1. Integrating National Clinical Audit in Policy and Performance Management Systems Chris Dawson Head of Major Health Conditions Policy, Welsh Government www.hqip.org.uk

2. NHS Wales

3. Role of Government Set the direction Hold to account

5. How does Government understand quality To set direction and hold to account need to understand the quality of services

6. Building the Picture Quality Audit Patient Experience / Complaints PerformancePeer Review Soft Intelligence Serious Incidents Mortality Review InspectionFinance

7. Patient Experience Community Health Councils Voice- Complaints as a gift Integrated Health and Social Care Patient Experience

8. Mortality Reviews Mortality Case note reviews operational in all hospitals in Wales 1000 Lives Improvement collaborative has ensured that all Health Boards are now applying a two- stage process to review mortality case notes and have a forum to ensure shared learning both from the process as well as from the findings Mortality Reviews

9. Audit 36 Audits as part of national programme agreed by Advisory Committee Mandatory Participation as part of NHS Outcomes (performance) Framework Clinical Leadership Audit

10. So What? Performance Management Policy

11. Performance Management NHS Outcomes Framework Escalation Intervention Health Inspectorate Wales and Wales Audit Office Transparency http://mylocalhealthservice.wales.gov.uk/#/en http://mylocalhealthservice.wales.gov.uk/#/en

12. Policy Quality driven policy Clinical Leadership Transparency

13. 13 What do we do with the findings?

14. Diabetes Policy Diabetes Delivery Plan Focus on Inpatient Diabetes Insulin Management Focus on Foot care

15. 15 Stroke The pace of change experienced in Wales since 2010 is higher than that noted in England and Northern Ireland. Percentage of adults, who reported ever having been treated for a stroke, by – 2003/04 – 2012 (16 plus) Good progress has been made in developing thrombolysis services. Wales had minimal provision 2 years ago and now offers round the clock thrombolysis provision in 100% of its hospitals either onsite or in collaboration with a neighbouring hospital.

16. Policy- Prudence

17. The End Planned system driven by quality Audit, as part of a quality system, driving policy direction Audit, as part of a quality system, driving policy delivery

18. Exercise Using your knowledge of Quality what one national policy would you change or introduce (remembering there is no new money) What one local (Trust/ Health Board) Policy would you change or introduce

19. Final Thought When did you last pitch an idea to your organisation? Christopher.Dawson@wales.gsi.gov.uk