1. Safe, high quality care for all – the importance of accreditation
Fiona Deputy Chief Scientific Officer
Apr 2017

2. The push for Quality
We are what we repeatedly do. Excellence, then, is not an act, but a habit.
Aristotle
“Transparency about quality has helped care improve”
NHS Five Year Forward View

3. The drivers of change in healthcare
Demographics
Scientific Advance
Expectations
Social, political, economic, environmental
Service models
Care & Quality Gap
Health & Wellbeing Gap
Finance & Efficiency Gap
Utilising technology & information
Improving integration
New models of Care
Multiprofessional working
Carter efficiency review (2016)
Introducing and sustaining minimum quality standards will address these gaps.
Doing so will give assurance to:
Local and specialised commissioners – services are being delivered to appropriate quality standards
Patients and carers – standards are the same wherever they receive their care
Organisations – standardisation to improve effectiveness and reduce inefficiencies.

4. The value of accreditation
With accreditation, services can demonstrate that they:
meet performance standards sustainably & support continuous improvement
deliver clinical and administrative practices professionally
focus on patient safety and high quality of care
have appropriate resources, facilities and workforces
Accreditation provides:
Commissioners - independent assurance of quality and safety
Patients - drives care quality of care for patients,
Services - delivers efficiency and productivity
Informs commissioning decision-making, secures quality assurance knowledge & is increasingly uses in service assessment & contracting

5. Accreditation schemes
A 25 year track record of NHS experience in using accreditation to assure standards and drive improvement
HOWEVER
Uptake still variable
Much more scope to collaborate & share good practice
ACCREDITATION SCHEMES
JAG
GI Endoscopy
CEPSS
Engineering & Physical Sciences
Others
POCT, Med Devices
IQIPS
Physiology
ISO 15189
Medical Labs (Path & Genetics)
ISAS
Imaging

6. Why isn’t uptake happening faster?
Attitude to & appetite for accreditation
Interest vs influence to make it happen
Engagement
- Barriers Identified through a ‘deep-dive’ of accreditation initiatives country-wide
Attitude towards and appetite for accreditation
Of the 34 stakeholders consulted everyone was positive that accreditation is a good thing as a benchmark of quality and all wanted to work towards it or achieve it. It is perceived as a badge or mark of quality for the services they provide.
Interest versus influence to make it happen
Of the people that were interested in their services being accredited they had no or very little influence to make it happen and required executive engagement to mobilise the internal resources and support.
Support required for implementation and accreditation
There are three levels of support required, national, regional and local.
It was perceived that much more can be done to reduce the process and administrative burden at all levels.
A range of support recommendations were identified and ranged from greater transparency and ease of access to the organisations and teams going through accreditation, to developing networks nationally regionally and locally for support.
The creation of shared portals to house a repository of case studies and examples of documents or procedures that could be shared and then localised.
It was also proposed that the timescales for completion of the process are too long and nurture change fatigue.
Perceived benefits
Support required for implementation

7. Driving uptake of accreditation
A number of leading trusts have secured board-level support for accreditation programmes:
University Hospitals Birmingham (UHB) and Imperial Healthcare Trust (London) for comprehensive trust-wide accreditation.
Cambridge Hospitals for trust-wide IQIPS.
Key role for Lead Healthcare Scientists
Major initiatives – eg NHS Genomic Medicine Centres are driving accreditation across hospital networks

8. Crucial for inspection and patient assurance
Accreditation now forms a cornerstone of the evidence gathered by the CQC as part of their inspection regime:
“We will look at how we can work more effectively with our partners by using each other’s information, such as accreditation schemes” CQC, Shaping the future : What our strategy means for the health and adult social care services we regulate
“We believe that… all services need to meet recognised and independently assessed standards that ensure provision is fit for purpose… To give parents of deaf children the assurances they need about the quality of provision, all services should be accredited.”
National Deaf Children’s Society, Lessons from accredited paediatric audiology services, 2015

9. Why accreditation?
Develops culture of quality and reflection
Improves care standards and outcomes
Reduces cost to system & patients of unwarranted variation
Commissioning push – becoming a contractual obligation
Inspection requirement
Staff morale
External improvement support
Productivity/ Sustainability – STPs & Carter
VISION: All scientific & diagnostic services accredited to support safe, high quality care for all
Providers: encourage all services to achieve accreditation & improve quality
Commissioners: uses accreditation to identify & select high quality services

10. The push for Quality
Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skilful execution; it represents the wise choice of many alternatives.
War hero William A Foster (after John Ruskin)