What to expect from CHI Primary Care Team Jocelyn Cornwell & Emilie Roberts

CHIs aim To bring about demonstrable improvement in the quality of NHS patient care throughout England and Wales

CHIs principles patient centred independent, rigorous & fair developmental evidence based open and accessible apply the same expectations to ourselves

Issues & challenges for PCTs? new complex shared services deficits performance targets commissioning and providing services old structures to deal with mergers moving goalposts

Issues for CHI PCTs are complex, heterogeneous, dispersed and developing organisations PCTs can exercise different levels of responsibility: they can commission and provide quite markedly different ranges of services what CHI sees in these reviews may be as much a legacy of the PCTs past as a testament to progress

PCT Boards have responsibility for, but no direct control over, a significant proportion of the services they provide the public has a relatively low level of background knowledge of primary care trusts. What does PCT stand for? we have been asked on more than one occasion the language of clinical governance is still new to some practitioners commissioning and health improvement as well as provision

What does a PCT clinical review involve? For more detailed information on PCT clinical governance review methods go to 1.click on the clinical governance reviews tab at the top of the page 2.scroll down to the link clinical governance reviews of primary care trusts

The review methods refined methods for use in PCTs expert panel consultation with patient organisations and primary care field two seminars pilot process feedback from PCTs evaluation revised process

How do we pick you for review? reviewing in clusters randomised system generally 2 months notice provided all PCTs listed on all PCTs will be reviewed

A CHI clinical governance review identifies best practice and areas for improvement is an independent assessment of systems to assure quality of patient care looks at 3 levels: patients & carers; the practice & service level; corporate level does not: assess individual performance or named practices examine every service area

Components of clinical governance (1) Public & patient involvement Risk management Clinical audit Clinical effectiveness Staffing and staff management Education, training and CPPD Use of information Processes for quality improvement Staff focus Information Components will be scored from 1-4.

Components of clinical governance (2) CHI is also developing its approach to assessing clinical governance in relation to: strategic capacity PCT commissioning health improvement prescribing & medicines management patient experience Partner organisations

The CGR process 3 months 17 weeks notification pre review phase preparation, preliminary meeting site visits, feedback reporting Action planning & ongoing monitoring

Confidence table Amount of evidence and sources A number of sources: data; documents; interviews; observation Several items of information from the same source type (e.g. interviews) from different areas or organisations One interview or observation confirmed by an independent source Several items of information from the same source type (e.g. interviews) from the same area or organisation One interview or observation only Reporting Report Verbal feedback Report Verbal feedback ? Report Verbal feedback Report ? Verbal feedback Degree of confidence Very confident Confident Some confidence Little confidence Review teams triangulate evidence to be confident in their judgements:

Reporting more consistent feedback published final report – 5 days for comments PCT provided with detailed evidence tables (not published) press release to inform the public PCT publishes action plan once agreed with StHA and CHI to address action points

Performance ratings PCTs will be given scores for each component of clinical governance clinical governance will feature as a key element in future performance ratings more news to follow

Do you have further questions about CHI? Finsbury Tower, Bunhill Row London EC1Y 8TG Tel: