1. Service Accreditation in England Marcia Fry, Molly Corner, Paul Long

2. 2 A history of standards for services in England  Standards have traditionally been set by clinicians for clinicians eg by Royal Colleges  From the late 1990s government developed National Service Frameworks – outlines what services should look like  Introduction of ‘Standards for Better Health’ (2004) – and regulation against them by the Healthcare Commission  Drive to be able to measure quality of services being delivered  Royal Colleges now developing service accreditation schemes  NICE tasked with developing standards of care as part of the quality framework

3. 3 Darzi review  Darzi review – ‘Better care for all’ – review of healthcare provision in England  Recommendations include: >Improved measurement of quality – nationally agreed indicator set >Introduction of National Quality Board >Service accreditation >Change to role of NICE

4. 4 NICE – expanded role  Remit to develop or approve standards  NHS Evidence – pulling together all reliable sources of evidence based good practice into one place  Standards will lead to the development of indicators to measure implementation of these standards  Involvement of patients, clinicians and managers in the development of standards

5. 5 National Quality Board  National body overseeing quality of care in England  Duty to produce an annual State of Quality report using internationally agreed comparable measures  Act as a steering group for NICE – suggested topics and standards  Close interaction with regulators

6. 6 Accreditation of services Defined principles for accreditation: accepted by a large majority of professionals based on evidence subject to arrangements for compliance measurable susceptible to amendment subject to the involvement and approval of representatives of service users and patients

7. 7 Accreditation methods  Development of standards  Self assessment against standards  Peer review – external scrutiny  External scrutiny of overall process  Evaluation  Review of standards  Duration?

8. 8 Working with HC/CQC  Looking at how we can incorporate service accreditation into the regulatory framework  Light touch regulation – assurance of a level of quality of service  Regulator can concentrate efforts elsewhere  Links with registration process

9. 9 Progress to date Current service accreditation programmes:  Clinical Pathology Accreditation – accreditation of diagnostic laboratories  Royal College of Psychiatrists schemes – eg ECT, Adult in-patient, Peer review quality networks (nb not accreditation but peer review schemes)

10. 10  RCGP has developed an accreditation scheme for primary care providers  Some cynicism in GP community – others can see benefit  Pilots currently being run – evaluation of pilots later this year/early next year  Roll out of scheme due 2010. Accreditation of GP Practices/primary medical care providers

11. Some other schemes in development 11 Royal College of Radiologists – radiology Royal College of Physicians – Stroke Royal College of Surgeons – Trauma Royal College of Obstetrics and Gynaecology – maternity

12. 12 Related matters for discussion  Links between service accreditation and clinician revalidation/re-certification?  No common definition of service – what is the accredited ‘unit’?