While quality has always been an implicit component of the NHS, recent scandals involving poor standards have led to demands for the development of a transparent and accountable system, which ensures quality issues are addressed. The starting point for this was the first report by Lord Darzi (2008), High Quality Care for All.

The second Darzi report (2009) is more prescriptive and looks at service delivery in the community. Most recently, the Department of Health (DH, 2009) publication, NHS 2010–2015 From Good to Great represents a step forward for health care in England, especially in tissue viability. The document focuses on greater efficiency with improved standards. It also recognises the importance of pressure ulcer prevention. Primary care trusts will be able to withdraw payments when care does not meet minimum standards and the occurrence of so-called ‘never events’, including grade 3 and 4 pressure ulcers,