Paul White Managing Director – Health Horizons Ltd IQIPS and AQP – Actually Quite Perplexing? BSHAA Annual General Meeting 2nd November 2012 Thank you for the introduction. Personal background: I’ve been working in healthcare (both public and private sector) for the last 12 years I have undertaken major projects for the Department of Health as part of Health Horizons Ltd in last 4 years including work on quality and accreditation (which I’ll talk more about later) but has included the Audiology Quality Enhancement Tool. Because of my work on quality and accreditation I’ve been involved with projects that involve BSHAA now for the last 3 years. Paul White Managing Director – Health Horizons Ltd

More than a third of babies born in 2012 will live to 100! Wow! More than a third of babies born in 2012 will live to 100! http://www.guardian.co.uk/society/2012/mar/26/third-babies-2012-live-100

Impact on Hearing Aid Audiology - Prevalence of hearing loss >35 dB HL 3kHz in two cohorts over age group

Background on Any Qualified Provider (AQP) Today will provide … Background on Any Qualified Provider (AQP) Background in IQIPS (Improving Quality In Physiological diagnostic Services) Information on what resources BSHAA have made available to help you with AQP and IQIPS? Plenty of time for discussion and questions! Key points to cover today. I’m planning to leave time at the end for questions, so will do my best to answer any queries you have then.

Background on Any Qualified Provider (AQP) Today we will provide … Background on Any Qualified Provider (AQP) Background in IQIPS (Improving Quality In Physiological diagnostic Services) Information on what resources BSHAA have made available to help you with AQP and IQIPS? Plenty of time for discussion and questions! Key points to cover today. I’m planning to leave time at the end for questions, so will do my best to answer any queries you have then.

Any Qualified Provider (AQP) Any Willing Provider (AWP) Any healthcare provider, including those in the independent and voluntary sector, that is registered with the CQC (or other body where / if appropriate), that has agreed to the Terms and conditions within the NHS Standard Contract and can offer services at NHS prices. Change of name from “Any Willing Provider” to “Any Qualified Provider” ‘Any Qualified Provider’ is a way of commissioning services that enables patients to choose any provider that meets the necessary NHS standards on quality and price (either a national tariff or a locally set price). The AQP model operate on the basis that the commissioner sets the price which then applies to all qualified providers for that service for that commissioner. Under AQP qualified providers compete on the basis of quality not on price. Monitor (new) will be the economic regulator.

Which services will be covered under AQP initially For each area a lead PCT cluster is developing an implementation pack. PCTs can choose from the list of eight areas or pick a local priority area. We should know by November 2011 what areas PCT clusters had opted for. It will be for commissioners to decide whether it was appropriate to use Any Qualified Provider or a tender model for commissioning particular diagnostic services. Those providing NHS Audiology services have been encouraged to give consideration to the issues linked to providing services under the AQP model and to consider how to best position their service to be able compete on quality and convenience of access for patients

Which PCTs have nominated Adult Hearing Services? Window 1: NORTH EAST STRATEGIC HEALTH AUTHORITY; HARTLEPOOL PCT; MIDDLESBROUGH PCT; REDCAR AND CLEVELAND PCT; STOCKTON-ON-TEES PCT Window 2: SOUTH CENTRAL STRATEGIC HEALTH AUTHORITY; HAMPSHIRE PCT; PORTSMOUTH CITY TEACHING PCT; SOUTHAMPTON CITY PCT Window 3: DERBY CITY PCT; DERBYSHIRE COUNTY PCT; BARNET PCT; BEXLEY CARE TRUST; BROMLEY PCT; EALING PCT; ENFIELD PCT; GREENWICH TEACHING PCT; HAMMERSMITH AND FULHAM PCT; HOUNSLOW PCT; KENSINGTON AND CHELSEA PCT; LAMBETH PCT; LEWISHAM PCT; SOUTHWARK PCT; WESTMINSTER PCT; COUNTY DURHAM PCT; DARLINGTON PCT; GATESHEAD PCT; SOUTH TYNESIDE PCT; SUNDERLAND TEACHING PCT; ASHTON, LEIGH AND WIGAN PCT; BLACKBURN WITH DARWEN CTP; BLACKPOOL PCT; BOLTON PCT; BURY PCT; CENTRAL LANCASHIRE PCT; EAST LANCASHIRE TEACHING PCT; HALTON AND ST HELENS PCT; HEYWOOD, MIDDLETON AND ROCHDALE PCT; KNOWSLEY PCT; LIVERPOOL PCT; MANCHESTER PCT; NORTH LANCASHIRE TEACHING PCT; OLDHAM PCT; SALFORD PCT; SEFTON PCT; STOCKPORT PCT; TAMESIDE AND GLOSSOP PCT; TRAFFORD PCT; BUCKINGHAMSHIRE PCT; OXFORDSHIRE PCT; BRIGHTON AND HOVE CITY PCT; CORNWALL AND ISLES OF SCILLY PCT; DEVON PCT; NORTH SOMERSET PCT; PLYMOUTH TEACHING PCT; TORBAY CARE TRUST; BIRMINGHAM EAST AND NORTH PCT; COVENTRY TEACHING PCT; DUDLEY PCT; HEART OF BIRMINGHAM TEACHING PCT; HEREFORDSHIRE PCT; NORTH STAFFORDSHIRE PCT; SANDWELL PCT; SHROPSHIRE COUNTY PCT; SOLIHULL CARE TRUST; SOUTH BIRMINGHAM PCT; SOUTH STAFFORDSHIRE PCT; STOKE ON TRENT PCT; TELFORD AND WREKIN PCT; WALSALL TEACHING PCT; WARWICKSHIRE PCT; WOLVERHAMPTON CITY PCT; WORCESTERSHIRE PCT For each area a lead PCT cluster is developing an implementation pack. PCTs can choose from the list of eight areas or pick a local priority area. We should know by November 2011 what areas PCT clusters had opted for. It will be for commissioners to decide whether it was appropriate to use Any Qualified Provider or a tender model for commissioning particular diagnostic services. Those providing NHS Audiology services have been encouraged to give consideration to the issues linked to providing services under the AQP model and to consider how to best position their service to be able compete on quality and convenience of access for patients

