NHS Quality Improvement Scotland NHS QIS

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NHS Quality ImprovementScotland (NHS QIS)

• Scottish Schizophrenia Outcomes Study - National
  Meeting
• 12 June 2003
• Sean Doherty - Review Team Manager

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NHS QIS

• established in January 2003
• integration of
• Clinical Resource and Audit Group (CRAG)
• Clinical Standards Board for Scotland (CSBS)
• Health Technology Board for Scotland (HTBS)
• Nursing and Midwifery Practice Development Unit
  (NMPDU)
• Scottish Health Advisory Service (SHAS)
• working closely with
• Scottish Intercollegiate Guidelines Network
  (SIGN)
• Scottish Medicines Consortium (SMC)

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NHS QIS - Why?

• to build on existing foundations
• filling in gaps
• promoting implementation
• fewer organisations
• stronger strategic direction
• avoiding duplication of effort
• reducing visit fatigue

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NHS QIS - Aims

• to report to the public on the performance of
  NHSScotland against nationally agreed standards
• to support NHSScotland in improving the quality
  of care and treatment it provides

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NHS QIS - Key Values

• patient and public focus
• partnership
• independence
• evidence-based
• openness and transparency
• quality assurance
• professionalism
• sensitivity

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NHS QIS - Tasks (1)

• determining and sharing good practice through
• clinical guidelines
• clinical audit
• assessing the clinical and cost effectiveness of
  health interventions
• collecting and publishing clinical performance
  data
• learning lessons from adverse events

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NHS QIS - Tasks (2)

• setting clinical and non-clinical standards
• reviewing and monitoring performance through
• self-assessment
• external peer review
• investigating serious service failures
• supporting implementation of clinical governance

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NHS QIS - Key Messages

• meantime all organisations core activities
  continue but better co-ordinated
• full consultation to be undertaken before new
  functions introduced

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NHS Quality ImprovementScotland

• Progress in Mental Health

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NHS Quality ImprovementScotland

• Core Mental Health Standards Anne Hawkins
  (Chair)
• Schizophrenia Standards
• Linda Watt (Chair)

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Phase 1

• March - November 2001
• 18 organisations visited
• Reviewed against standards
• 2 Initial Diagnosis
• 7 Information Support for Carers
• 8 Prescribing Anti-psychotic Drugs - General
  Principles
• 9 Prescribing Anti-psychotic Drugs - Special
  Circumstances
• 10 Social Psychological Approaches to Care
• 11 Misuse of Alcohol Illicit Drugs

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Phase 1 - Update
Standard 2 - Initial Diagnosis Every Person for
whom a diagnosis of schizophrenia is being
considered is reviewed by a consultant
psychiatrist and the appropriate members of the
multidisciplinary mental health team, until this
diagnosis is confirmed or refuted. The person,
and with their consent their carer, are actively
involved throughout the diagnostic process.
NHS Trust
3 The following are undertaken as part of the
diagnostic process a) a psychiatric History,
including an assessment of alcohol and illicit
drug use b)a general medical history c) a
mental state examination d) a physical
examination including a neurological evaluation
e) basic biochemical and haematological tests
and f) information is sought from the carer.
STATUS Partially Met The diagnostic process
includes a psychiatric history, a general medical
history and a mental state examination. Basic
blood tests, and a physical examination including
a neurological are undertaken routinely. In the
self-assessment exercise, mental health teams
reported that information is routinely sought
from the carer. The review team concluded that
there is insufficient evidence to ascertain
whether information is or is not routinely sought
from the carer.
(Trust to include update comments or information
in space provided)
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Phase 2

• August - December 2003
• Reviewing Against Standards
• 1 Information on Populations Individuals
• 3 Initial Assessment Care Planning
• 4 Ongoing Assessment Care Planning
• 5 Transferring Care - Admission to Hospital
• 6 Transferring Care - Discharge from Hospital

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Visit Schedule - 2003
Lomond Argyll - 21 August Fife - 27
August Highland - 02 September Grampian - 10
September The State Hospital - 18
September Renfrewshire Inverclyde - 25
September Western Isles - 01 October Dumfries
Galloway - 08 October Shetland - 15 October
Forth Valley - 22 October Orkney - 29
October Ayrshire Arran - 04 November Greater
Glasgow - 12 November Borders - 18
November Lanarkshire - 25 November Tayside - 03
December West Lothian 09 December Lothian - 16
December
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Review Teams

• Team leader
• Clinical Review Team Member (seconded)
• 2 x Lay representatives 1user, 1 carer
• 3/4 professional reviewers
• Support from NHS QIS

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Reporting

• National Overview Local Reports published May
  2004