Transcript How to Find Your Way Around…

SEPT - MANDATORY TRAINING
How to Find Your Way Around…
1. You can
play the
PowerPoint,
and find the
Test here
SEPT - MANDATORY TRAINING
2. You can
minimise this
column and
make the main
page bigger by
clicking this
icon.
Click it again to
bring it back.
SEPT - MANDATORY TRAINING
3. Always
click this
‘Home’ icon
to save your
progress and
log off.
This is very
important!
SEPT - MANDATORY TRAINING
Clinical Governance
What is Clinical Governance?
Clinical Governance is about providing a patient-centred,
accountable, safe and high quality service in an open and
questioning environment.
Clinical Governance questions traditional structures and
ways of doing things and creates a consistent and
sustained approach to improving the quality of healthcare.
Definition of Clinical Governance
“A framework through which NHS organisations are accountable for continuously improving the quality
their services and safeguarding high standards of care by creating an environment in which excellence i
clinical care will flourish".
SEPT - MANDATORY TRAINING
Definition of Quality
There have been several definitions of quality care in the last 20 years The definition below was adopted by the
NHS in 2008
Quality treatment and care has three elements which must come together to ensure the delivery of HIGH
QUALITY CARE:
Effectiveness of the treatment and care provided to patients – measured by clinical outcomes and patient
related outcomes
The Safety of treatment and care provided to patients
The experience patients have of the treatment and care they receive (Lord Darzi, NHS Next Stage Review,
Leading Local Change, May 2008.)
The NHS Constitution (2010) enshrines the right of people to receive high quality care and treatment
SEPT - MANDATORY TRAINING
History of Clinical Governance
1997 : Labour Government in the White Paper ‘The New NHS’ – Modern & Dependable abandoned the
internal market and introduced a statutory duty for quality improvement that was called CLINICAL
GOVERNANCE.
1999: Trust Boards assumed a legal responsibility for quality of care that is equal in measure to their other
statutory duties. Clinical governance is the mechanism by which that responsibility is discharged
2003: This “Duty of Quality” is a legal requirement and is found in the Health and Social Care (Community
Health and Standards) Act 2003:
2004: Health Commission established to improve the quality of services in the NHS
2009: Department of Health.: A First Class Service
2009: Standards for Better Health Declaration
2009: Care Quality Commission to regulate National Standards across health and social care providers
SEPT - MANDATORY TRAINING
Service User Involvement
The Legislative Framework to ‘put patients at the
Key Components of Clinical Governance centre of care’ was announced through the NHS
Plan -Section 11 of the Health and Social Care Act
Person centred care with service user involvement Visible 2001;
Trust Board Level leadership
This act came into force on 1st January 2003 and
Use of Clinical Information;
states that all Trust’s must, as a matter of course,
• Patient safety and robust risk management;
consult and involve patients and members of the
• Clinical Audit;
public;
• Research & Development
• Clinical Effectiveness
Consult not just when a major change is proposed,
• Staffing & Management;
but in the on going planning and development and
the delivery of services day to day.
Feedback from Service Users
We must actively seek feedback from our service users and make sure that action and
changes occur in response to this feedback. Feedback can come from a variety of sources:
• Sources of Feedback
• Complaints / compliments; comment cards
• National Surveys (including the National Patients Survey);
• Local Surveys;
• Advocacy services
• The Patient Advice and Liaison Service (PALS);
• Patient’s experience group (PEx).
• Involvement in the annual Business Planning cycle along with staff and other
stakeholder groups
• Service user son recruitment panels
• Staff induction training for staff
• Take it to the Top Forums give direct access to the Chief Executive and Team
• Mystery Shoppers
SEPT - MANDATORY TRAINING
Trust Board Leadership
PALS Involvement
Regular visits from executive and non-executive
directors to clinical areas to discuss element of
quality and safety:
Patient safety walk rounds
Patients, relatives or carers may sometimes need help,
advice or support;
• PALS will provide confidential advice and support,
helping with any concerns about the care provided by
the Trust;
• PALS can guide patients, relatives and carers through
the different services available
Director CQC spot checks
Improvement programmes led by directors and
senior management.