AQP Key Points and Timescales This year, commissioners have been asked to identify three or more services in their locality in which patients feel they want more choice. Providers must meet the NHS criteria on quality and price. Commissioners could not refuse to accept providers once they have qualified! No volume or payment guarantees for providers – the amount of business you get depends on patient choice. Unlike any normal tender process: - income would be wholly dependent on patients choosing to use their services. Commissioners would be able to set additional contractually binding quality standards to meet the needs of particular communities or patient groups. Providers would be expected and required to work within and as part of the local health system. Commissioners could not refuse to accept providers once they have qualified unless they fall foul of the expected standards. BUT – Prices can also be subject local agreements, which means that although the price must be the same (agreed by commissioners and providers) in one location, the price for the same service provision could be different in another area! The listening exercise has delayed a number of the AQP timescales. Where are we now: Taking a natural break in the legislative process, the NHS future forum is currently inviting views from patients, clinicians, and the public on a range of themes including choice and competition in the NHS to reflect and improve existing proposals. The DH are also engaging with national patient organisations and commissioners to seek their views on introducing AQP and to seek their views on priorities for introducing AQP and the criteria which should be used to accredit providers. AQP unlikely to be mandated nationally for any services until March/April 2012. NB There are some local variations here!

More on Qualification - CQC CQC Regulations change – March 2012 “Providers of adult hearing assessments and fitting hearing aids should not be registered with CQC because the burden on providers and CQC would be disproportionate to the risk posed by such activities.”

Background on Any Qualified Provider (AQP) Today will provide … Background on Any Qualified Provider (AQP) Background in IQIPS (Improving Quality In Physiological diagnostic Services) Information on what resources BSHAA have made available to help you with AQP and IQIPS? Plenty of time for discussion and questions! Key points to cover today. I’m planning to leave time at the end for questions, so will do my best to answer any queries you have then.

More on Qualification - IQIPS Improving Quality In Physiological diagnostic Services Self-assessment and improvement tool (SAIT) 28 detailed standards and over 150 criteria statements Evidence must be submitted for each criterion Full day assessment £2,600 per year for a ‘small, simple service. Early bird fee £1,680! Written into the NHS Contract and information about it required by 50% of PCTs for AQP Qualification.

Background on Any Qualified Provider (AQP) Today will provide … Background on Any Qualified Provider (AQP) Background in IQIPS (Improving Quality In Physiological diagnostic Services) Information on what resources BSHAA have made available to help you with AQP and IQIPS? Plenty of time for discussion and questions! Key points to cover today. I’m planning to leave time at the end for questions, so will do my best to answer any queries you have then.

The AQP Qualification Questionnaire has 8 sections Offer Details Address Organisation Regulation Service Delivery IM&T Legal Declarations Most Difficult!

BSHAA Assistance Pack

BSHAA Assistance Pack

IQIPS specific assistance

There is a lot of nervousness and debate about AQP because most of it is completely unknown.

Background on Any Qualified Provider (AQP) Today will provide … Background on Any Qualified Provider (AQP) Background in IQIPS (Improving Quality In Physiological diagnostic Services) Information on what resources BSHAA have made available to help you with AQP and IQIPS? Plenty of time for discussion and questions! Key points to cover today. I’m planning to leave time at the end for questions, so will do my best to answer any queries you have then.

Thank you for listening ... Any Questions? Email: paul@health-horizons.co.uk Phone: 07989 606736 Web: www.health-horizons.co.uk