NCPR –

User Reviewer Workshop Ruth Bridgeman Acting National Coordinator

The National Cancer Peer Review Report 2009/2010

The report has been published today and includes a section on each of the Tumour sites reviewed during 2009/2010 www.cquins.nhs.uk

The intension is that some sections of the report may be included in the CRS refresh

Key National Headlines

• Improvement has been observed for all tumour groups • Increases in median compliance scores • Reductions in variations between MDTs • One quarter (25%) of MDTs scored over 90% against the peer review measures • However, a small number of teams (around 5%) are performing poorly, with compliance score below 50%

Key National Issues

• • • •

Core Membership -

Some MDTs still have gaps in their core membership – commissioners will need to determine whether these services are viable or should be merged with other services to give critical mass of expertise required

Data Collection -

Data collection remains poor in many MDTs and where data has been collected it is not being used optimally

Centralising Complex Surgery-

Some complex surgery is still being undertaken outside specialist centres

Communication Pathways -

Communication across organisational boundaries is still poor in some places, impacting adversely on quality of care for patients who need services from both secondary and tertiary providers

Overall Compliance by MDT Tumour Site 04/08 Adjusted

Overall Compliance per MDT Tumour Site 2009/2010

Good Practice

Three key areas of good practice identified in relation to the internal validation process were where the internal validation panel included one or more of the following: – Trust Executive Director – Commissioner – Patient / Carer (Users)

• www.cquins.nhs.uk

• National Report • Network Reports

The new healthcare environment

The Comprehensive Spending Review

• The Department of Health allocation now known.

• National Cancer Action Team waiting to be informed of the budget • National Cancer Peer Review will need to be prepared for cuts.

Reducing the burden on peer review on the service by 40%

• Following discussion with Jim Easton and Mike Richards in relation to QIPP back office efficiency saving it has been agreed the Peer Review should at least match the efficiency cut expected off the NHS.

• Discussions are currently underway with the executive group on how to achieve this and views are being sort from the networks • The reductions needs to be made for the beginning of the new financial year – April 2011.

Early Suggestions for reductions

• Change in culture for Cancer Managers and networks • Further reduction in the number of measures • Bi-annual review rather than annual review • Extension of Earned autonomy

Teeth

Care Quality Commission

• Mapping of measures to CQC registration outcomes • 2009/2010 data incorporated into CQC Quality and Risk Profiles (QRPS) in October 2010 • Immediate Risks and Serious Concerns reported to CQC regional assessors • Names of the teams with 50% or less compliance will be shared with CQC • Partnership working on CQC visits

The Schedule for 2010/2011 and Beyond

The Aims of National Cancer Peer Review Programme Remain Unchanged

Ensuring Services are as safe as possible Improving the quality and effectiveness of care Improving the patient and carer experience Undertaking independent, fair reviews of services Providing development and learning for all involved Encouraging the dissemination of good practice

The Peer Review Programme Peer Review Visits

Targeted

Externally Verified Self Assessments

Sampled

Validated Self-Assessments

(annual)

All Teams

Outcomes Focus - CLE

• Extending the Clinical Lines of Enquiry – Early feedback for the breast and lung pilot has been very positive – CLE to be developed for all tumour groups – UGI, Gynaecology, Colorectal and Head and Neck in 2011/12 – New measures should have CLE established when the measures are developed – Sarcoma, Brain and CNS

Users involvement in NCPR

• Peer Review Visits • Internal Validation • National User Steering Group • Zonal Advisory Groups • Users are not currently involved in external verification or Self Assessment

Your Questions

(think of your questions to put to me later in the Q&A session)

The user reviewer perspective on the highs & lows of the 2010 programme for both external review visits and internal validations. Table discussions

Dissemination of good practice

Julie Oldroyd Vice Chair NUSG Table discussions

Questions and answers session

Ruth Bridgeman Acting National Coordinator

Positioning peer review in the changing NHS- Quality framework, NICE, Quality standards, CQC, GP commissioning Tim Jackson Network nurse Director & Co-chair NUSG & Michel Golden, Compliance Manager, CQC London Zone

Should there be user involvement in self assessment?

Keith Foster Table discussion

Self assessment

• Annual self assessment by all MDT, Network groups etc.

• Aim to embed quality assurance into routine practice • Annual assessment of – Measures compliance – Update of • annual report • work programme • operational policy

Next steps & close

Keith Foster

Aims of workshop

• To provide an opportunity to reflect on user engagement in the National Cancer Peer Review programme.

• To hear the reality from user reviewers regarding both external visits and internal validations • To consider how the Peer Review program should develop in the future and how users may be involved.

Thank you for your contribution –

have a safe journey home