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Integrating National Clinical Audit in Policy and Performance Management Systems Chris Dawson Head of Major Health Conditions Policy, Welsh Government www.hqip.org.uk
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NHS Wales
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Role of Government Set the direction Hold to account
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How does Government understand quality To set direction and hold to account need to understand the quality of services
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Building the Picture Quality Audit Patient Experience / Complaints PerformancePeer Review Soft Intelligence Serious Incidents Mortality Review InspectionFinance
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Patient Experience Community Health Councils Voice- Complaints as a gift Integrated Health and Social Care Patient Experience
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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
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Audit 36 Audits as part of national programme agreed by Advisory Committee Mandatory Participation as part of NHS Outcomes (performance) Framework Clinical Leadership Audit
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So What? Performance Management Policy
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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
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Policy Quality driven policy Clinical Leadership Transparency
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13 What do we do with the findings?
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Diabetes Policy Diabetes Delivery Plan Focus on Inpatient Diabetes Insulin Management Focus on Foot care
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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.
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Policy- Prudence
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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
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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
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Final Thought When did you last pitch an idea to your organisation? Christopher.Dawson@wales.gsi.gov.uk
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