Assessment for improvement

Assessment for improvement

[Name][Title]

[Date / Event]V4.5

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Our statutory roles

Assessment of the provision of health care including public health in the NHS & independent sectors

Annual ratings for NHS trusts

Regulation of the independent sector through licensing and annual inspections

Consideration of complaints which NHS trusts have not resolved

Investigations into serious service failures

Coordination of healthcare inspection activity

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Purpose of our assessments

The Healthcare Commission aims to promote improvement in health and healthcare

Our assessments will emphasise the steps to improvement, rather than criticism of the past

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The start of a journey…

From… To…

• Planned

• Nationwide plans

• Centralised inspection

• Assurance

• Visit based

• Focus on organisations

• Scores for performance

• Responsive

• Local plans

• More local self-assessment

• Improvement

• More information based

• Focus on services & outcomes for populations

• Scores for improvement & performance

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…for all healthcare

Transition… …towards integration

• a risk-based approach

• more self assessment

• existing requirements mapped to standards

• reports in line with those for the NHS

• single set of standards

• single approach to assessment

• a consistent focus on promoting improvement

From April ‘05, our inspection of independent healthcare will use:

From April 2006, subject to legislation, our inspections will move to:

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Principles for a new approach

Assessments that are relevant to patients, public and providers

No unnecessary burden– build on organisation’s own responsibilities– intelligent use of information– partnership with other agencies inspecting, regulating & auditing healthcare: the ‘concordat’– focus inspection where it is most valuable

Fair judgements, reported clearly to each of our audiences

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Our assessments

Annual review

Core standards

Getting the basics right

Developmental standards

Making & sustaining progress

National targets

Local targets

Progress against developmental standards

Existing targets

Use of resources

Core standards

Other regulatory findings

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Core standards assessment

Guidance: on how we will judge compliance and the systems trusts will need to make sure they meet the standards

Declaration: from the trust and its local partners on how far they have complied with the standards

Corroboration: cross-check the declaration with the results the trust has recently achieved

Spot checks: where we have concerns about compliance, and also at random: assess whether standards breached

Reporting and follow up: we will report whether the trust has the basics in place - or effective plans to correct breaches

Core standards


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Further core assessments

Core standards


Existing targets Use of resourcesThe 20 targets to which the NHS is already committed

Influences a trust’s ability to maintain and improve services

Methods familiar from the current performance ratings

using results from the Audit Commission, Monitor & auditors

For example:• A&E access• choice for planned care• screening for retinopathy• practice based registers

Covers:• the financial position• financial management• financial governance• value achieved from resources

Both of these core assessments will be reported separately within our annual review.

Other regulatory findings…… including those by other agencies, will be used when checking trusts’ declarations, for example. We are also exploring how the conclusions of other regulators could additionally have a direct input into our annual review of trusts.

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Making & sustaining progressImprovement reviews

An in-depth review, focusing on:

• An aspect of the patient pathway…– a service, across organisations– a population group, e.g. children– a condition, such as diabetes

• A domain of the developmental standards

• Leadership and organisational capacity



Reviews will often be carried out in partnership with other agencies.

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Improvement reviewsProgramme for 2005/06

Topic – focus on patient pathway

Heart failure / implementation of NICE guidance Y Y

Children's hospital services (NSF) Y

Joint Area Reviews (Children's Services) - Ofsted-led Y Y Y Y

Adult Community Mental Health Services - with CSCI Y Y

Substance Misuse - with NTA Y Y

Public health - Sexual health Y

Public health - Tobacco control Y

Older People's services - with CSCI and AC Y Y Y Y

Admissions to hospitals (Acute Hospital Portfolio) Y Y

Diagnostic services (Acute Hospital Portfolio) Y Y Y

Medicines management (Acute Hospital Portfolio) Y Y Y

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Improvement reviewsPiloting in 2005/06

Topic – focus on developmental standards

Safety – HAI & cleanliness Y Y

Access - the role of commissioners Y Y Y Y Y

Public health – planning and delivery Y Y Y Y Y

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Topic – focus on governance

Leadership and organisational capability Y Y



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Sustaining progressLeadership and organisational capacity

An assessment of the developmental standards within the governance domain

Will tell patients and the public…

Will support trusts by:

…whether a trust can both:• sustain the basics

and • keep making progress

beyond them

• highlighting where they need to strengthen their capability;

• providing early warnings of potential failures; and

• identify and share successes



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National and local targets

National targets

The Department of Health will specify indicators to measure progress for each kind of trust. We will confirm data collection arrangements by April 2005 so that national target indicators can included in the annual review for 2005/2006

Local targets

Local targets will be for trusts to negotiate with their local partners.

This process is new and it may take time to ensure consistency across the country. For this reason local targets will not be included in the annual review for 2005/2006



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Reporting the Annual Reviewthe dashboard – part one

Core standards



Elsewhere Mental Health Partnership NHS trust

Annual Review 2006/07

Other regulatory findings

Unsatisfactory

Core standards

Satisfactory

Existing targets

Satisfactory

Use of resources

Satisfactory

Progress against standards developed by the Department of Health (DH)

The trust achieved minimum DH standards in all domains.

more... assessment details

An assessment of relevant reports and interventions by the Healthcare Commission and

other regulatory bodies

The trust has recently been prosecuted following a failure to follow up Health and Safety Executive improvement notices on fire safety . A report by the Mental Health Act Commission criticised the trust for long term staff shortages.


An assessment of how efficiently the trust uses public money

The trust has achieved minimum standards in all areas.



Progress against existing targets set out in DH national standard C7f

The trust continues to achieve targets for access to crisis services and Child and Adolescent Mental Health services.

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Reporting the Annual Reviewthe dashboard – continued

Making and sustaining progress

Improvement review: Substance misuse

Unsatisfactory

Good

Satisfactory

Local targets

Improvement review: Adult community mental health

Poor Prospects

Improvement review: Governance

Satisfactory

New national targets

Progress in achievement of national Public Service Agreement targets

The trust has made reasonable progress against all new targets.

Progress against targets set by the local healthcare community

The trust met the locally set target for reducing suicide rates of teenagers. Though the trust has failed to meet the locally set target for improving rates of staff turnover in community mental health services, performance did improve during the year.

Progress against developmental standards set out in Substance Misuse thematic review

framework

The trust has attained all milestones outlined in the framework for the review of substance misuse services with the exception of increasing the participation of problem drug users in treatment programmes.

An assessment of how effective the management of the trust is in driving

improvements in the service

The trust has failed to meet several significant criteria by which corporate leadership have been assessed. Of particular note have been the vacancies within several executive team positions over the past year. Clear lines of accountability have been lacking.

Progress against developmental standards set out in Mental Health thematic review framework

The trust has attained all current milestones outlined in the review framework for adult Mental Health services. It was commended for the quality of day centre provision.


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Timeline

2005/2006July 2004 November 2004 Spring 2005

DH published Standards for Better Health

Phased implementation

Start of 12 week consultation across England on our proposals for new systems of assessment

Report back on the results of consultation:

• Summary on website• Event participants receive a copy

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How you can get involved

For more copies of the consultation documents:

•e-mail [email protected]

•call our help desk on 0845 601 3012

All consultation materials are available at:

• www.healthcarecommission.org.uk

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Documents

Assessment for improvement