Improving the quality of long-term care has been central to the agenda of successive UK Governments since the late 1980s and a number of mechanisms have been introduced to achieve this end. The quality assurance framework that exists in England is comprehensive and supported by legislation. It is also supported by a number of national quality measures, including performance indicators from administrative systems to user surveys and composite measures of quality. There is close interaction between the quality assurance system and the collection of data for quality measures; additionally, the measures are used to support quality assurance activities. This relationship has consequences for the accuracy and validity of the measures
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