Transcript Document

How NICE quality Standards can help drive and
measure quality improvement
Dylan Jones
Associate Director - Quality Standards
Health and social care quality programme
Presentation overview
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Policy background
What is a quality standard?
What makes up a quality standard?
How they help measure quality
improvement.
• How they can drive quality improvement.
Policy Background
The relevant commissioner may direct NICE to
prepare statements of standards in relation to
the provision of:
a) NHS service
b) Public health services or
c) Social care
In discharging its duty, the Board/Secretary of
State must have regard to the quality
standards prepared by NICE.
Organisations improving the quality of health
services must have regard to the quality
standards prepared by NICE.
Quality standards – three interfaces
Social care
NHS
Public
health
What are NICE quality
standards?
A comprehensive set of recommendations for a particular
disease or condition, particular need or service
Evidence
Guidance
Quality
Standards
A NICE Quality Standard is a concise set of statements
designed to drive and measure priority quality
improvements within a particular area of care. Around 6-8
statements per standard – up to 15 in exceptional
circumstances.
What makes up a QS?
Quality statement
Rationale
Quality measure
Audience descriptor
Source guidance
Data Source
Definitions
How they help measure quality
Quality Measures
Structure
Process
Outcome
Organisational
characteristics
Interactions
Functions
Actions
Changes in
individuals and
populations
Example – Stroke (QS2)
Statement
Patients with suspected stroke are admitted directly to a
specialist acute stroke unit and assessed for thrombolysis,
receiving it if clinically indicated
Structure
Evidence of local arrangements to ensure that patients with
suspected stroke are admitted directly to a specialist acute
stroke unit and are assessed for thrombolysis, receiving it if
clinically indicated
Example – Stroke (QS2)
Process
a) Proportion of patients admitted directly to a specialist
acute stroke unit and assessed for thrombolysis
b) Proportion of patients with suspected stroke assessed
for thrombolysis who receive it in accordance with NICE
technology appraisal guidance 122 (2007) and NICE
clinical guideline 68 (2008).
National Comparison
• Where they can Quality Standards will help
inform future national audits
• The Sentinel Stroke National Audit Programme
(SSNAP) is an example of this.
• Quality statements 3, 5 and 11 are all
considered within the 2012 report
How they can drive improvement
They do not restate essential standards or regulatory
requirements. Where there is overlap, statements should
be mutually supportive and complementary.
NICE quality standards
CQC- Registration
requirements
Proportion of services
Standard of services
Unsafe
Substandard
Adequate
Good
Excellent
How they can drive
improvement
National Outcomes
Framework
Local provider
payment mechanisms
• Triggering a review of local performance
against relevant national outcome indicators
• Commissioning for Quality Improvement
Initiatives (CQUIN)
• Quality Outcomes Framework (QOF)
Local commissioning • CCG Outcomes Indicator Set (CCG OIS)
• Indicators for local use
mechanisms
Commissioner and provider perspectives
Providers
Commissioners
• Meeting QS will help:
• Demonstrate that a high quality
service is being delivered
• Achieve any financial incentives, eg
QOF
• Using QS will help:
• Inform contract specification and
monitoring of contracts
• Set indicators for local CQUIN
• Achieve outcomes as part of the CCG OIS
Professional and lay perspectives
Healthcare
professionals and
social care
practitioners
People receiving
health and social
care services, their
families and carers
and the public
• Using QS will help:
• Make decisions about care based on the
latest evidence and practice
• The development of local audit and
practice reports or in professional
development and validation
• Using QS will help:
• People decide which services to
access.
• To holding commissioners to account
• To make choices between providers.
More information
• All the details regarding the background,
the development process, stakeholder
involvement and the standards themselves
(published and in development) are
available on the NICE website
(www.nice.org.uk)