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What to expect from CHI

What to expect from CHI. Primary Care Team. Emilie Roberts & James Ford. Recognise any of these?. new complex shared services deficits performance targets commissioning and providing services old structures to deal with mergers moving goalposts. CHI’s aim.

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What to expect from CHI

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  1. What to expect from CHI Primary Care Team Emilie Roberts & James Ford

  2. Recognise any of these? • new • complex • shared services • deficits • performance targets • commissioning and providing services • old structures to deal with • mergers • moving goalposts

  3. CHI’s aim To bring about demonstrable improvement in the quality of NHS patient care throughout England and Wales

  4. CHI’s principles • patient centred • independent, rigorous & fair • developmental • evidence based • open and accessible • apply the same expectations to ourselves

  5. What have we done so far? • inspected 80% of acute trusts • reviewed ambulance, mental health and NHS Direct services • completed 8 PCT pilot reviews • by this time next year, we will have published a further 150 reports – mainly on PCTs

  6. Refined methods for use in PCTs Expert panel Consultation with patient organisations and primary care field 2 seminars Pilot process Feedback from PCTs Evaluation Revised process The review methods

  7. How do we pick you for review? • reviewing in clusters • randomised system • generally 2 months notice provided • all PCTs listed on www.chi.nhs.uk • all PCTs will be reviewed

  8. What does a PCT clinical review involve?

  9. What is clinical governance? The framework through which NHS organisations and their staff are accountable for the quality of patient care, including • a patient centred approach • up to date clinical care • high standards and safety • improvement in patient services and care

  10. A CHI clinical governance review • identifies best practice and areas for improvement • is an independent assessment of systems to assure quality of patient care • looks at 3 levels: patients & carers; the practice & service level; corporate level N.B. a CGR does not: • assess individual performance or named practices • examine every service area

  11. Public & patient involvement Risk management Clinical audit Clinical effectiveness Staffing and staff management Education, training and CPPD Use of information Processes for quality improvement Staff focus Information Components of clinical governance (1) Components will be scored from 1-4.

  12. Partner organisations Components of clinical governance (2) CHI is also developing its approach to assessing clinical governance in relation to: • strategic capacity • PCT commissioning • health improvement • prescribing & medicines management • patient experience

  13. 17 weeks 3 months preparation, preliminary meeting reporting notification site visits, feedback pre review phase The CGR process Action planning & ongoing monitoring

  14. Pre visit preparation • data provision • self assessment • appoint coordinator • Reporting • respond to draft report • prepare action plan • publicity • Reporting • feedback • draft report • publicity 5 stages of a review CHI NHS organisation • staff survey • local consultation • Pre visit preparation • data analysis • practice survey • Review week visit • interviews • site visits eg practices, other diagnostic or treatment centres or teams • Review week visit • interviews during review visit • Action planning • respond to areas for action • Action planning • agrees action plan • Ongoing monitoring • under performance monitoring arrangements for NHS • self monitoring

  15. Degree of confidence Amount of evidence and sources Reporting Very confident A number of sources: data; documents; interviews; observation  Report  Verbal feedback Confident Several items of information from the same source type (e.g. interviews) from different areas or organisations One interview or observation confirmed by an independent source  Report  Verbal feedback Some confidence Several items of information from the same source type (e.g. interviews) from the same area or organisation ? Report  Verbal feedback Little confidence One interview or observation only  Report ? Verbal feedback Confidence table Review teams ‘triangulate’ evidence to be confident in their judgements:

  16. Reporting • more consistent feedback • published final report – 5 days for comments • PCT provided with detailed evidence tables (not published) • press release to inform the public • catalytic effect driving improvement • communicating with staff and stakeholders • PCT publishes action plan once agreed with StHA and CHI to address action points

  17. Performance ratings • PCTs will be given scores for each component of clinical governance • clinical governance will feature as a key element in future performance ratings • more news to follow.

  18. Commission for Healthcare Audit & Inspection (CHAI) • will assess every part of NHS and private healthcare • will be independent of Government and the NHS • report annually directly to Parliament on the state of the NHS and how NHS money is being used • expect Chairman will be announced shortly • “CHAI will be the judge of the NHS – the people will be the jury” (Rt Hon Alan Milburn MP)

  19. Do you have further questions about CHI? Ask us now! Email info@chi.nhs.uk Finsbury Tower, Bunhill Row London EC1Y 8TG Tel: 020 7448 9200 www.chi.nhs.uk

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