Impact of the Care Quality Commission on provider performance. Room for Improvement?

A policy briefing is available for LKS staff to share in their organisations. Produced by the JET Library at Mid Cheshire Hospitals NHS Foundation Trust. Feel free to reproduce it (with acknowledgement).

What does this mean for libraries? An increased focus on the need for systemic transformation and improvement following CQC inspections  may provide further opportunities to support organisations. Libraries should understand the areas in which their organisations require improvement and develop services to support these.

Source: The King’s Fund

Link to main document 

Date of publication: September 2018

Summary of driver: This report summarises the findings of the first major evaluation of the CQC’s approach to inspecting and rating healthcare providers. The King’s Fund and Alliance Manchester Business School developed framework outlining 8 ways that regulation can affect provider performance, which was used to evaluate the first cycle of CQC inspections in acute, mental health, general practice and adult social care in 6 areas of England.

National Information Board – Patient Carers and Service User Vision

A Policy Briefing aimed at healthcare professionals is available for LKS staff to share in their own organisations. This has been produced and shared by the JET Library, Mid Cheshire Hospitals NHS Foundation Trust. Please feel free to reproduce it (with acknowledgement to JET Library) for your own purposes.

Impact on library policy/practice: 

These plans do not directly apply to libraries, but some of the vision has implications for information libraries may wish to make available through their activities for providing information to patients or the public; or to NHS /social care staff that need to know of or share this information with the public and patients.

As these plans are intended for local development and implementation – which aspects of the plans are developed will vary from one place to another.

If locally the plans are taken forward to highlight access to good quality information online via NHS Choices, or for the NHS to help patients understand what mobile apps and wearable devices for tracking/monitoring their health can be safely trusted – libraries may wish to include this information their provision/signposting of information to the public and patients.

If organisations focus on the implementation of more telehealth or telemedicine solutions for providing service to patients or for the sharing of patient data, test results and information between organisations e.g. hospital and GP, there may be an interest in resources around these topics from staff to raise their awareness of these technologies and see what good/existing practice is already in place.

Source: National Information Board

Link to main document: https://www.gov.uk/government/publications/personalised-health-and-care-2020-service-user-vision

Supporting documentation: The Clinical version: Information and Digital Technologies Clinical Requirements 2020 http://www.aomrc.org.uk/publications/reports-guidance/information-digital-technologies-clinical-requirements-2020/

 Publication format: PDF

 Date of publication: October 2017

Summary of driver: Patient Carers and Service User Vision: Personalised Health and Care 2020.

This vision document states what the Government’s and national health and care organisations’ current digital technology programmes will enable health and social care services to deliver for people in England; through improved use of information technology.

These plans are to be implemented locally, with local decision making, so how they are achieved may different from one area to another. The plans may mean doing things differently, doing new things or just doing existing things better.

Key features of driver:

• It will be easier to find reliable online information and advice to maintain fitness and wellbeing
• Online support through NHS 111 will help people if they have a health problem
• NHS 111 will signpost people to the right help
• It will be easier to find information at nhs.uk
• The NHS will help people understand which apps they can trust
• People will be able to link information from wearable and devices to their own health records
• There will be free wi-fi in all NHS premises
• People will be able to book and change appointments online
• People will be able to track their test results online
• People will be able to talk to their doctors via phone or Skype
• GPs will be able to use remote consultation more quickly and easily
• GP and hospital systems will link up more effectively
• Children’s red books will become electronic
• People will have a choice about where, when and how medicines are delivered
• The accuracy of prescriptions will be improved
• Test results will be available more quickly and easily
• It will be easier for different health-care teams to work together
• It will be easier to find out what social care support people are eligible for and how to access it
• Carers will find it easier to get hold of the information and support they need
• Data from gene testing will be linked to other information and analysed in new research hubs
• Health and care services will have more reliable, joined-up and secure systems

 Primary audience: Public, NHS and social care organisations.

 Date last updated: November 2017

 Due for review: November 2018

 Group member responsible: FG

 

Developing People – Improving Care: A national framework for action on improvement and leadership development in NHS-funded services.

Title of driver: Developing People – Improving Care: A national framework for action on improvement and leadership development in NHS-funded services.

Source: National Improvement and Leadership Development Board

Impact on library policy/practice:

• Library staff should take up the opportunity to attend training which their organisations provide, to develop leadership and talent management skills for the benefit of themselves, their library services and for when working with other libraries and services in wider projects.

• There may be increased interest in the resources the library can provide to support the in-house development of leadership, talent management, systems leadership skills and training courses. Some libraries may wish to expand their collections in these areas.

• Libraries may be able to highlight how their provision of literature searching skills training, literature search services and inter-library loan services can ease access to leadership and improvement resources; which the framework indicates can be difficult to access.

Link to main document:

https://improvement.nhs.uk/uploads/documents/Developing_People-Improving_Care-010216.pdf

Summary: https://improvement.nhs.uk/uploads/documents/10591-NHS_-Improving_Care-Summary.pdf

Publication format: PDF

Date of publication: 1 December 2016

Summary of driver: This is the framework developed by 10 organisations that form the National Leadership and Improvement Board, to guide the development of compassionate leadership, systems leadership, quality improvement and talent management skills amongst NHS staff.

This is the first version of the framework – further regular updates are envisioned.

