S2 6&7 - Quality Mechanisms in the NHS Flashcards
State 4 quality mechanisms within the NHS.
National Quality Board (NQB) Health and Wellbeing Boards National Standards - NHS Outcomes Framework - National Service Frameworks Clinical Governance
State quality mechanism regulators within the NHS.
Care Quality Commission (CQC)
Healthwatch England and Local Healthwatch
NHS Improvement (Discussed in later session)
National Organisations (Discussed in later session)
- NICE
- Public Health England
Draw a Venn diagram and a circle diagram to illustrate the ‘Dimensions to Quality in Healthcare.’
see document
What does High-Quality Patient Care involve?
Healthcare professionals Provider organisations Commissioners System and professional regulators National bodies e.g. Department of Health and Social Care
Describe the National Quality Board (NQB).
Remit to provide coordinated leadership for quality across the NHS
The only place where national organisations tasked with safeguarding and improving quality come together
Advises on priorities for clinical standards – informs work of NICE
State 3 things the National Quality Board (NQB) works to do.
Improve quality in all that the NHS does nationally
Support local quality improvement with providers, commissioners, users of services
Identify new challenges and opportunities to improve quality
Describe Health and Wellbeing Boards.
Key leaders from the health and care system:
- work together to improve the health and wellbeing of their local population and reduce health inequalities
- collaborate to understand their local community’s needs, agree on priorities and encourage commissioners to work in a more joined-up way
What are the NHS National Standards?
- NHS Outcomes Framework (currently under review)
- National Service Frameworks
(included within the NHS Outcomes Framework now)
Describe the NHS Outcomes Framework in 5 points.
Set of indicators developed by Department of Health and Social Care to monitor health outcomes of adults and children in England
Provides an overview of how the NHS is performing
Enshrined in Health and Social Care Act 2012
Sets national outcomes that all providers of NHS-funded care should be contributing towards
The Framework sets 5 overarching outcomes or domains which summarise what the NHS should be aiming to achieve for patients
State the 4 principles of NSF.
Put in place strategies to support the implementation
Establish performance milestones against which progress can be measured
Aims to raise quality and decrease variations in service
Includes NHS Health Checks
Which NHS Health Checks are available and what are they based on?
Available to all adults in England 40 – 74
Assess the risk of heart disease, stroke, kidney disease, diabetes
Looks at age, gender, family history, ht, wt, BP, cholesterol
Found to be cost-effective and clinically beneficial
What is ‘Clinical Governance?’
‘a framework through which NHS organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish’
State the 5 ‘Principles of Clinical Governance.’
Clear lines of responsibility and accountability for the overall quality of clinical care
A comprehensive programme of quality improvement systems (clinical audit, evidence-based practice, clinical standards and guidelines, work-force planning and development)
Education and training plans
Clear policies aimed at risk management
Procedures to identify and remedy poor performance
Draw out the 7 pillars of the clinical governance model.
see document
State 3 NHS regulators.
Care Quality Commission (CQC)
Healthwatch England and Local Healthwatch
NHS Improvement
Describe the Care Quality Commission (CQC).
Independent regulator of all health and social care services in England
Role to ensure that care provided by hospitals, primary medical services, GPs (from 2013) dentists, ambulances, care homes, services in people’s own homes and elsewhere meets national standards of quality and safety
State 4 reasons for the rationale for developing CQC.
Integration of services
One port of call for independent information on standards, safety and available provision
Brings together best inspection and regulation methods
Tough new powers to act on public’s behalf if services are unacceptably poor
State the 5 priorities of the CQC.
Care centred on people’s needs Joined-up care Swift action to eliminate poor quality care Promoting high-quality care Effective regulation
State 8 main activities of the CQC.
Ensure care services meet fundamental standards
Registration of care services that meet set standards
Monitoring, inspecting and regulating care services
Powers of enforcement – taking action if care services fail to meet fundamental standards
Improving health and social care
Mental Health Act visits – protecting rights of vulnerable people
Listening to and acting on patient and public experiences
Reporting health and social care information – performance ratings
What are the 5 key questions the CQC asks of all care services?
Are they safe? Are they effective? Are they caring? Are they responsive to people's needs? Are they well-led?
