Transcript Slide 1

Promoting quality for
better health services
Local Improvement Following
National Clinical Audit
Bristol
4th October, 2012
Welcome
• Housekeeping
• Why are we here?
– HQIP is committed to increasing the impact of national
clinical audit (NCA)
– How can you ensure that your participation in NCAs leads
to improvements in the quality of local services?
– Sharing ideas and good practice
Programme
10:00
10:30
11:00
11:30
11:45
12:30
13:15
14:15
15:00
15:15
15:45
16:00
16:10
Introduction – HQIP and the national perspective
Laying the Groundwork – policy and processes
Preparing for change – local example and group discussion
Refreshments
Breaking down the report – presentation and discussion
Lunch
Facilitating improvement 1 – effective action planning
Facilitating improvement 2 – change management
Refreshments
Case study – improvement in a local trust
HQIP NCA feedback mechanism – how can it help?
Workshop evaluation
Close
HQIP’s role
• 2008 – To manage and improve the national Clinical Audit and
Patient Outcomes Programme (NCAPOP).
– The Department of Health decides which projects should be
part of NCAPOP, on the recommendations of the National
Advisory Group on Clinical Audit and Enquiries (NAGCAE).
– HQIP implements the decisions, commissions the projects,
and manages the contracts with the NCA providers.
– The programme is expanding – 31 active projects, 9 more
planned
• 2013 - Decision making will move to the National
Commissioning Board, management contract will be renewed.
HQIP’s role
• HQIP also contract manages the National Joint Registry and
the Clinical Outcomes Review Programme (CORP – previously
National Confidential Enquiries)
• What about non-NCAPOP NCAs?
– HQIP has no direct control over projects outside the
NCAPOP, but can advise and provide guidance
– Wide variation in approach, methods and effectiveness
– At present, no system of review or accreditation
• Principles of Quality in National Clinical Audit HQIP 2012
http://hqip.org.uk/hqip-principles-of-quality-in-national-clinical-audit/
Why participate?
• Quality in the new health system (Draft report) National Quality
Board 2012 https://www.wp.dh.gov.uk/publications/files/2012/08/nqb-quality-draft.pdf
– Measuring quality and using clinical audit data to drive
improvement
• Statutory and mandatory requirements for clinical audit
http://hqip.org.uk/statutory-and-mandatory-requirements/
• NHS standard contract
– Providers must participate in the NCAPOP audits which are
relevant to the services they provide
– and must implement all relevant recommendations of any
appropriate clinical audit.
Why participate?
• CQC Essential Standards
– Outcome 16 - Healthcare providers must regularly assess
and monitor the quality of the services provided.
– They must use the findings from clinical and other audits,
including those undertaken at a national level, and national
service reviews to ensure that action is taken to protect
people who use services from risks associated with unsafe
care, treatment and support
• CQC Quality and Risk Profiles
– Used to monitor compliance with Essential Standards
– Compiled from sources including NCA reports
Why participate?
• Monitor
– Current compliance framework: Foundation Trust Boards
must certify that they have effective arrangements in place
for the purpose of monitoring and continually improving the
quality of healthcare provided to patients.
– Consultation on the new provider licence (2013 onwards)
• NHSLA
– Risk management standard 2.1: All organisations must
have an approved documented process for making sure
that all clinical audits are undertaken, completed and
reported on in a systematic manner.
Quality Accounts
• Statutory obligation introduced by the Health Act 2009.
• Act and regulations specify the format which must be used for
clinical audit information.
• Key content:
– Number of national clinical audits and national confidential
enquiries which the provider has participated in
– Number of national and local clinical audit reports reviewed by
trust board
– Actions the provider intends to take to improve services
• Clarity of reporting in the first year was ‘variable’, so
Department of Health published the Quality Accounts Toolkit.
Quality Accounts
• The toolkit introduced the Quality Accounts list
• The list is compiled by NAGCAE, publicised by HQIP
http://www.hqip.org.uk/national-clinical-audits-for-inclusion-in-quality-accounts/
• The list includes both NCAPOP and non-NCAPOP audits, and
the HQIP resource provides information on data collection
schedules and reporting.
• No obligation to participate in listed projects – BUT ‘For each
national audit or confidential enquiry that you are not currently
participating in, you are encouraged to explain your reasons for
not doing so’
• Changes for 2013/2014?
Summary
• NCAs can lead to sustained improvements in local services
• Trusts have contractual and statutory obligations to participate
in NCAs, AND to report on what actions they take as a
consequence
• Patients, the public, commissioners, regulators and licensing
authorities are all making increasing use of NCA results to
make decisions about local services
• How can you ensure that your participation in NCAs leads
to improvements in the quality of local services?