1. An introduction to ACSA

2. What is Anaesthesia Clinical Services Accreditation (ACSA)?
A voluntary scheme for NHS and independent sector organisations
Quality improvement through peer review
A period of self-assessment and then improvement, with support from the College
Working towards the goal of becoming an accredited department

3. What are the ACSA standards?
Based on the RCoA’s NICE-accredited “Guidelines for the provision of anaesthetic services”
Separated into 5 domains:
The care pathway,
Equipment, facilities and staffing
Patient experience
Clinical governance
Optional Subspecialties: Neuroanaesthesia, Adult cardiothoracic services, Ophthalmic, Vascular
Prioritised into 3 categories – all Priority 1standards must be met for accreditation to be awarded.

5. Process Internal Decision Self-assessment Contact Engagement Review
Accreditation
The department receives the onsite review report and works to close any gaps
Once 100% of Priority 1 standards are agreed as being met, the department is awarded accreditation
Internal Decision
The department decides that they want to participate in the ACSA Scheme
Self-assessment
The department self-assesses using the ACSA self-assessment tool
The department works to close the gaps between current practice and the required standards
Contact
The department sends their registration form to the ACSA team
An optional teleconference is held to discuss details, practicalities and answer any queries
Engagement
The department decides that they are ready to formally engage with the ACSA Scheme – usually 70% compliant
The department pay their ACSA subscription and gain access to the Good Practice Library and are assigned a College Guide
Review
The department decides they are ready for an onsite review visit
An ACSA onsite review team, including two clinicians, a lay member and an administrative reviewer, visits the department

6. How long does accreditation last?
The accreditation cycle lasts 4 years
You will have to confirm continued compliance with the standards in Years 2, 3 and 4
If the department decides to continue to engage with ACSA after year 4, an onsite review visit will be required

7. How Much Does It Cost?
The annual subscription charge is based on the size and complexity of the department; information obtained from your department’s Registration Form
The minimum subscription is £2,570 per year for a small (< 50 consultants) single site hospital
The initial payment agreement lasts for 4 years. An up-to-date subscription is required to maintain your accreditation status

8. Why engage with ACSA?
A pro-active, structured process for improving services
A process to self-check local guidelines and standards against nationally recognised standards
Engagement in service improvement from staff within the department and at management level
The benefit of expert advisory review on-site and help toward compliance

9. What are the benefits of ACSA?
Departments will have a positive ACSA report to support funding and resource bids
Direct feedback on service delivery in comparison with other anonymised providers
Year-on-year comparison with local, regional and national standards of performance
Access to a network of accredited departments willing to share best practice and service improvement initiatives
Accredited departments will project a more attractive professional environment to potential employees and trainees

10. What do official bodies think of ACSA?
Commissioner recognised enthusiasm for service improvement
In England, CQC recognises accredited departments as low-risk.
Similar recognition is being sought from Healthcare Improvement Scotland, Healthcare Inspectorate Wales and Regulation and Quality Improvement Authority, Northern Ireland
ACSA contributes to meeting the Quality, Innovation, Productivity and Prevention programme (QIPP)
Accreditation provides evidence that may support future Commissioning for Quality and Innovation (CQUIN) payments
Additional recognition being is being discussed at NHSLA and NICE

11. What do accredited departments say about ACSA?
Add profile from most similar accredited site
Add quote from that site

12. Who else is engaging with ACSA?
XX departments are registered with ACSA across the country – XX are in your region
Of these, XX have formally engaged through payment with ACSA
Of these, XX have been visited by an onsite ACSA review team
Of these, 16 have been accredited so far

13. What’s in it for the RCoA?
Meeting RCoA strategic goal: “Setting and maintaining the highest standards for anaesthesia and delivering healthcare improvements to secure the best outcomes for patients”
Greater engagement with departments
Updating College guidelines from direct feedback
Data gathering on a national level
Integration with key stakeholders including patients and regulators
Proactivity recognised by national bodies representing regulation, governance, indemnity, and political positions

14. Where to start? Self-assessment against the ACSA standards
What are our strengths and weaknesses?
What is the size of the gap between current practice and meeting the ACSA standards?
Communication with colleagues – clinical and non-clinical
Involving as many people as possible from the start will make it easier to identify problem areas and spread the work
Wider input and a whole-team approach is the key to implementing improvements
Management support is essential
Improvement – what and how can we improve?
Some improvements will be straight forward to implement, even before the department is formally engaged with ACSA
Other improvements will take more effort and the College will offer help from experienced clinicians and via examples of good practice

15. More information Visit our webpage: www.rcoa.ac.uk/acsa
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