NHS QIS COPD Standards Lessons learned from Tayside and Borders Dr J F Faccenda Dr P Slane
What is NHS QIS? NHS Quality Improvement Scotland Healthcare Improvement Scotland ‘Improving the quality of care and treatment across NHS Scotland’ Scottish Patient Safety programme Scottish Medicine Consortium Scottish Health Council Healthcare Environment Inspectorate SIGN
Standards Clear and measurable Evidence based Stretching but realistic and achievable Essential Desirable
Process Multi disciplinary group Using NHS QIS methods Drafted document Public consultation Final draft Pilot visits- NHS Borders and NHS Tayside
There are 7 standards Organisation and delivery of COPD services Case finding Diagnosis and periodic review of COPD Pulmonary rehabilitation Oxygen therapy Home support, intermediate care and supported discharge services Palliative care services
The Standards Evidence provided Met Unmet Insufficient evidence
Visit Planned? What to do next …..
Visit Planned?
Visit Planned?
Gathering Evidence
NHS Tayside Pilot Experience Why did we do it? How much work/time? What did we learn? Will it help improve care? Advice
NHS Tayside Hospitals Ninewells, Perth Royal Infirmary and Stracathro Roxburghe House/Cornhill House Hospices 3 Community Health Partnerships 12 Community Hospitals 76 GP practices 89 Community Pharmacies (oxygen 33)
Why? Raise profile of MCN and COPD in Tayside Benchmarking Impetus to change- at all levels Help with NHS QIS Standard development
Workload August-November preparation for December inspection Clinical Governance Support Meetings Data gathering No MCN manager!!
Data No evidence = NOT met MCN maturity 3 CHPs IT department difficulties – data quality BTS audit not done in secondary care Timescales
What did we learn? 3 CHPs have different priorities and structures* Maturity of COPD services varied Level of activity and recording of evidence varies - but “pre standards” Secondary Care contribution constrained - don’t have inspection same time as BTS!
What did we learn? Need better IT support – national and local TARDIS - good feedback, but not used in all CHPs Degree of apathy towards process
Will it help improve care? NHS QIS COPD Standards now inform workplan for Tayside MCN COPD subgroup Impetus for IT support Prompt to CHPs, secondary care and NHS Board?? Implementation support Service development
Advice Start now! Identify lead - MCN Manager? Collect Information Benchmark Push for IT to support data recording - national/local?
Future NHS QIS COPD reports? Significant workload for MCN, boards and QIS New model not yet defined?