National Quality Improvement

and Clinical Audit Network (formerly National Audit Governance Group)

HQIP Conference – Plenary Workshop

October 2013

Prepared by Kat Young (NQICAN Chair,) Sue Venables (General Secretary), Julie Hancocks (Communications Officer) and Jim Shaw-

Cotterill (Chair SECEN )

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NQICAN: Background• 2000 - NAGG set up

• 2008 - moved to

representatives for each region

• 2013 – – purpose revised and

objectives developed– group renamed to

NQICAN to reflect the changing quality landscape and the changing role of clinical audit staff

• people with an interest in the development of clinical audit

• health (all sectors), starting to involve social care

• Mostly unfunded and little/no cost to join regional network

NQICAN: how it works

Context - national• Demands on the NHS +++• Pressure to improve the quality of care+++ • Increasing pressure on NHS staff including clinical

audit / quality• Variation in level of improvement following national

audit • Growth of improvement science (particularly clinicians) • Plethora of national organisations making decisions

about QI and clinical audit• High level decisions about audit/QI need to engage to

staff on the ground

Francis, Berwick & Keogh• Leadership, culture, NHS

as learning organisation• Board responsibility• Clinical engagement• Clinical audit / QI

programme• Measurement and real-

time accurate data • Mortality• Response to outliers

• Openness and transparency

• Patient and public involvement/ patient partnership

• QI strategy• Capability of the system• Role of QI/CA staff

Feedback from regional networks

• Uncertainty about future• Clinical audit staff role expanding to QI• Lack of understanding of what is meant by Quality

Improvement?• Lack of standardised approach / QI training• Need to talk the same language• Lack of leadership• Conflict between clinical audit and improvement

science

Question.1What is your primary role?

1. Clinical audit / quality improvement

2. Health professional

3. Social care

4. Patient / carer

5. Voluntary organisation

6. Other

"Question Mark Cloud", (c) 2003 by Micky Aldridge

Question.2Before this morning were

you aware of the existence of the National Audit Governance Group (NAGG) / National Quality Improvement Network (NQICAN)?

1. Yes

2. No

"Question Mark Cloud", (c) 2003 by Micky Aldridge

NQICAN Map – your rep…

Question.3Before this morning were

you aware of your regional clinical audit / effectiveness network (s)?

1. Yes

2. No

"Question Mark Cloud", (c) 2003 by Micky Aldridge

Question.4Have you ever attended your

regional clinical audit / effectiveness network?

1. Yes – regularly

2. Yes – infrequently

3. No

"Question Mark Cloud", (c) 2003 by Micky Aldridge

Example of a local network, South East Clinical Effectiveness Network (SECEN)

Prepared by SECEN Chair, James Shaw-Cotterill

NQICAN Map – SECEN…

What is SECEN?

• A network of professionals working in quality improvement including; – Clinical audit, – Effectiveness and – Governance.

• Established in Summer 2000• The network brings people together to:

– Share good practice– Provide peer support– Influence/contribute to the national quality agenda

• Most of our members are from Kent, Surrey and Sussex • We welcome members who support quality

improvement in both NHS and non-NHS organisations.

SECEN: What do we do?

Healthcare Quality Quest

HQIP feedback

Round table

discussion

CQC

NQICAN Feedback

Managing change

SNAP

NICE Triangulation

Managing Audit

programme

Strategic objective• To work with and provide a (national and

regional) voice for staff working in clinical audit and quality improvement in health and social care organisations

Question.5In matters relating to clinical audit

and quality improvement do you feel you have a voice at the national level?

1. Yes

2. No

3. Sometimes

4. Unsure

"Question Mark Cloud", (c) 2003 by Micky Aldridge

Question.6When you provide feedback to the

national level do you feel you are listened to and feedback acted upon?

1. Yes

2. No

3. Sometimes

4. Unsure

"Question Mark Cloud", (c) 2003 by Micky Aldridge

Question.7What is your preferred

method of communication for NQICAN to use?

1. Face to face at meetings

2. Visit website

3. Via email

4. Twitter

5. Other

"Question Mark Cloud", (c) 2003 by Micky Aldridge

Strategic objective

• Support Regional Network Chairs and relevant others in the development of regional networks

Question.8What would make you more likely to attend a

regional network meeting? Pick top one

1. More training

2. Better sharing of learning between organisations

3. More focus on quality improvement

4. Greater opportunity to influence national picture

5. More support from my organisation

"Question Mark Cloud", (c) 2003 by Micky Aldridge

Strategic objective

• Engage, influence and advise key organisations such as HQIP, NHS England, NAGCAE, Improving Quality, NICE– Representation on HQIP Advisory Board– Development of National audit

programme strategy

Strategic objective

• Support development of national clinical audit to ensure it is robust, effective, fit for purpose– National audit programme strategy– NCAPOP Specification Development

meetings– Criteria for national audits being

included in Quality Accounts

Question.9What should be the primary

aim of the national audit programme?

1. Assurance

2. Improvement

3. Both

"Question Mark Cloud", (c) 2003 by Micky Aldridge

Strategic objective

• Work with HQIP, Improving Quality & other agencies to align clinical audit and improvement science

Question.10In the organisation where you work are clinical audit

staff involved in other quality improvement projects?

1. Yes

2. No

3. Sometimes

4. Don’t know

5. We have no clinical audit staff

"Question Mark Cloud", (c) 2003 by Micky Aldridge

"Collaborative learning through safety and quality improvement networks can be extremely effective and should be

encouraged across the NHS.  The best networks are those that are owned by

their members, who determine priorities for their own learning."

(Berwick Report, 2013)

Exercise: Creative thinking - effectiveness

STEP 1:

Brainstorm words associated with the random word on your table [5 mins]

STEP 2

Brainstorm - What would make you /us more effective in improving the quality of patient care? [5 mins]

STEP 3

Share learning with wider audience

On your table:

• Flip chart paper• Pens• Random word (different on each table)

Over to you…

Are we getting it right?

Feedback?

Questions?

Thank you

Suggestions welcome – box in lobby

nqican@gmail.com