State the 13 CQC fundamental standards for care
- Person-centred care
- Dignity and respect
- Consent
- Safety
- Safeguarding from abuse
- Food and drink
- Premises and equipment
- Complaints
- Good governance
- Staffing
- Fit and proper staff
- Duty of candour
- Display of ratings
What was Healthwatch England?
Set up as part of NHS reforms
An independent consumer champion for health and social care
Specific remit to represent at a national level people using health and social services – the voice of the people
Legal requirement for its views to be taken into account by Secretary of State, NHS England and Regulators including CQC
They asked the public what they expected when it came to managing their health and care. What are the 8 principles of Healthwatch England?
Essential services Access A safe dignified and quality service Information and education Choice Being listened to Being involved A healthy environment
What was Healthwatch England (focus for 2018-2023)?
Supporting you to have your say:
- Having the information to take control of your health and care, make informed decisions, shape the services you use
Providing a high-quality service
Ensure your views help improve health and care
What is the Local Healthwatch?
There is a Healthwatch organisation covering every local authority area in England
Describe the 5 aspects of local Healthwatch.
Have the power to enter and view services
Influence how services are set up and commissioned (through local Health and Wellbeing Board)
Produce reports that will influence the way services are designed and delivered
Produce information, support and advice about local services
Pass information and recommendations to Healthwatch England and CQC
State and explain the 5 “NHS Improvement” the operational name for an organisation that brings together what?
Monitor – the financial regulator of NHS foundation trusts
NHS TDA – support, oversight and governance for NHS trusts (non-foundation)
Patient Safety and NRLS – NRLS is a central database of patient safety incident reports
Advancing Change Team – helps the organisation plan and deliver transformational change and service improvement
Intensive Support Teams – specialise in urgent, and emergency care, elective care – focus on quality improvement, dissemination of good practice
State the 3 roles of NHS Improvement.
Overseeing foundation trusts and NHS trusts and independent providers of NHS-funded care
Offer providers the support needed to give patients consistently safe, high quality, compassionate care within local health systems that are financially sustainable
Hold providers to account and can intervene
What does NICE stand for and what is its overall role?
National Institute for Health and Care Excellence
Overall role is to improve outcomes for people using the NHS, other public health and social care services
What is NICE?
Formed in 1999 with a key aim to reduce variation in availability and quality of treatments and care (postcode lottery)
Since April 2013 new responsibilities to provide guidelines for social care
Accountable to DoH but operationally independent of Government (Non-Departmental Public Body)
State the 3 main responsibilities of NICE.
providing national evidence-based guidance and advice for health, public health and social care practitioners
developing quality standards and performance metrics for those providing and commissioning health, public health and social care
providing information services for practitioners, commissioners and managers across health and social care
State the 6 parts of Evidence-based guidance.
Clinical guidelines Technology appraisals Social care guidance Diagnostics and medical technologies Interventional procedures Public health guidance
State the 10 roles of Public Health England (PHE).
Executive Agency of Department of Health and Social Care
Role to protect and improve the nation’s health and well-being, and to reduce inequalities
Aims to influence population health outcomes
Also to protect and improve global health
Promote healthier lifestyles, advise Government, support local government, ↓ health inequalities
Protect nation from public health hazards
Prepare for, and respond to, public health emergencies
Identify and prepare for future public health challenges
Support local authorities and NHS to plan and provide health and social care services e.g. immunisation, screening programmes and develop public health system
Research, collect and analyse data to improve understanding of public health challenges and come up with answers
State the 10 Key public health priorities (part of The NHS Long Term Plan) and how it works.
Prevention Smoking Obesity and Type 2 diabetes Diet and alcohol Anti-microbial resistance and vaccines Cancer Mental Health Air pollution Children and maternity care Gambling
Works locally, nationally and globally
Draw out a pie chart to show the proportional contribution to premature death.
see document
State 6 achievements of Public Health England.
Contributing to the world’s response to Ebola outbreak
Developed a smart sugar app
Stoptober
Published review on e-cigarettes
Supported vaccine development – flu, Ebola
Launched Data Capture System to enable mandatory surveillance of healthcare-associated infections
