Table 1 The Dutch Health Care Inspectorate (IGZ)

The Dutch Health Care Inspectorate (IGZ) is an agency of the Ministry of Health, Welfare and Sport. It is the official regulatory body charged with supervising the quality and safety of healthcare services, prevention activities and medical products in the Netherlands. The IGZ has organised its supervision in several ways in order to ensure compliance with professional standards and guidelines and to ensure patient safety. The most important methods are supervision based around incidents and analyses of various types of risk information, also known as risk-based supervision.

If risks are identified, then the IGZ visits a nursing home or a home for older people. This method of supervision consists of general supervision and, what is defined as thematic supervision. In this case the IGZ conducts visits to several organisations based on a specific theme common to the whole sector. This action is the result of research or incidents such as medication safety. The IGZ then assesses one or more risks depending on the diversity and severity of the risks identified within a specific organisation. This assessment is based on reviewing documents relating to the quality management systems, such as care protocols and patient files, but also to reviewing the communications with, for example, care managers, care professionals and patients.

The organisation must then take measures to improve safety and thus reduce the risks. These improvements and their results must then be reported to the IGZ. The IGZ will then conduct a follow-up visit to assess the implementation of the improvement measures. The IGZ is mandated to use enforcement measures if the organisation does not comply and there is insufficient faith in the organisation to realise the improvements in time. For instance, the IGZ can impose intensified supervision of an organisation. This may involve frequent visits, announced or unannounced, and consultations with the board. They can involve the organisation as a whole or just one of its departments. The IGZ can also penalise the organisation including prohibiting it, temporarily or even permanently from accepting new patients.