Transcript Slide 1

Quality and Safety in
Cancer Care
- the view from NHS QIS
Dr Frances Elliot & Hilary Davison
Chief Executive & Director of Guidance
and Standards
13 November 2009
www.nhshealthquality.org
Strategic context
 Better Health, Better Care (2007)
 Better Cancer Care (2008)
 Living and Dying Well (2008)
 Scottish Government Quality Strategy
(2009)
NHS QIS
 Special Health Board established by the
Scottish Parliament in 2003
 independent in our advice, assessments
and recommendations
Our vision and purpose
To lead the use of knowledge to promote
improvement in the quality of healthcare for
the people of Scotland
To deliver internationally recognised
excellence in quality improvement
What we do
We :
 provide advice and guidance on effective clinical
practice, including setting standards
 drive and support implementation of
improvements in quality
 assess the performance of the NHS, reporting
and publishing the findings
 Increasingly we do this as an integrated approach
Advice,
guidance and
standards
NHS QIS
Key Activity
Assessment,
measurement
and reporting
Assurance
Accountability
Implementation
and
improvement
support
Local
improvement
cycles
Implementation
 Scottish Patient Safety Programme
 New Directorate of Improvement and
Implementation Support
 Networks
Clinical
Practice development
 Clinical governance support
Changing Role
 NHSScotland Quality Strategy
 Healthcare Improvement Scotland
- a new body responsible for scrutinising
health services, including independent
healthcare
- retains and emphasises current functions of
NHS QIS in relation to quality improvement
The future
 Integrated improvement programmes
 Based on a robust analysis of the
evidence base
 Will include a package of advice and
guidance for the service
The future
 “Care bundle” approach with appropriate
improvement tools for the service to enable
implementation
 Support from QIS and partners to make it
happen
 Key quality indicators to enable local selfassessment and reporting on progress, with
proportionate external quality assurance
Quality Performance Indicator
Development Process
QPI Development Group Launch Meeting
(QPI development group)
Preparatory work
(QIS Knowledge Management Team)
Scoping
6-8 Months
(QPI development group, NHS QIS KMT)
Indicator Development
(QPI development group)
Cancer Taskforce Ratification of QPI
(Scottish Cancer Taskforce)
Consultation
(Regional Cancer Networks)
Finalisation
(NHS QIS, QPI development core group)
Publication
(NHS QIS)
’’s
QPI Development Group Launch
Meeting
 Agree scope of preparatory work
 Define criteria for QPI development
 Inaugural meeting March 2010
 Secretariat?
Preparatory Work (2 months)
 NHS QIS Knowledge Management Team
 Assess current guidance/evidence (AGREE)
 Suggest scope for indicator development
 Develop scope of indicators – background and need
Scoping (1 – 2 months)
 NHS QIS knowledge management team and QPI
development group
 Briefing paper
 Overview of preparatory work
 Summarise key information
 Recommendations for draft QPI’s
 Filter recommendations using agreed criteria/framework
Indicator Development Group
(1-2 months)
 Review briefing paper and consider proposed
draft QPI’s
 Create short list (?10)
 Define numerators, denominators and
exclusions for each draft QPI
Draft Indicators Ratified
 Draft QPI’s presented to SCTF for approval
prior to wider consultation
Consultation (1 – 3 months)
 Consultation via regional networks
 Local, regional and national
 Who should we consult with?
 For what purpose?
 Level of user involvement?
Finalisation (2 months)
 NHS QIS, QPI Development Group
 Collate feedback from consultation
 Refine QPI’s including numerators, denominators,
exclusions
 Final ratification by SCTF
 Publication and dissemination to Boards
Involvement
 SCTF
 Agree proposed QPI development process and final
sign off
 NCQSG
 Advise on tumour sites to be addressed and
sequencing
Involvement
 Quality Performance Indicators Development Group
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Short life group
clinical experts
Review information on topics referred from NCQSG
Draft QPI’s
Definitions
Involvement
 NHS QIS
 Review of evidence
 Prepare briefing paper
 Quality assurance, consistency checking, advice on
implementation
 ISD
 Alignment with national datasets
 Ensure measurability
 Input to definitions
For Consideration and Discussion
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Ownership of the process
Ownership of the final output
How do we “badge”
How do we address tumour sites with little or
no evidence
 Generation of the evidence base