4 Nations Thematic Activity Conference CQC - 11 November 2011
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Transcript of 4 Nations Thematic Activity Conference CQC - 11 November 2011
4 Nations Thematic Activity Conference CQC - 11 November 2011
RQIA Thematic Activity in
Northern Ireland
Programmes of Thematic Activity
• Thematic Review Programme for Health and Social Care (HSC) Services
• Thematic approaches within the Programme of Inspections for Regulated Services
• Inspection Programme to fulfil RQIA responsibilities under the Mental Health Order
• HSC Infection Control and Hygiene Inspections• Programme of IR(ME)R Inspections• Joint inspections of Prison Health with Criminal
Justice regulators
Review Programme 2009-2012
PRIMARY CARE TEAM
Discharge Guideline
HYGIENE TEAM
INSPECTION
Stroke Services }Cardiovascular Framework }
Ambulance Services
Child Protection
CLINICAL & SOCIAL CARE GOVERNANCE TEAM
MENTAL HEALTH & LEARNING DISABILITY TEAM
REVIEW PROGRAMME2009/2010 2010/2011 2011/2012
Hyponatraemia
CAHMS
Out of Hours Hospital Services
Vulnerable Adults
Application of NICE/NPSA Guidance
Care Management - NISAT
Diabetic Services }
Carer's
On-going Programme of Themed Inspection
Mixed Gender Accommodation
Care Management:Baseline-NISAT
Secure Accommodation
Dental Sedation
GP Out of Hours
GMC Pilot on Revalidation
Infection Control (C Diff Bundle)
Food & Nutrition (10 a Day)
Revalidation: Primary Care Services
Admission & Discharge Information Procedures
Maternity Services
Blood Safety Patient Journey via A&E
Risk Assessment in Mental Health }Risk Assessment in Addiction Services }
Learning Disability Community ServicesPrison Healthcare
Community Standards for Sensory Impairment
Review Programme 2012-2015
Unforeseen DHSSPS Commissioned 1 Unforeseen DHSSPS Commissioned 1 Unforeseen DHSSPS Commissioned 1
Unforeseen DHSSPS Commissioned 2 Unforeseen DHSSPS Commissioned 2 Unforeseen DHSSPS Commissioned 2
RQIA Initiated Review 6 RQIA Initiated Review 6 RQIA Initiated Review 6
RQIA Initiated Review 7 RQIA Initiated Review 7 RQIA Initiated Review 7
RQIA Initiated Review 4 RQIA Initiated Review 4 RQIA Initiated Review 4
RQIA Initiated Review 5 RQIA Initiated Review 5 RQIA Initiated Review 5
RQIA Initiated Review 2 RQIA Initiated Review 2 RQIA Initiated Review 2
RQIA Initiated Review 3 RQIA Initiated Review 3 RQIA Initiated Review 3
2012-13 2013-14 2014-15
RQIA Initiated Review 1 RQIA Initiated Review 1 RQIA Initiated Review 1
REVIEW PROGRAMME
DHSSPS Commissioned Review 2
DHSSPS Commissioned Review 1
DHSSPS Commissioned Review 3
DHSSPS Commissioned Review 1
DHSSPS Commissioned Review 2
DHSSPS Commissioned Review 3
DHSSPS Commissioned Review 1
DHSSPS Commissioned Review 2
DHSSPS Commissioned Review 3
PEOPLEGenderAgeEthnicitySection 75
PLACEGeography
Areas of DeprivationHSC Trusts
Settings eg: Prisons, IHC
Priorities for Action ThemesProgrammes of CareProgramme ExpenditureService FrameworksPROGRAMME
LegislationHPSS Quality Standards
Human RightsA Healthier Future - Strategy for HSC in NI
POLICY
OVERALL HEALTH & SOCIAL CARE ASSESSMENT
RQIA provides independent assurance about the quality, safety and
availability of health and social care services in Northern Ireland,
encourages continuous improvements in those services and safeguards the
rights of service users
Balancing the Review Programme
Proposed list of RQIA reviews for 2012 to 2015
Discharge arrangements from hospital
Care of older people in acute hospital wards
Care of patients with learning disabilities in acute hospitals
Palliative care services
Dementia care services
Sexual Health Services
Northern Ireland Respiratory Services Framework
Services for stroke
Management of controlled drugs in hospitals
Nutrition in hospitals
Proposed list of RQIA reviews for 2012 to 2015
Access to services by disadvantaged groups
Suicide prevention in the community
Community services for acquired brain injury
Community services for learning disability
Diabetic retinopathy screening service
Implementation of NI Single Assessment Tool for older people
Implementation of NICE guidelines (1 per year)
Governance arrangements in HSC organisations
Review of systems which support professional regulation
Overview of patient finances in residential settings
Review of Northern Ireland Guardian Ad Litem Agency
Use of thematic approach in Mental Health and Learning Disability Services
1 April 2009:Assumed responsibilities under the Mental Health (NI) Order 1986
Core Activities
Improving Care
Informing the Population
Safeguarding Rights
Influencing Policy
RQIA’s approach
• Talking directly with service users their relatives and carers
• Patient Experience• Reviews/ Inspection
information and Intelligence • Monitoring of detention and
conditions of detention • SAIs • Early days – getting a
baseline
Adoption of the Rights based approach
– key principles of:
• Protection (2011/12)• Respect • Autonomy • Fairness (2010/11)• Equality
Framework for regulation
• Framework for regulation - Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003
• Subordinate regulations
• Associated service-specific standards
Thematic approach to regulation
• Selection of 4 standards or theme areas for each service on annual basis
• Focus on outcomes for users
• Themes selected by prioritisation
• Introduction of regulation for improvement
Identifying themes
• Issues identified by service users
• Concerns identified by regulation team
• Strategic/ political issues (currently: whistleblowing, complaints, care management)
• Unresolved major concerns
Selecting themes
• Categorisation of issues as weighted to quality or safety
• Application of prioritisation criteria
• Balancing tool approach
• Selection for all service types agreed with Director
Inspection template
• Possible alignment of themes with standards
• Criteria (indicators) identified from standards and other sources
• Correlation with regulations
Prioritisation factors - 1
• Regional and/or national priority for safety and/or quality
• Variations in quality create a major risk for the population affected
• Area of significant or developing public concern
Prioritisation factors - 2
• High proportion of the population is affected
• Evidence of a possible variation in quality arising from existing data and/or existing reports
• Recognised inequality in how health and social care services are provided
Proportionate approach
• “Dipstick” unannounced inspections
• Risk rating framework – Inspection Planning Tool
• Factors from regulations – focused on safety
• Individual regulation plans for each service