Quality standards- NICE and the new
NHS
Naomi McVey
Commissioning Adviser, NICE
March 2013
Overview
• NICE in the new NHS – focus on NICE quality
standards
• How the quality standards relates to physiotherapy
services, where we are and where we need to be
• NICE guidance can support physiotherapists to
ensure the services they provide are of the best
possible quality and offer the best value for money,
and to demonstrate this to patients, the public, other
professions and commissioners
• Perspectives on influencing commissioners
NICE and the new NHS
New system relationships
• Commissioning
and system
integration
• Registration and
assurance
• Evidence,
guidance and
Standards
NHS CB
NICE
CQC
Monitor
• Regulation
NICE and the new NHS
Clinical practice
guidance and
standards
Public health and
social care guidance
and standards
NHS Evidence
• Clinical practice advice for health
professionals and the NHS Commissioning
Board
• Quality standards for national outcomes
framework(s) and CCGs
• Public health advice for Public Health England
and the wider public health community
• Social care advice and quality standards to
Secretary of State (from 2013)
• Primary evidence resource for health and
social care professionals
• NICE pathways
NICE Quality Standards
“Progress on outcomes will be supported
by quality standards.
These will be developed for the NHS
Commissioning Board by NICE, who will
develop authoritative standards setting
out each part of the patient pathway, and
indicators for each step. …
The standards will cover areas that span
health and social care.”
NICE Quality Standards
• Define high-quality, cost-effective care across a
disease, condition or clinical area
• Presented as a set of specific, concise
statements that:
– act as markers of high-quality, cost-effective
patient care;
– are derived from the best available evidence;
and
Developing quality standards
A comprehensive set of
recommendations for a particular
disease or condition
Evidence
Guidance
Quality
Standards
‘Sentinel markers’
A prioritised set of concise, measureable
statements designed to drive quality
improvements across a pathway of care.
Where the quality standards fit in
Preventing people from
dying prematurely
Enhancing quality of
life for people with long
term conditions
Helping people to recover
from episodes of ill health
or following injury
Ensuring that people
have a positive
experience of care
Treating and caring for people
in a safe environment and
protecting them from harm
180 healthcare quality standard topics
Key quality standards for
physiotherapists – published
•
•
•
•
•
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Stroke (QS2)
Chronic heart failure (QS9)
COPD (QS10)
End of life care for adults (QS13)
Patient experience in adult NHS services (QS15)
Service user experience in mental health
services(QS14)
• Hip fracture in adults (QS16)
• Asthma (QS25)
(See here for more information)
Key quality standards for
physiotherapists – in development
•
•
•
•
•
•
•
•
Supporting people to live well with dementia
Autism
Faecal incontinence
Lower urinary tract symptoms
Metastatic spinal cord compression
Peripheral arterial disease
Rheumatoid arthritis
Smoking cessation
(See here for more information)
Stroke quality standard
Quality standard for stroke
• Quality statement 3: ‘Patients with stroke are assessed and
managed by stroke nursing staff and at least one member of the
specialist rehabilitation team within 24 hours of admission to
hospital, and by all relevant members of the specialist rehabilitation
team within 72 hours, with documented multidisciplinary goals
agreed within 5 days.’
• Quality statement 7: ‘Patients with stroke are offered a minimum of
45 minutes of each active therapy that is required, for a minimum
of 5 days a week, at a level that enables the patient to meet their
rehabilitation goals for as long as they are continuing to benefit
from the therapy and are able to tolerate it.’
• Quality statement 10: ‘All patients discharged from hospital who
have residual stroke-related problems are followed-up within 72
hours by specialist stroke rehabilitation services for assessment
and ongoing management.’
Hip fracture
• A walk through the hip fracture QS on NICE website…
Smoking cessation - draft QS
Currently available for consultation, statements include:
1.People are asked if they smoke by their healthcare
professional, and those who smoke are offered brief
advice on how to stop.
2.People who smoke are referred to an evidence-based
stop smoking service.
•Potential to impact on interaction of all healthcare
professionals with each of their patients, and therefore on
skills and competencies in behaviour change etc
•? CSP registered as a stakeholder
CCG Outcomes Indicator Set
CCG Outcomes and indicators
• Provide clear, comparative information for CCGs, HWBs
and LAs about the quality of services & health outcomes
• NICE's role is to develop indicators for the CCGOIS, in
particular from quality standards
• Origins in Liberating the NHS: Commissioning for
Patients as the Commissioning Outcomes Framework,
renamed as the CCG Outcomes Indicator Set
• Chosen on the basis that they contribute to the
overarching aims of the five domains in the NHS
Outcomes Framework
• It does not set thresholds or targets for CCGs, it is a tool
for CCGs to drive local improvement & set priorities
Quality standards and physiotherapy
• Physios have a good track record using NICE guidance
• Now need to get to grips with the quality standards
• Process within your organisations for implementing
NICE guidance? Does this include the QS?
 Implement NICE guidance to achieve the
standard/statement
• Use NICE implementation tools
• If no relevant QS and no NICE guidance use other or
recognised national guidance
• Important that physios have the opportunity to
contribute to the consultation process for the QS
Influencing commissioners and key
organisations in the new NHS
Influencing local commissioners
Get your ducks in a row…
• Plan – what are you planning to
achieve?
• Research – know your local
population, commissioners, local
plans and priorities, local leads
• Know your service
• Be integrated and patient focused
• Use the evidence-base
• Demonstrate outcomes & quality
improvement
• Get marketing!
.
Also available – the app for the British National
Formulary and the British National Formulary for
Children
Keeping up to date
• Sign up for the NICE News
• Twitter @NICEcomms
• Log on to the website and register
your details at www.nice.org.uk
• Email naomi.mcvey@nice.org.uk