Use of Clinical Information - Evidence
Clinical Governance requires evidence of effective patient care and safe and
appropriate services; Accurate, meaningful and reliable information provides
a vital support to quality improvement processes;
Information comes from many different sources including:
• Routine monitoring and reports;
• Clinical Audit;
• Essence of Care Benchmarks
• Productive Series outcomes
• Patient & Carers surveys
• Ward Dashboards
SEPT - MANDATORY TRAINING
Risk Management
People Safety is about ensuring that people in our care receive high quality care and treatment by the right
people at the right time in the right place.
•
•
•
•
•
•
•
There are risks associated with all episodes of care.
Risk Management is about minimising risks to patients and staff;
It is a positive function and central to the quality of care we give to patients
Risks need to be avoided or controlled;
We do this by carrying out a Risk Assessment and agreeing the level of seriousness attached to each risk;
Actions are then taken on the result of the Risk Assessment to ensure everyone's safety.
Where risks cannot be completely removed we aim to minimise the harm caused by any adverse incidents.
Risk Management is about "stopping bad things from happening"
Clinical Audit
As part of local arrangements for clinical governance, all NHS organisations are required to have a
comprehensive programme of quality improvement activity that includes clinicians participating fully in audit;
Clinical audit is the component of clinical governance that offers the greatest potential to assess the quality of
care routinely provided for NHS users – audit should therefore be at the very heart of clinical governance
systems;
• National Institute for Health & Clinical Excellence (NICE).
• Clinical Audit is part of the CQUIN and Quality Account work undertaken in local areas in partnership with
commissioners
SEPT - MANDATORY TRAINING
Research & Effectiveness - Evidence Based Practice
The work that we carry out daily should be based on accepted good practice. It should be proven to be
appropriate and effective by people with knowledge and expertise. This is evidence based practice;
The guidance provided by the National Institute for Health & Clinical Excellence (NICE) is a good example of
evidence based practice.
NICE Guidance
NICE develop and distribute guidelines, technology appraisals (Drugs and equipment) and quality standards on
a national level. These guidelines are all evidence based and well researched before distribution.
Each Trust within the country is responsible for evidencing compliance with the NICE Guidance.
The Head of Clinical Effectiveness has responsibility to ensure that we are applying all the NICE guidelines,
where appropriate.
Local NICE Groups have responsibility to ensure that where guidance is applicable there is an achievable
action plan in place monitored within the service and progress sis reported to the Clinical Effectiveness Group
(CEG)
The Clinical Effectiveness Group (CEG) is responsible for ensuring that key decisions are made in relation to
NICE guidelines.
SEPT - MANDATORY TRAINING
Staffing & Management
Doing things differently
If you do what you always did, you get
what you always got!
The Trust aims to:
• have staff that are well trained and have appropriate skills to
provide a high quality service through: Training;
• Education;
• Appraisal;
Education & Training
• Clinical & Managerial Supervision
Care Quality Commission
The purpose of the Care Quality
Commission is to promote improvements
in the quality of healthcare and public
health, through independent,
authoritative, patient-centred
assessments, of the performance of
those who provide services.
From 1 April 2009 the Care Quality
Commission brought together the
Commission for Social Care Inspection,
the Healthcare Commission and the MH
Act Commission.
All Trusts are monitored by the Care
Quality Commission.
The Trust aims to:
• Develop staff, at all levels, to their full potential, as a means of
providing high quality, efficient and effective services and
individual patient care;
• Become a centre of excellence for lifelong learning which is
fundamental to the continuous improvement of services to
patients and to fulfilling the local and national objectives;
• Supporting personal growth, career development and
employability, against a background of ongoing organisational
change.
SEPT - MANDATORY TRAINING
Now You need to take the Test.
Please click
the ‘Test’ icon
in the left
column, and
then click for
Questions.
Remember to click the
‘Home’ icon when you
finish the Test to save
your results