CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 1 Healthcare Inspectorate Wales Our focus over the next three years

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 2 A Quick Reminder of Our Powers and Remit?

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 3 Part 2 Chapter 4 of the 2003 Health and Social Care Act  The availability of and access to health care  The quality and effectiveness of health care  The financial or other management of health care and the economy and efficiency of its provision  The availability and quality of information provided to the public  The need to safeguard and promote the rights and welfare of children

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 4 Our powers enable us to  Conduct inspections & investigations  Require documents & information  Require people to provide explanations  Publish reports

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 5 Our powers and responsibilities have kept on growing Healthcare Inspectorate Wales NHS Inspection and Investigation Regulation of Independent Healthcare Statutory Supervision of Midwives Clinical Reviews of Deaths in prison Homicide Investigations Assessment of Nurse Agencies Ionising Radiation (Medical Exposure) Regulations Reviews of Youth Offending Teams Reviews of Substance Misuse Services Mental Health Act Review Service Regulation of Dentists Deprivation of Liberty Safeguards (DOLS)

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 6 The organisations we have access to  NHS Local Health Boards and Trusts  Primary and community care practitioners – health visitors, district nurses etc.  Primary care contractors – GPs, dentists, ophthalmologists, pharmacists  Independent healthcare providers

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 7 HIW Patients and public National Health Service and Independent Healthcare Welsh Government

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 88 How do we do it?

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 99 have been designed to foster the ‘right’ behaviours necessary to uphold our values and achieve our vision in the longer term Our ways of working….

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 10  Integrated service delivery  Project based deployment  Knowledge driven inspectorate  Using external expertise  Using information and intelligence We have set clear operating principles

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 11  Collaborative – working with others and sharing knowledge, experience and expertise  Learning – constantly evaluating and developing  Flexible - finding the best approaches  Supporting, encouraging, clear and firm Our working style

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 12  Inherent risk of service  Identified risks  Serious concerns about patient safety  Issues of concern to public  Where we need to ensure progress and improvement What influences what we look at:

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 13 Our basket of tools and approaches has expanded and developed. Inspection visits Special themed Reviews Investigations/Special Exercises Standards for Health Services assessments Unannounced Cleanliness & Infection Control spot checks Unannounced Dignity & Respect Essential Care spot checks Healthcare Summits

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 14  Set up advisory group  Develop specific scope and approach  Develop appropriate tools for testing  Pull together a team with necessary knowledge and expertise Our approach to our work

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 15  Preliminary planning  Detailed plan  Agreed scope and approach  Testing programme  QA at regular intervals  Sign off and cross referencing of working papers  Proving and proofing Backbone of rigour

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 16  Ensuring organisations are fit for purpose  Annual validation and testing of compliance with Doing Well Doing Better: Standards for Health Services in Wales  Regulation of independent sector  Dignity and essential care visits What we will do every year

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 17  Ensuring patients and service users in potentially vulnerable situations are safeguarded  Monitoring the application of the Mental Health Act  Deprivation of Liberty Safeguards  Unannounced cleanliness spot checks  Unannounced dignity and essential care visits  Monitor compliance with IR(ME)R controlled drugs What we will do every year

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 18  Services for those who may be in particularly vulnerable situations or may be at a particular risk  Risk assessment in mental health  Oxygen and medical devices  Action on Patient Safety Alerts  Community mental health services: Community Treatment Orders  Medication  Joint work with CSSIW, Estyn and the WAO Current and future areas of focus In we will focus on:

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 19  Management and care of patients with fractured neck of femur  Food, fluid and nutritional care  Eating disorders  Maternity services  Speech and language therapy  Children’s palliative care services  Cancer Services: referral pathways  Diagnostic services  Disabled children  Provision of care and services to people with Autism Current and future areas of focus In we will focus on:

CHC Annual Conference 28 June 2012 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 20  Falls and fractures  Palliative care  Young people moving from child to adult healthcare services  Blood services  Putting things right  Are we keeping people out of hospital  Services for transgender people Current and future areas of focus In we will focus on: