VIEWS: 2 PAGES: 11 POSTED ON: 2/3/2010
Attach 9 REPORT TO TRUST BOARD 31st January 2007 Agenda No. 7.4 Title of Document: The Annual Health Check in 2006/2007 Report Author: Yvonne Connolly, Simon Harris Lead Director: Di Caulfeild-Stoker, Director of Provider Services Contact details: Yvonne.Connolly@wpct.nhs.uk, Simon.Harris@wpct.nhs.uk Summary: This paper describes the Healthcare Commission’s approach to managing the annual health check in 2006/2007. It contains a number of recommendations in light of the changes to this assessment and the PCT’s new Integrated Governance Structure proposals. RECOMMENDATIONS: The Board are asked to approve the recommendations outlined in this paper. Committees which have previously agreed the report: None PEC Comments where appropriate: N/A Financial Implications: None Other Implications including patient and public involvement/Legal/Governance/Diversity/ Staffing Equality Impact Assessment Has an EIA been carried out? (If not, state reasons) Yes: Phase 1 impact assessment carried out. (No adverse impact anticipated) This has been passed onto Diversity Manager. Attach 9 The Annual Health Check in 2006/2007 The purpose of this paper is to inform the Board of the Healthcare Commission’s (HCC’s) annual assessment process and performance ratings of NHS organisations in 2006/2007. (Please refer to the glossary for full terms). This document will outline the key processes and timescales and suggests a number of recommendations for the Board to approve. Wandsworth PCT received its annual performance rating for 2005/2006. It received a rating of ‘fair’ for quality of services and ‘weak’ for use of resources. All five PCTs in South West London received the same rating of ‘fair’ for quality of services. Two PCTs received the rating of ‘good’ for use of resources and two others, like Wandsworth PCT received the rating of ‘weak’ for this element. Information about the assessment in 2006/2007 The diagram below demonstrates what elements the HCC will use to calculate their annual performance rating in 2007. Figure 1. taken from ‘The annual health check in 2006/2007, assessing and rating the NHS’ In the first year of the annual health check (2005/06), The HCC focused much of their activity on ensuring that basic, core standards were being met. This time they will continue with this approach but will increase their focus on whether NHS organisations are driving improvement in the commissioning and delivery of healthcare. Attach 9 As in 2005/2006, they will assess organisations in a range of ways. Firstly, they will assess whether Trusts are getting the basic standards of care right. They assess how Trusts are performing on: o core standards (core standards assessment) o long standing targets set by Government (existing national targets) o effective management of resources, including finance (use of resources) o newer targets set by Government (new national targets) (It is these four elements that will dictate the PCT’s annual performance rating in 2006/2007) Secondly they will assess whether improvements are being sought. They will do this by assessing performance on: o service reviews and national studies o developmental standards (developmental standards assessment) (These form part of the annual health check but do not contribute to the performance rating in 2006/2007) Where does accountability currently lie within the organisation and what are the deadlines for submission? The annual health check in 2006/2007 Deadline for Does it feed submitting this to into 2006/2007 Element Responsibility the Healthcare performance Commission/Audit ratings? Commission Clinical Governance Core Standards Yes April 2007 & Risk Department Meeting existing Performance HCC have not yet Yes national targets Management confirmed this Meeting new Performance HCC have not yet Yes national targets Management confirmed this Various milestones, Use of Resources Finance Yes rough timescales of dates shown in ‘Figure 5.’ Service Reviews and national Dependent on particular studies (formerly Services involved No review. Detailed in called improvement ‘Figure 3’ reviews) Developmental PCT to self assess Standards (through Clinical Governance No against these in April shadow and pilot & Risk Department 2007 assessments) Figure 2. Attach 9 Timeframe of deadlines for Service Reviews and National Studies Service Review Date for Submission Lead Diabetes Healthcare Commission Nigel Everson have not confirmed this yet Race Equality Healthcare Commission Margaret Adjaye have not confirmed this yet Substance Misuse 1st December 2006 Ian Wilson Acute Inpatient Mental February 2007 Stephen Warren, Health Paul Chapman Maternity Services N/A for PCT Heart Failure Healthcare Commission Stephen Warren have not confirmed this yet National Study Date for Submission Lead Audit of Learning Begins January 2007 Peter Warburton/ Disabilities Alastair Bearne Audit of Handling of Healthcare Commission Shona Ruff Complaints have not confirmed this yet National study of Healthcare Commission Yvonne Connolly healthcare associated have not confirmed this infection yet Figure 3. Calendar for entire Annual Health Check Process Oct 06 – Oct 07 Timeline for submission of elements O N D J F M A M J J A S O 2006- 2007 C O E A E A P A U U U E C T V C N B R R Y N L G P T Board agree status of Core & Developmental Standards * Board make public declaration on Core & Developmental standards * Use of resources information submitted? Existing National Targets Data submitted? New National Targets Data submitted? Service Reviews National Studies * * * Annual Performance rating awarded * * Figure 4. Attach 9 Key information about the elements that make up the annual health check in 2006/2007 Core standards – The Board will be required to agree the level of compliance with the core and developmental standards at their March meeting. This will then need to be shared with the Overview and Scrutiny Committee, the Patient Public Involvement Forum, Internal Audit and the Strategic Health Authority. Once these groups have had a chance to comment on it, the Board will review these comments and formally sign off the declaration at their April meeting and submit it to the Healthcare Commission by no later than midday 1st May 2007. There are likely to be a few changes to the declaration process this year and we are awaiting final guidance from the HCC. So far we are aware that: o There will be no draft declaration process this year. o The HCC will further develop their methods of surveillance and local intervention to give greater assurance that organisations are meeting basic standards of care. National targets (New and Existing) – More guidance was due be issued by the HCC in December 2006, as of the date of writing this paper we are still awaiting this. o The HCC have indicated that there will be minor changes to the indicators on the existing national targets. o They have also indicated that there will be minor changes to the indicators on the new national targets. These will be published on their website shortly, following approval from the Secretary of State for Health. The key change is that in 2006/2007, the ‘quality of services’ part of the performance rating will be derived from the assessment of core standards and the assessment on existing and new national targets only. It will not directly include the results from the programme of service reviews and national studies as it did last time, or Developmental Standards. Use of resources - o The HCC’s assessment will continue to be derived mainly from information supplied by the Audit Commission and Monitor. o They will work with the Audit Commission, Monitor and others to agree and publish comparative indicators on productivity. o They will develop a programme of work to extend our assessment of value for money Attach 9 The timetable for ‘use of resources’ last year was: Auditors complete phase one of fieldwork for financial March 2006 management, internal control and value for money Audit Commission’s quality assurance process for May 2006 phase one draft scores Audited accounts for non-foundation trusts submitted July 2006 Audited accounts for PCTs submitted Auditors complete Auditors’ Local Evaluation scores August 2006 Quality assurance and query resolution by the Audit Commission Transfer of score to the Healthcare Commission. Healthcare Commission receives, checks and September 2006 considers scores. The five auditor scores are reported to NHS organisations. Scores available on Healthcare Commission website for ratification Annual rating published October 2006 Audit Commission publishes auditor assessments and commentary on the five areas Figure 5. It is likely that a similar timetable will be in place this year and it is proposed that these deadlines are monitored by the Audit Committee in the new Integrated Governance structure. (This is detailed in the recommendations at the end of this paper). Programme of service reviews and national studies – The HCC plan to issue detailed guidance specific to individual service reviews and studies throughout the year. The guidance will be scheduled to coincide with the timing of each review. o The programme of service reviews and national studies includes those reviews previously called improvement reviews and the acute hospital portfolio. It also includes national reviews for which the HCC may only collect information on a subset of organisations. A number of these reviews and studies will provide comparative information on services. o In 2006/2007, this programme will include the following major services or topics: maternity, diabetes, substance misuse, adult acute inpatient mental health, race equality, learning disabilities, complaints handling and healthcare associated infection. (The substance misuse review took place in December 2006 and we are awaiting the results). The other reviews are due to start shortly, please refer to the table titled ‘figure 3.’ Earlier on in this document to see when.) Attach 9 o Results of the HCC’s review on heart failure services carried out in 2005/2006 will also be published during 2006/2007. o Results from the HCC’s service reviews and national studies will feed into the assurance process for assessing performance in relation to standards. They will not feed directly into the overall rating for 2006/2007. Developmental standards o Developmental standards outline improvements that the Government expects all trusts to aspire to in order to improve the quality of care and treatment provided. This is a new part of the annual health check. o In 2006/2007, the HCC will focus their assessment in three of the seven areas or domains set out in the Department of Health’s standards. These are safety, clinical and cost effectiveness, and public health. o Only the ‘public health’ developmental standards are applicable to the PCT this year. Performance against developmental standards will not feed into the overall annual rating in 2006/2007. However the HCC have indicated that they do expect it to form part of the rating from 2007/2008. o Over the three-year cycle 2006/2007 to 2008/2009, the HCC expect to cover all seven domains within the developmental standards framework. Future Healthcare Commission development During 2006/2007, the HCC will work with the Department of Health, the NHS, the Commission for Social Care Inspection and other partners to determine their approach for the future in commissioning arrangements that organisations have in place. Attach 9 Recommendations for the Board One of the primary concerns for the Board will be how it knows that there are robust systems and processes in place to monitor all elements of Healthcare Commission assessment and that areas of concern are escalated quickly. It is anticipated that the new Integrated Governance structure for the PCT will be the mechanism for doing this. It is proposed that the foundations of the structure will be in place for the new financial year 2007/2008. As this will not be fully embedded in time for this year’s declaration on the 1 st May, it is recommended that the organisation maintain the following reporting structure in the interim period: All Healthcare Commission processes including all elements of assessment should pass through the Clinical Governance & Risk Management Committee or Healthcare Commission Steering Group for initial discussion and areas of concern escalated to the Board accordingly. This will allow the organisation to take a holistic approach to the annual health check and be fully aware of all areas of assessment. From the beginning of the new financial year, it is proposed that the Integrated Governance Committee be the method for monitoring all elements of the ‘quality’ part of the HCC assessment, including core and developmental standards, national targets and service reviews. Each of the committees reporting through Integrated Governance Structures will have the relevant core/developmental standards and national targets linked to their Terms of Reference and will have five key responsibilities with regard to each of these: 1. Raising at an early stage any concerns about compliance from relevant leads. 2. Providing evidence/assurance of compliance with relevant responsibilities. 3. Escalating any exceptions to the Integrated Governance/Audit Committee. 4. Using the HCC’s cross-checking data to identify any areas of potential concern. 5. Ensuring comprehensive action plans for gaps identified. The Integrated Governance Committee will review evidence from all commissioned and contracted services (including Provider services) and flag concerns up to the Audit Committee. The Audit Committee will continue its current functions including monitoring of all elements to do with the ‘use of resources’ part of the annual assessment. Additionally it will examine all the concerns raised by the Integrated Governance Committee. Where there are quality issues that may require financial support, the audit committee will agree how this can be allocated within budget. This will then be reported to the Board. Attach 9 Having the system set up this way would ensure integration right the way through the organisation with ownership of every standard/target taken into consideration at all levels. To support this proposal, a robust system of monitoring will need to be put in place. It is suggested that the PCT’s ‘Ariadne’ electronic monitoring system be used. Information can be extrapolated from this database and presented in a number of ways. For each standard the PCT needs to provide evidence of compliance within its own provider services and with contractor groups and commissioned services. Systems have already been set up to ensure that evidence will be forthcoming from all for these areas: Provider Services - via the ‘Team Tool’ results and action plans tracked on Ariadne. Independent Contractors - via contract reviews which have standards embedded in them and will also be reported on Ariadne Commissioned Services - by sharing their HCC cross-checking data with us so that any areas of concern that the HCC may have can be more closely monitored by Wandsworth PCT. The table on the next page demonstrates how the PCT can report on progress towards meeting core standards for all of the above groups. Attach 9 Appendix A Attach 9 Glossary of terms Ariadne This is a web-based application which permits the PCT to monitor evidence for all of its functions. It is an electronic document storage facility that helps management maintain evidence, keep it up to date and set up robust accountability structures. Commissioned Services St Georges NHS Trust, South West London St Georges Mental Health Trust and Wandsworth Prison Cross-checking data Information that the Healthcare Commission used to assess the likelihood of non-compliance with a standard based on other sources of information that they have access to. HCC Healthcare Commission, the national organisation charged with running the annual health check and publishing and annual performance rating. Independent Contractors Dentists, GPs, Optometrists and Pharmacists Team Tool A yearly audit programme (one per month) that all teams within the provider services are required to complete. These audits have been based on core standards, Essence of Care requirements and NHS Litigation Authority criterion as well as other national requirements, to ensure staff are aware of the must dos and have a logical way of checking these.
Pages to are hidden for
"the annual health check in 20062007"Please download to view full document