Integrating National Clinical Audit in Policy and Performance Management Systems

Chris DawsonHead of Major Health Conditions Policy,

Welsh Government

www.hqip.org.uk

NHS Wales

Role of Government

• Set the direction

• Hold to account

How does Government understand quality

• To set direction and hold to account need to understand the quality of services

Building the Picture

Patient Experience

• Community Health Councils

• Voice- Complaints as a gift

• Integrated Health and Social Care

Patient Experience

Mortality Reviews

• Mortality Case note reviews operational in all hospitals in Wales

• 1000 Lives Improvement collaborative has ensured that all Health Boards are now applying a two-stage process to review mortality case notes and have a forum to ensure shared learning both from the process as well as from the findings

Mortality Reviews

Mortality Reviews

Audit

•36 Audits as part of national programme agreed by Advisory Committee

•Mandatory Participation as part of NHS Outcomes (performance) Framework

•Clinical Leadership

Audit Audit

So What?

• Performance Management

• Policy

Performance Management

• NHS Outcomes Framework • Escalation• Intervention • Health Inspectorate Wales and Wales Audit

Office• Transparency

http://mylocalhealthservice.wales.gov.uk/#/en

Policy

• Quality driven policy

• Clinical Leadership

• Transparency

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What do we do with the findings?

Diabetes Policy

• Diabetes Delivery Plan• Focus on Inpatient Diabetes Insulin Management• Focus on Foot care

15

Percentage of adults, who reported ever having been treated for a stroke, by – 2003/04 – 2012 (16 plus)

• Good progress has been made in developing thrombolysis services. Wales had minimal provision 2 years ago and now offers round the clock thrombolysis provision in 100% of its hospitals either onsite or in collaboration with a neighbouring hospital.

Policy- Prudence

The End

• Planned system driven by quality

• Audit, as part of a quality system, driving policy direction

• Audit, as part of a quality system, driving policy delivery

Exercise

• Using your knowledge of Quality what one national policy would you change or introduce (remembering there is no new money)

• What one local (Trust/ Health Board) Policy would you change or introduce

Final Thought

• When did you last pitch an idea to your organisation?

• Christopher.Dawson@wales.gsi.gov.uk