Service Accreditation in England Marcia Fry, Molly Corner, Paul Long

1. Service Accreditation in England Marcia Fry, Molly Corner, Paul Long

2. A history of standards for services in England • Standards have traditionally been set by clinicians for clinicians eg by Royal Colleges • From the late 1990s government developed National Service Frameworks – outlines what services should look like • Introduction of ‘Standards for Better Health’ (2004) – and regulation against them by the Healthcare Commission • Drive to be able to measure quality of services being delivered • Royal Colleges now developing service accreditation schemes • NICE tasked with developing standards of care as part of the quality framework

3. Darzi review • Darzi review – ‘Better care for all’ – review of healthcare provision in England • Recommendations include: • Improved measurement of quality – nationally agreed indicator set • Introduction of National Quality Board • Service accreditation • Change to role of NICE

4. NICE – expanded role • Remit to develop or approve standards • NHS Evidence – pulling together all reliable sources of evidence based good practice into one place • Standards will lead to the development of indicators to measure implementation of these standards • Involvement of patients, clinicians and managers in the development of standards

5. National Quality Board • National body overseeing quality of care in England • Duty to produce an annual State of Quality report using internationally agreed comparable measures • Act as a steering group for NICE – suggested topics and standards • Close interaction with regulators

6. Accreditation of services • Defined principles for accreditation: • accepted by a large majority of professionals • based on evidence • subject to arrangements for compliance • measurable • susceptible to amendment • subject to the involvement and approval of representatives of service users and patients

7. Accreditation methods • Development of standards • Self assessment against standards • Peer review – external scrutiny • External scrutiny of overall process • Evaluation • Review of standards • Duration?

8. Working with HC/CQC • Looking at how we can incorporate service accreditation into the regulatory framework • Light touch regulation – assurance of a level of quality of service • Regulator can concentrate efforts elsewhere • Links with registration process

9. Progress to date • Current service accreditation programmes: • Clinical Pathology Accreditation – accreditation of diagnostic laboratories • Royal College of Psychiatrists schemes – eg ECT, Adult in-patient, Peer review quality networks (nb not accreditation but peer review schemes)

10. Accreditation of GP Practices/primary medical care providers • RCGP has developed an accreditation scheme for primary care providers • Some cynicism in GP community – others can see benefit • Pilots currently being run – evaluation of pilots later this year/early next year • Roll out of scheme due 2010.

11. Some other schemes in development • Royal College of Radiologists – radiology • Royal College of Physicians – Stroke • Royal College of Surgeons – Trauma • Royal College of Obstetrics and Gynaecology – maternity 11

12. Related matters for discussion • Links between service accreditation and clinician revalidation/re-certification? • No common definition of service – what is the accredited ‘unit’?