Hugo McClean, Chair BASHH National Audit Group

Background to HQIP NCAPOP audits Current BASHH/MedFASH & BHIVA proposals Development to support new joint proposal Know how to obtain further information/help * Healthcare Quality Improvement Partnership: ** National Clinical Audit and Patient Outcomes Programme

HQIP will procure a NCAPOP STI/HIV Audit Separate BASHH/MedFASH & BHIVA proposals accepted by HQIP/DH, but... BASHH/MedFASH & BHIVA to submit a new joint proposal Development project needed to support new joint proposal... engagement with key stakeholders (No guarantee that contract will be awarded to proposers!)

Why do people want to continue to live in the UK? o Low tax rates o Weather o Community strengths o Quality of healthcare o Affordability of healthcare o Cost of living

Runnymede 2011

Care Quality Commission: – STI management is included in regulated activities – Annual Provider Compliance Assessment requires evidence of use of audits in quality improvement Department of Health/ NHS standard contracts: – “The Provider shall participate in the national clinical audits within the relevant National Clinical Audit Patients Outcome Programme (NCAPOP)” Department of Health/Quality Accounts: – Requirement to take part in, publish and act on, national audits NHS Litigation Authority, Clinical Negligence Scheme for Trusts – “All organisations must have an approved documented process … making sure … all clinical audits are undertaken, completed and reported on in a systematic manner” GMC & Revalidation: – “Evidence of effective participation in clinical audit or an equivalent … that measures the care with which an individual doctor has been directly involved”

Established in 2008 Aim: increase impact of clinical audit has on healthcare quality (medical, mental & social care) Consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices (formerly the Long-term Conditions Alliance) Funded by DH Manages NCAPOP audit projects Nov 2011: 11 new audit topics accepted by HQIP, including STI/HIV programme

HQIP criteria for best practice in audit Quality Accounts With NCAAG* to test proposals for new national audit topics *NCAAG: National Clinical Audit Advisory Group (DH)

Preparation Priorities Settings Standards Engagement & agreement: key stakeholders Organizations fund audits Patient involvement Performance measurement Methods Sampling Data collection/ pre-existing databases Reporting Impact Change implementation Agreed action plans Responsibilities Resources Communication Monitoring Sustaining improvement Support Re-audits Communication

Criteria (Basic criteria for inclusion in Quality Accounts) BASHH audits HQIP NCAPOP audits Led by clinically appropriate body Stakeholder views  Performance measured against defined clinical standards Individual patient data collected Results disseminated Results publicly by open report  Report at trust level or lower Patients involved in governance  Provide support to trusts/clinicians to implement findings 

May 2011: Separate proposals submitted by BASHH/MedFASH & BHIVA for new NCAPOP audit topics Aug 2011: Acceptance of both proposals by DH – … new single audit programme spanning scopes of both Aug May 2012: Collaboration – High level Development Project agreed and submitted to HQIP to support new joint proposal May 2012: Development Project accepted by HQIP Current to end Jan 2013: Development Project in action Feb 2013: Completed new proposal. Procurement begins

Aim: to prepare a new topic proposal for a national audit programme covering: – Detection and Management of STIs, including HIV infection, in adults Objectives: – Engage with stakeholders: patients and service users, service providers including NHS, independent and third sectors, primary care, public health, other professional bodies, managers and commissioners – Propose a scope for the programme, including priority topics and settings – Specify the aims and objectives for a future audit programme over year time frame.

STI testing across range of services, measuring: – Access – Uptake – Methods of testing – Partner notification – Access to test results – Timeliness of HIV test results – BASHH management guidelines Assessing quality of routine care of people with HIV, including: – Reducing onward transmission – Adherence to BHIVA treatment guidelines Measuring patients’/service users’ experience and outcomes

Ratification new joint proposal by DHDevelopment of specificationsContract notice advertised in OJEU PPQs, shortlisting, specifications finalized (Jan 2013) Capable parties submit full tenders … contract … 29 weeks

BASSH website: BHIVA website: HQIP website: – – – –

Thanks:  MedFASH/Ruth Lowbury  Hilary Curtis  Ann Sullivan  MediScript (Faarid & Mitul)

Key topics/indicators to measure Settings: not just GUM for STIs! Operational issues – e.g. data collection and scope for using existing data sources Transparency – Requirement to publish outcomes at site/clinic level – HIV infection: possibility of data linkage across settings via NHS number