COG 3/2014
Council of Governors
CNWL Quality Account
2013-14 Indicator Selection for External Audit:
Endorsement of recommendation
Wed, 19 March 2014
The guidance and purpose
• To endorse the recommendation made by a smaller group of
CoGs re indicator selection for external audit
Background:
• The Quality Account forms one half of CNWL’s Annual Report
• Data feeds must be accurate and robust; have business rules
and stand up to data quality testing
• Quality Account is externally audited by KPMG (including
our consultation process, sign-off
• Monitor have determined two indicators nationally for
external audit/assurance and a third is to be selected by our
Council of Governors
Indicators for Quality Account audit
• 2 x National indicators
– CPA 7-day follow up
– CRT Gate-keeping
• 1 x locally selected indicator – ‘what can we choose from?’
- must be auditable back to source information for
verification/validating
- patient survey indicators therefore n/a
- where possible include the whole trust
• Suggestions:
– “Inpatients receive a nursing physical health assessment after
admission”
– “Readmission rates”
Indicator selection
• All Council of Governors were invited to attend a mini
meeting (following the main Quality Account Priority
stakeholder event) on 6 March 2014 – to discuss and select
the 3rd indicators to recommend to the Council of Governors
for final endorsement/sign-off
• For information, in attendance:
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Lina Christopoulou, Service User Governor
Sam Whiteside, Public Governor
Irene Leeman, Public Governor, Harrow
Peter Bradley, Public Governor, MK
Molly Bandah, Carer Governors, Brent
Carina Sheridan, Staff Governor
Ann Sheridan, Staff Governor
Ela Pathak-Sen, Chair (Associate Director for Quality & Service Improvement
Matt Malherbe, Quality Assurance Manager
Indicator selection
• Readmission rates selected to be endorsed by
the Council of Governors
• Rationale:
Council of Governors are asked to
consider and endorse this indicator
selection for external audit
– Is Trust-wide in that it includes all mental health services, including
Milton Keynes
– Is a national indicator which is therefore nationally benchmarked
– Data is produced from our electronic reporting system, and so not
open to subjectivity of analysis via clinical audit
– Providers continuity and consistency from previous year
– Recommended to us from our auditors
Next steps..
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Analysis of feedback from the main stakeholder event
Production of the draft Quality Account
Internal and external audit of the Quality Account
Quality Account 30-day public consultation (4 April – 5 May)
Sign-off and submission to Monitor by 30 May
Publish on NHS Choices by end June and Easy Read
production
Thank you