Key features of driver:

• This is a framework for developing the skills of NHS funded staff at all levels, in clinical and non-clinical roles; and will in future include social care staff.
• The focus is on developing leadership and improvement skills and knowledge to close gaps identified in the NHS Five Year Forward View:
  • Systems leadership, for cross boundary working and joining up healthcare systems,
  • Quality improvement methods knowledge
  • Compassionate and inclusive leadership
  • Talent management

• The ultimate aim is that these capabilities will later be represented in senior leadership and management teams.

 

• These skills should result in continuous improvement of the healthcare system, patient care, improve population health and value for money, and will develop future leaders.

• Local organisations are tasked with reviewing their people development strategies, priorities and budgets so that these capabilities can be developed; primarily by: using their existing funding, developing training in-house and sharing knowledge and experience amongst themselves.

• National oversight bodies see their role as providing to support, supporting structures and schemes, and guidance for the development of these skills.

• The framework lays out a series of actions for the next 12 months and for 1 – 3 years’ time for national oversight bodies to provide this support, build networks and develop national leadership and management schemes. These actions are mainly for: NHS England, Health Education England, NHS Leadership Academy, NHS Equality and Diversity Council, NHS Improvement, Care Quality Commission, Department of Health and the National Improvement and Leadership Development Board.

Primary audience: Senior managers in NHS organisations and partners, and the organisations making up the National Leadership and Improvement Board.

Date last updated: February 2017

Due for review: February 2018

Group member responsible: FG

Operational productivity and performance in English NHS Acute Hospitals: Unwarranted variations

Title of driver: Operational productivity and performance in English NHS Acute Hospitals: Unwarranted variations

Alternative Titles: Productivity in NHS hospitals Carter Review

Source: Lord Carter of Coles (Independent report commissioned by the Department of Health)

Link to main document https://www.gov.uk/government/publications/productivity-in-nhs-hospitals

Publication format: PDF

Date of publication: February 2016

Summary of driver:

Report sets out the findings of Lord Carter’s review of how non-specialist acute hospital trusts can reduce unwarranted variation in productivity and efficiency to save the NHS £5 billion each year by 2020 to 2021.

15 recommendations are made to reduce this variation, including proposing a set of metrics be developed for a ‘model hospital’ for trusts to be benchmarked against.

Key features of driver:

Various sources of unwarranted variation in productivity, costs and efficiency in acute hospitals were identified.

The review looked at clinical staffing, pharmacy and medicines, diagnostics and imaging, procurement, back-office functions, estates and facilities; and at the quality and efficiency of clinical specialties.

The report makes recommendations in 15 areas to reduce this variation, improve quality and productivity, make cost savings, use resources in a cost effective manner and increase efficiency.

The report calls for action by NHS Improvement, NHS England, the Department of Health and hospital trusts with recommendations for the below areas:

• Developing and implementing a national people strategy – simplifying system structures, raising people management capacity, building greater engagement and improving leadership capability.
• Ensuring hospital pharmacies and pathology and imaging departments achieve their benchmarks – resulting in pharmacists spending more time on clinical activities, and a consistent approach to the quality and cost of diagnostic services
• Procurement – trusts should report procurement information monthly to NHS Improvement; collaborate with other trusts and the NHS Supply Chain; and commit to the NHS Procurement Transformation Programme – resulting in increasing transparency and at least 10% reduction in non-pay costs across the NHS.
• Estates and facilities management – trusts should meet or operate above NHS Improvement’s benchmarks. Including not exceeding a maximum of 35% of floor space for non-clinical functions and 2.5 % of space unoccupied/underused.
• Trust corporate and administration functions – should be rationalised so that costs don’t exceed 7% of their income by April 2018 and 6% of income by 2020, or have plans for shared service consolidation or outsourcing to other providers.
• NHS Improvement and NHS England should establish joint clinical governance to set standards of best practice for all specialties.
• Key digital information systems – should be in place in all trusts.
• The Department of Health, NHS England and NHS Improvement should work with local government to provide a strategy for trusts focusing patient care on recovery and how patients can leave acute hospital beds as their clinical needs allow.
• Quality and efficiency opportunities for better collaboration and coordination of clinical services across local health economies – NHS England and NHS Improvement should work with trust boards to identify these.
• NHS Improvement should develop the Model Hospital and underlying metrics so there is one source of data, benchmarks and practice.
• Metrics and reporting – NHS Improvement should develop an integrated performance framework to ensure there is one set of metrics and approach to reporting; reducing the reporting burden for trusts.
• Various deadlines are suggested- all trusts should work towards these and national bodies should develop timetables for efficiency and productivity improvements.

Primary audience: Department of Health, NHS Improvement, NHS England, Acute Trust Boards

Impact on library policy/practice:

Libraries are not specifically mentioned but:

• The focus on efficiency, quality and benchmarking may lead to increased interest in resources for business decision making, and clinical/service auditing.
• Consortia purchasing of library resources could contribute towards cost reduction.
• Libraries can supply resources on leadership and people management to support the staffing changes proposed.
• Library staff could partake in any leadership training and development made available by their trusts – for CPD and to improve the structure and leadership of the library service.
• Library services can highlight that by having trust computers available in their setting – they are supporting staff to have access to the digital information systems the report calls for.
• Working in collaboration with other libraries to deliver projects and services e.g. inter-library loans could support the initiative of collaboration and cost reduction.

However with the stipulation for the maximum percentage of hospital floor space for non-clinical functions – if trusts feel they need to reduce non-clinical floor space, libraries may be one of the areas that faces challenges to their use of space. Library managers will need to highlight the value of the library service to counter this pressure.

Date last updated: November 2016

Due for review: November 2017

Group member responsible: FG