NICE quality standard for COPD Craig Grime Technical Analyst Quality Standards NICE

Content What is a quality standard? Topics for 2010 and 2011 What makes up a quality standard? Who are quality standards for? How are quality standards developed? NHS White Paper NICE quality standard for COPD Contact details

Quality Standards Since April 2009 NICE has been commissioned by the Department of Health to develop independent quality standards Topics sequenced by National Quality Board (NQB) To offer clarity about what high quality care looks like across the 3 dimensions of quality ensuring: –Patient care is effective –Patient care considers patient experience –Patient care is safe Over time a library of over a hundred topics is likely to be developed

Definition A quality standard is a set of statements that are: –markers of high-quality, clinical and cost-effective patient care across a pathway or clinical area; –derived from the best available evidence such as NICE guidance or other NHS Evidence accredited sources; and –produced collaboratively with the NHS and social care, along with their partners and service users

Current Work Programme – Pilot Phase StrokeCOPD DementiaChronic Kidney Disease (Adults) VTE – PreventionDiabetes (Adults) Specialist Neonatal CareDepression (Adults) End of Life Care Glaucoma Heart Failure Breast Cancer Alcohol Dependence

Components of a quality standard Each quality standard contains: Quality statements –5 to 10 descriptive statements of the critical infra- structural and clinical requirements for high quality care which cover key points on care pathway Quality measures –Process, structure and outcome measures –Currently “High Level” Quality Indicators Use at local level as audit criteria Inform subsequent national indicator development Audience descriptors –A description of what the quality standards mean for different audiences

Who are quality standards for (audience)? Potential audiences for NICE quality standards include: Healthcare professionals Public health practitioners Social care professionals Patients and the public Service providers Commissioners

Overview of Quality standards process Topic Evidence Source NICE or other NHS evidence accredited source Guidance RecommendationsQuality StatementsQuality Measures Requires Generates Distilled into Produce

How are quality standards developed? Topic referral from National Quality Board / Department of Health TEG Selection Induction / Topic Scoping Review of Clinical Guidelines and development of preliminary prioritisation of recommendations with TEG Chair First TEG Meeting: Wording of draft statements and measures agreed Field testing & consultation of draft quality standard Second TEG Meeting: Agreement of final quality standard NICE sign off process Co- badging Timing: 9-12 months following commencement, depending on extent and nature of evidence sources and field testing/consultation

NHS Outcomes Framework Focussed set of national outcome goals Accountabilities to be focussed on delivering high quality outcomes for patients Delivery of the outcomes in the NHS Outcomes Framework will be supported by a suite of NICE quality standards NHS Commissioning Board to set the topics Quality standards will support the design of payment mechanisms and incentive schemes such as the Commissioning for Quality and Innovation (CQUIN) Payment Framework

Quality standard for COPD Consultation starts today (30/09/10) Comments welcomed from all organisations Consultation closing date 10/11/10 Consultation website address: nt/qualitystandardsindevelopment.jsp Expert group meet again in December 2010 Publication of final version March 2011

Quality standard for COPD Chaired by Dr. Michael Rudolf, Consultant Physician at Ealing Hospitals NHS Trust Primary evidence source: –NICE clinical guideline CG101. Management of chronic obstructive pulmonary disease in adults in primary and secondary care. Other key information sources: –DH consultation on a strategy for COPD services –National audit on COPD

Assessment and Diagnosis 1: Recorded symptoms 2: Post- bronchodilator spirometry 3: Severity assessment Management of stable COPD 4: Smoking cessation 5: Inhaled therapies 8: Pulmonary rehabilitation Oxygen therapy 6: Assessment7: Review Exacerbation of COPD 9: Self- management 10: NIV 11: Assisted discharge schemes Palliative care 12: Specialist palliative care Information for patients 13: Information

For more information on NICE’s quality standards Craig Grime Technical Analyst – Quality Standards Rachel Neary Interim Quality Standards Programme Manager Nicola Bent Associate Director – Quality Systems