Standards & Accreditation for Occupational Health Services

1. Standards & Accreditation for Occupational Health Services Paul J Nicholson

2. Scope • Background • Developing the standards • Definitions • The scope and aims • The standards • The accreditation process

3. Background 2006 – Department of Health Standards for Better Health • Require a rigorous approach to assessment and accreditation of providers of NHS services. 2008 – Lord Darzi’s Report High Quality Care for All: NHS Next Stage Review • Confirmed Government support for provider accreditation schemes in the NHS. 2008 – Dame Carol Black’s Report Working for a Healthier Tomorrow

4. An integrated approach to working age health should be underpinned by:the inclusion of occupational health and vocational rehabilitation within mainstream healthcare; clear professional leadership;clear standards of practice and formal accreditation for all providers; a revitalised workforce; a sound academic base; systematic gathering and analysis of data; and a universal awareness and understanding of the latest evidence and most effective interventions. Working for a healthier tomorrow

5. The production of agreed common standards will facilitate the development of an accreditation scheme for health, work and well-being services We believe there is a strong desire for some form of national accreditation system across OH & VR services We are committed to funding a project to support the delivery of an accreditation system for OHS and support its first year of operation. Improving Health and Work: Changing Lives

6. Developing the standards • Faculty of Occupational Medicine led • 47 people represented 35 organisations • Occupational medical & nursing professional bodies [AOHNP(UK), RCN, SOM] • Commercial OH providers [including COHPA] • Employer representative bodies [BITC, CBI, CIPD, EEF] • Worker representative bodies [Unite, USDAW] • NHS Plus / HSE / DETINI

7. Key milestones ACCREDITATION LAUNCH Pilot web tool Accreditation body chosen STANDARDS LAUNCH Consultation & piloting Agreed 1st draft Agreed domains

8. Definitions • Standard • Minimum requirement • Accreditation • Registration

9. Definitions A standard is something considered by an authority or by general consensus as a basis of comparison in measuring or judging adequacy, quality, etc

10. Definitions • Minimum requirements relate typically to existing professional guidance • They must be met to satisfy the standard • They are intended to be well-defined and easy to understand

11. Definitions Accreditation is a self-assessment and external peer assessment process used to accurately assess level of performance in relation to established standards and to implement ways to continuously improve the healthcare system International Society for Quality in Health Care (ISQua)

12. What does accreditation mean?

13. Accreditation vs Registration Accreditation is a voluntary process Registration is a statutory process with which providers must comply “to assure people who use health and adult social care of standards of safety and quality, regardless of provider, and to enable independent and strong enforcement where there are unacceptable services”. Care Quality Commission (CQC)

14. The scope of the OHS standards • The standards apply to broad-based clinical occupational health services, be they: • in-house services in the public and private sectors • commercial occupational health providers from single handed providers to large organisations • They do not apply to non-clinical services, e.g. occupational hygiene, ergonomics, etc. • They reflect existing professional guidance

15. Aims • Enable OHS to identify the standards of practice to which they should aspire • Credit good work being done by high quality OHS, providing independent validation that they satisfy standards of quality • Raise standards where they need to be raised • Help purchasers differentiate OHSthat attain the desired standards from those that do not

16. The standards 13 standards are grouped into 6 domains: • Business probity • Information governance • People • Facilities and equipment • Relationships with purchasers • Relationships with workers

17. The standards Business probity A1 Conduct business with integrity A2 Maintain financial propriety Information governance B1 Maintain adequate OHCRs B2 Implement systems to protect confidentiality People C1 Ensure staff are competent C2 Ensure appropriate supervision

18. The standards Facilities and equipment D1 Conduct business in safe, accessible and appropriate facilities D2 Ensure that medical equipment is safe and appropriate D3 Ensure that medicines are handled appropriately Relationships with purchasers E1 Deal fairly with purchasers E2 Be customer focused Relationships with workers F1 Ensure that workers are treated fairly F2 Respect and involve workers

19. Standard A1An OHS must conduct its business with integrity Minimum requirements: The following minimum requirements apply to all OHS: A1.1 An OHS must only publish information about services which is factual and verifiable The following additional minimum requirement applies to all OHS except single-handed practitioners: A1.2 An OHS must take reasonable steps to ensure that all of its staff are honest and trustworthy The following additional minimum requirement applies to an OHS that outsources work to another organisation: A1.3 An OHS must maintain systems to check the qualifications of and monitor the standard of work that is outsourced to third party providers

20. Examples of evidence

21. Customer survey E1.1 An OHS must provide purchasers & potential purchasers with clear & user-friendly information on fees E1.2 An OHS must agree with purchasers the extent and scope of any business continuity planning that is required to protect service delivery E1.3An OHS must agree with customers, at the outset, the processes for referrals to the OHS, case management and reporting of cases of occupational disease and any onward referral of workers for further investigation E2.1 An OHS must be in touch with individual purchasers to understand their culture, values & needs based on reliable and recent information E2.4An OHS must use formal & informal methods to regularly seek information about customer satisfaction from purchasers & referring managers

22. Assessment & accreditation Register for information Register as a user / input OHS details Upload evidence against minimum requirements Perform self-assessment / develop action plans Apply for accreditation

23. Application Will include an attestation to: • meeting eligibility criteria • providing true and contemporaneous information • complying with all applicable laws and regulations and • having appropriate insurances Must be signed or co-signed by at least one registered health professional

24. Assessment & accreditation At least once every 5 years

25. What happens if an OHS fails? • It depends on what the challenges are • Clear recommendations • Timescales for improvement • Direct support from the SEQOHS office to attain full accreditation We want services to pass, it’s a supportive process

26. Web-based tool • Online self assessment tool • Evidence record for external audit • Knowledge management system

27. Knowledge Management System Knowledge Management System Introduction Top 5 KMS Downloads 1. 2. 3. 4. 5. Latest Uploads 1. 2. 3. 4. 5. Search KMS  Domain to search Standard to search Minimum requirement to search Text to search for Presentations 1. 2. 3. 4. 5.

28. Online: www.facoccmed.ac.uk/library/docs/standardsjan2010.pdf How do I find out more? STANDARDS Hard copy: Faculty of Occupational Medicine 6 St Andrews Place Regent’s Park London NW1 4LB

29. How do I find out more? ACCREDITATION FOM Winter Conference: 1st December 2010 Royal College of Physicians Regent’s Park London Online: SEQOHS will have its own web address