4 Nations Thematic Activity Conference CQC - 11 November 2011 RQIA Thematic Activity in Northern Ireland

4 Nations Thematic Activity Conference CQC - 11 November 2011

RQIA Thematic Activity in

Northern Ireland

Programmes of Thematic Activity

• Thematic Review Programme for Health and Social Care (HSC) Services

• Thematic approaches within the Programme of Inspections for Regulated Services

• Inspection Programme to fulfil RQIA responsibilities under the Mental Health Order

• HSC Infection Control and Hygiene Inspections• Programme of IR(ME)R Inspections• Joint inspections of Prison Health with Criminal

Justice regulators

Review Programme 2009-2012

PRIMARY CARE TEAM

Discharge Guideline

HYGIENE TEAM

INSPECTION

Stroke Services }Cardiovascular Framework }

Ambulance Services

Child Protection

CLINICAL & SOCIAL CARE GOVERNANCE TEAM

MENTAL HEALTH & LEARNING DISABILITY TEAM

REVIEW PROGRAMME2009/2010 2010/2011 2011/2012

Hyponatraemia

CAHMS

Out of Hours Hospital Services

Vulnerable Adults

Application of NICE/NPSA Guidance

Care Management - NISAT

Diabetic Services }

Carer's

On-going Programme of Themed Inspection

Mixed Gender Accommodation

Care Management:Baseline-NISAT

Secure Accommodation

Dental Sedation

GP Out of Hours

GMC Pilot on Revalidation

Infection Control (C Diff Bundle)

Food & Nutrition (10 a Day)

Revalidation: Primary Care Services

Admission & Discharge Information Procedures

Maternity Services

Blood Safety Patient Journey via A&E

Risk Assessment in Mental Health }Risk Assessment in Addiction Services }

Learning Disability Community ServicesPrison Healthcare

Community Standards for Sensory Impairment

Review Programme 2012-2015

Unforeseen DHSSPS Commissioned 1 Unforeseen DHSSPS Commissioned 1 Unforeseen DHSSPS Commissioned 1

Unforeseen DHSSPS Commissioned 2 Unforeseen DHSSPS Commissioned 2 Unforeseen DHSSPS Commissioned 2

RQIA Initiated Review 6 RQIA Initiated Review 6 RQIA Initiated Review 6






2012-13 2013-14 2014-15


REVIEW PROGRAMME

DHSSPS Commissioned Review 2









PEOPLEGenderAgeEthnicitySection 75

PLACEGeography

Areas of DeprivationHSC Trusts

Settings eg: Prisons, IHC

Priorities for Action ThemesProgrammes of CareProgramme ExpenditureService FrameworksPROGRAMME

LegislationHPSS Quality Standards

Human RightsA Healthier Future - Strategy for HSC in NI

POLICY

OVERALL HEALTH & SOCIAL CARE ASSESSMENT

RQIA provides independent assurance about the quality, safety and

availability of health and social care services in Northern Ireland,

encourages continuous improvements in those services and safeguards the

rights of service users

Balancing the Review Programme

Proposed list of RQIA reviews for 2012 to 2015

Discharge arrangements from hospital

Care of older people in acute hospital wards

Care of patients with learning disabilities in acute hospitals

Palliative care services

Dementia care services

Sexual Health Services

Northern Ireland Respiratory Services Framework

Services for stroke

Management of controlled drugs in hospitals

Nutrition in hospitals

Proposed list of RQIA reviews for 2012 to 2015

Access to services by disadvantaged groups

Suicide prevention in the community

Community services for acquired brain injury

Community services for learning disability

Diabetic retinopathy screening service

Implementation of NI Single Assessment Tool for older people

Implementation of NICE guidelines (1 per year)

Governance arrangements in HSC organisations

Review of systems which support professional regulation

Overview of patient finances in residential settings

Review of Northern Ireland Guardian Ad Litem Agency

Use of thematic approach in Mental Health and Learning Disability Services

1 April 2009:Assumed responsibilities under the Mental Health (NI) Order 1986

Core Activities

Improving Care

Informing the Population

Safeguarding Rights

Influencing Policy

RQIA’s approach

• Talking directly with service users their relatives and carers

• Patient Experience• Reviews/ Inspection

information and Intelligence • Monitoring of detention and

conditions of detention • SAIs • Early days – getting a

baseline

Adoption of the Rights based approach

– key principles of:

• Protection (2011/12)• Respect • Autonomy • Fairness (2010/11)• Equality

Framework for regulation

• Framework for regulation - Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003

• Subordinate regulations

• Associated service-specific standards

Thematic approach to regulation

• Selection of 4 standards or theme areas for each service on annual basis

• Focus on outcomes for users

• Themes selected by prioritisation

• Introduction of regulation for improvement

Identifying themes

• Issues identified by service users

• Concerns identified by regulation team

• Strategic/ political issues (currently: whistleblowing, complaints, care management)

• Unresolved major concerns

Selecting themes

• Categorisation of issues as weighted to quality or safety

• Application of prioritisation criteria

• Balancing tool approach

• Selection for all service types agreed with Director

Inspection template

• Possible alignment of themes with standards

• Criteria (indicators) identified from standards and other sources

• Correlation with regulations

Prioritisation factors - 1

• Regional and/or national priority for safety and/or quality

• Variations in quality create a major risk for the population affected

• Area of significant or developing public concern

Prioritisation factors - 2

• High proportion of the population is affected

• Evidence of a possible variation in quality arising from existing data and/or existing reports

• Recognised inequality in how health and social care services are provided

Proportionate approach

• “Dipstick” unannounced inspections

• Risk rating framework – Inspection Planning Tool

• Factors from regulations – focused on safety

• Individual regulation plans for each service

Documents

4 Nations Thematic Activity Conference CQC - 11 November 2011 RQIA Thematic Activity in Northern Ireland