law, Ethics & Human Factors · Moderate
A CQC inspector asks the governance lead of an independent ambulance provider to demonstrate how the service meets Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Which of the following is a requirement of Regulation 17?
ABeing open and transparent with relevant persons, and notifying them in person of incidents
BDeploying enough suitably qualified, competent, skilled and experienced staff at all times
COperating systems to assess, monitor and improve quality and safety, and keeping records
DObtaining consent before care, or acting in best interests where the person lacks capacity
EEnsuring each person employed is of good character and has the skills needed for the role
Show answer
Answer: C
Operating systems to assess, monitor and improve quality and safety, and keeping records
Regulation 17 (good governance) requires systems or processes to be established and operated effectively, and in particular to enable the provider to assess, monitor and improve the quality and safety of the services; to assess, monitor and mitigate risks; to maintain securely an accurate, complete and contemporaneous record in respect of each service user; to keep other necessary records about staff and management; to seek and act on feedback; and to evaluate and improve practice. The CQC can require a written report within 28 days on how the first two duties are being met. The other options are real fundamental standards in other regulations: openness and in-person notification is the duty of candour (regulation 20); deploying sufficient suitably qualified, competent, skilled and experienced persons is staffing (regulation 18); consent is regulation 11; and good character of persons employed is regulation 19 (fit and proper persons employed). The records limb of regulation 17 is why the patient report form is a regulatory as well as a clinical document.