Managed Clinical Network (MCN) Showcase
Working in Partnership with MCNs
8 October 2009
Hilary Davison
Director of Guidance and Standards
Martin Moffat
Project Lead: CHPs/Shifting the Balance of Care
Lorna Thompson
Programme Manager, SIGN
NHS Quality Improvement Scotland
(NHS QIS)
NHS QIS’ vision is of an NHS that achieves
excellence in the care of every patient every time.
It leads the use of knowledge to promote
improvement in the quality of healthcare for the
people of Scotland and performs three key
functions:
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Integrated cycle of improvement
3 strands of equal importance
– Advice, guidance and standards
– Support for implementation and improvement
– Assessment, measurement and reporting
Next steps
– Greater focus on implementation and
improvement
– Supported by measurement
– Greater integration and matrix working
2
Future Developments
• The new strategic direction is evolving, but
aspects of this cycle have been incorporated into
the NHS QIS work programme.
• Dissolution of NHS QIS and creation of Healthcare
Improvement Scotland (HIS)
– Greater emphasis on self evaluation
– Proportionate, risk based scrutiny activity
– Ability to demonstrate links between scrutiny
and improvement
3
The development of a draft
Quality Assurance Programme (QAP)
• To measure performance against agreed
standards and the core principles
• To support improvements in care and services
• To learn from challenges and share strengths,
and
• To report openly.
4
Support material – work in progress
Production of draft process maps to
aid MCN steering groups with QAP
development and accreditation
processes.
5
MCN QAP development and
accreditation process information
sessions
Aims and objectives included:
• Laying the foundations of the QAP
• Standard setting
• Accreditation of the MCN, and
• Ongoing review and assessment of performance –
reporting procedures for local, regional and national
networks.
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Resources available
The MCN production crew at NHS QIS!
• MCN Co-ordinator
• Clare Echlin, Acting Head of the
Standards Development Unit, and
• Margaret McAlees, MCN Administrator.
Work in progress…
• The NHS QIS MCN website and shared space
• The NHS QIS MCN newsletter
• Draft process maps and most importantly…
• YOU!
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Quality assurance (QA) and
performance assessment
Work in progress…
• National MCNs – joint letter issued by NSD (Deirdre
Evans) and NHS QIS (Hilary Davison) to national
managed clinical network lead clinicians and network
managers in November 2008 outlining a simplified method
of annual reporting.
• Engagement between NHS QIS and National Services
Division (NSD) – NHS QIS attendance at NSD mid-year
reviews to look at the QA and performance assessment
measures of national MCNs, and
• Joint review of Yorkhill and Tayside national MCN offices.
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Next steps…
Including…
• Production of a final version guidance for consultation
• Development of NHS board guidance and correspondence
for distribution to NHS board Chief Executives and other
key stakeholders
• Clarification of the reporting procedure and content, e.g.
key inclusions, monitoring service achievements against
standards of care and added value – applicable to local,
regional and national networks, and
• Establishing a model for the review of, and provision of
feedback for, annual reports.
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Martin Moffat
Project Lead: CHPs/Shifting the Balance of Care
Shifting the Focus
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Shifting the Focus
• Shifting the Focus Strategy (October 2007)
• Stage 2 - CHPs/Shifting the Balance of Care Project
(January 2009)
Two year launch-pad project:
• Scope potential areas and opportunities where NHS QIS
support might add best value.
• Build on the outputs from the Delphi Consultation Pilot – initial
phase of the project.
• Begin the process of putting in place quality improvement
support to assist CHPs in delivering agreed outcomes and
improving outcomes.
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Shifting the Focus
Supporting Partnership Working
• A key theme emerging from our work so far – particularly in
relation to:
• The Patient Journey and flow of patients through the
system
- Referral management and processes
- Primary, secondary and social care interface - better
communication and exchange/sharing of information
• Supporting CHPs to deliver outcomes
• These areas are of particular relevance to the work of MCNs
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Shifting the Focus
CHP Regional Focus Groups
• Three regional CHP focus groups have been established.
• The focus groups will be a vehicle to:
– test potential models of quality improvement support
• building on the outputs from the Delphi study and
other feedback.
– help inform our CHPs/Shifting the Balance of Care work
programme so that it is meaningful and adds value to
CHP priorities and challenges.
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Shifting the Focus
CHP Regional Focus Groups Days Autumn 2009
• CHP Focus Groups have already begun to consider concepts of
quality improvement support around:
- Patient/Client Pathways - Quality management
• Making the most of Community and Specialist Services
- Supporting CHPs to deliver outcomes through effective
partnership working
- Quality assuring good practice
• Evaluating and sharing good practice (service
development and redesign solutions) across CHPs
- Tackling health inequalities
• Effective partnership working is the ‘success factor’ crucial to all
of these theme areas.
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Shifting the Focus
Next Steps
• Report on the outputs from the CHP Focus Groups
by the end of the year.
• Develop and share a Shifting the Focus Stage 2
work programme.
• MCNs Managers’ Network will be among the
stakeholder groups we consult with.
15
Lorna Thompson
Programme Manager, SIGN
SIGN Implementation Programme
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Vision
World leaders in
implementation support
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For more information:
Ali El-Ghorr
Implementation Adviser
ali.elghorr@nhs.net
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Implementation- The Plan…
Improved processes:
Awareness raising & Education:
 Robust dissemination
process
 More interactive website
 Local clinical champions
 Awareness raising activities
 Patients as champions for change
 Training modules linked to CPD
Networking:
Implementation support resources:
 Linking with existing
networks and projects
 Implementation conference
and meetings with NHS
Boards
 Field support team
 Resource implications calculator
 Algorithms & Care Pathways
 Data sets
 Electronic decision support tools
 Slide sets
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Examples:
Forthcoming Guidelines
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Depression guideline linking with:
• HEAT target
• Scottish Government Mental Health Collaborative
• Local depression ICP developers
• NHS Education
• NHS QIS ICP implementation toolkit
• Also networking and awareness raising using a
standard set of slides
21
Obesity guideline:
• Started to develop implementation approach
alongside guideline development
• Linking with Government
• Linking with Regional Planning Groups
• Developing resource implications tools
• Raising awareness in Primary Care
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Likely Future
• Fewer new guidelines taken on
• Staff trained in implementation support
• Targeted implementation strategy for each
guideline
• This work links with NHS QIS Implementation
Support Directorate
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Integrated Cycle of Improvement
Guidance and
advice (eg SIGN
guideline or clinical
standards)
Assessment, measurement
and reporting (eg peer
review or audit)
Implementation
and improvement
support package
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