New health service annual health check

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New health service annual health check

• Jo Dent
• Area Manager Yorkshire and the Humber
• Northern Region

July 2005
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Our statutory roles
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10 local areas across 4 regions
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North
Head of region Kate Lobley
Area North East Area manager TBC SHAs County
Durham and Tees Valley and Northumberland,Tyne
and Wear Area North West Area manager Mike
Rose (starting 4th July) SHAs Cheshire and
Merseyside, Greater Manchester and Cumbria and
Lancashire Area Yorkshire and Humberside Area
manager Jo Dent SHAs North and East Yorkshire
and Northern Lincolnshire, South Yorkshire and
West Yorkshire
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Working locally
Four regions with the majority of our operations
staff working locally

• Roles
• provide information, advice and assistance in
  support of the annual health check
• support sharing of learning and best practice
• work with local healthcare organisations, and
  patients and community groups
• carry out inspections in NHS and independent
  healthcare

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Working locally

• Roles
• coordinate our work with other regulators
• develop local knowledge of both the independent
  and NHS healthcare providers
• understand local needs and concerns for both
  patients and the public
• context setting for annual health checks and
  other evaluations
• provide a local interface for providers and
  patient representative groups

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Principles of new approach
Measuring what matters Richer picture of
performance Standards and targets

• Reduce unnecessary burden
• self assessment
• intelligent use of information
• partnership with other regulators - Concordat
• targeted inspection

Fair judgements, reported clearly to each of our
audiences
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Standards for better health

• safety
• clinical and cost effectiveness
• governance
• patient focused
• accessible and responsive care
• care environment and amenities
• public health

• Core standards must do now
• Developmental standards - aspirational

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Our assessments 2005/2006
Meeting core standards
Meeting existing targets
Use of resources
Annual review and performance rating
Improvement reviews
Meeting new national targets
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Assessing trusts on core standards

• April 2005 Guidance published
• Criteria for assessing core standards
• 24 standards, broken into 80 elements, or
  component parts
• key pieces of national guidance or legislation
  relevant to each element
• information we will use to check each element
  in the declaration

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Assessing trusts on core standards

• October 2005 Draft declaration
• Trust boards make a statement outlining
• if they are meeting core standards
• any significant lapse with action plan
• any standard where compliance is not clear
• We will require trusts to invite comments from
• patient and public involvement forums
• overview and scrutiny committees
• strategic health authorities

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Assessing trusts on core standards

• October/November 2005 Cross checking the draft
  declaration
• Check draft declarations against
• comments from third parties
• wide range of available information
• intelligence from our complaints and
  investigations work
• NHS staff and patients surveys
• other regulators findings
• Checking process identifies trusts most at risk
  of not meeting core standards

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Assessing trusts on core standards

• November 2005-April 2006
• Selective follow-up
• Two groups of trust
• risk-based group where checks have raised concern
  for some standards
• random spot checks
• Significant concerns may lead to a
• formal investigation

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Assessing trusts on core standards

• April 2006 Final declaration
• states how far the trust has met the core
  standards in the past year
• includes new comments from same third parties
• is made in public
• will form the basis for our assessment

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Assessing trusts on core standards

• April - September 2006 Cross checking and
  selective inspection
• same cross checking process as before
• selective inspections of trusts at risk of not
  meeting standards plus random spot checks,
  visiting a total of 20 of trusts
• we judge how well each trust is meeting core
  standards and may amend the declaration

September 2006 Scoring on 4 point scale
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Core standards assessmentTimeline
Oct. Nov. 2005
April June 2005
Nov. 2005 Apr. 2006
October 2005
April Sept 2006
Selective follow-up
Cross checking draft declarations
Guidance published
Draft declarations
Final declarations, cross checking and selective
inspection

• Annual performance rating published September
  2006

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Assessing trusts on core standardsPrimary care
trusts

• Standards apply to all PCT activities including
• services provided directly
• services provided by independent contractors
• services commissioned from other providers

• PCTs should
• use commissioning process to promote compliance
• take appropriate action when standards not being
  met

In 2005/2006 PCTs will be assessed on the process
of commissioning, not on services commissioned
from others
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Other components of getting the basics right

• Other regulatory findings will be used for
• checking trusts declarations
• as trump cards, taken as evidence of meeting a
  standard
• commentary on dashboard

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Making sustaining progressImprovement reviews

• In depth review to identify and measure the
  steps trusts can take to progress towards meeting
  developmental targets.
• Focusing on
• an aspect of the patients pathway
• a service e.g. adult community mental health
• a population group, e.g. children
• a condition e.g. heart failure
• a domain of the developmental standards
  - e.g. safety/hospital acquired
  infection/MRSA

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Improvement reviewsmain steps
Development identify best practice and factors
critical to performance
Collecting data gather data, where possible
using data which is already available
Assessing performance assess performance of all
relevant organisations
Planning improvement target visits on trusts
where there is greatest potential for improvement
Monitoring improvement we will monitor data to
track improvement
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Improvement reviewsProgramme for 2005/06
Primary care
Mental health
Ambulance
Specialist
Acute
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Improvement reviewsProgramme for 2005/06
Primary care
Mental health
Ambulance
Specialist
Acute
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Annual performance rating

• will be based on a four point scale
• will include separate ratings for components

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DashboardIllustration
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Opportunities for sector working to achieve the
standards

• Identifying shared goals/ outcomes.
• Developing complementary systems.
• Being willing to share the collection of
  information.
• Being willing to share information/ skills.
• Committment

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Assessing independent healthcare

• Targeted inspection
• Revised self assessments
• tailored to different types of establishment
• hospitals and mental health establishments
• single specialty services
• private doctors
• services which do not require a clinical
  qualification
• shorter forms, with more focused questions
• mapped to Standards for Better Health
• inspections focused on particular standards

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Future developments

• We are developing
• criteria for feeding other findings into ratings
• how to measure best practice in developmental
  standards
• assessment of leadership and capacity
• assessment of local targets
• ways to access the views of disadvantaged
  communities
• ...and we will be consulting on our strategy for
  regulation of independent healthcare.

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FOR MORE INFORMATION

• For copies of available guidance and documents on
  the new health check please contact
• e-mail feedback_at_healthcarecommission.org.uk
• call our helpdesk on 0845 601 3012
• All these materials are available at
• www.healthcarecommission.org.uk