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Setting standards in antenatal care

Setting standards in antenatal care. Jane Thomas Director NCC-WCH Hon consultant Obstetrics and gynaecology, Oxford 30.April 2003. Overview. NCC-WCH National Standards ANC Children’s National Service Framework National screening committee NICE Technology appraisals

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Setting standards in antenatal care

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  1. Setting standards in antenatal care Jane Thomas Director NCC-WCH Hon consultant Obstetrics and gynaecology, Oxford 30.April 2003

  2. Overview • NCC-WCH • National Standards ANC • Children’s National Service Framework • National screening committee • NICE • Technology appraisals • Clinical guidelines • Clinical Guidelines • ANC guidelines

  3. NCC-WCH Funded to produce guidelines and audit for the NHS by NICE RCOG Evidence Based Clinical Guidelines RCOG Manchester Audit Unit RCOG CESU Consumer RCOG, RCM, RCPCH, FFPRHC, AGUM, MSSVD 2002 HSR

  4. NCC-WCH guidelines Publication • Antenatal Care Oct ‘03 • InfertilityNov ‘03 • Caesarean sectionMar ’04 • Type 1 Diabetes in childrenFeb ‘04 • Long acting reversible contraceptionDec 04

  5. National standards for ANC • National screening committee • National Service Framework • NICE • Technology appraisals • Clinical guidelines National Service Framework

  6. National standards for ANC • National screening committee • National Service Framework • NICE • Technology appraisals • Clinical guidelines National Service Framework

  7. Continued Professional Development Clinical Governance Lifelong Learning First Class Service 1998 National service frame works National Standards NICE Local CHI National Monitoring National Collaborating Centre for Women’s and Children’s Health

  8. National standards for ANC • National Service Framework • National screening committee • NICE • Technology appraisals • Clinical guidelines

  9. NICE TA and guidelines • NHS clinical guidance based on • Clinical effectiveness • Cost effectiveness • Products • Clinical guideline (⇒Collaborating Centres) • Technology appraisals

  10. Clinical guidelines

  11. What are clinical guidelines? “systematically developed statements to assist practitioner and patient decision about appropriate health care for specific clinical circumstances’ National Institute of Medicine 1992

  12. improve quality + consistency + outcome of care promote effective interventions + discourage ineffective interventions make efficient use of resources highlight clinical need/service provision highlight gaps in research reassure clinicians and patients Aim of guidelines

  13. Key components for guideline validity 1. multi-disciplinary working groups 2. systematic review 3. explicit link of evidence to recommendations 4. explicit methods

  14. Antenatal care guideline

  15. NICE guideline development process Time months DH remit Scope 6 Submit Evidence GDG Develop questions 4. Apply evidence NCC-WCH • Systematic review • Evidence appraisal 12-18 1st Draft Final Draft 6 Stakeholder comment GUIDELINE

  16. DH remit ANC • " …NHS in England and Wales • routine antenatal care for all women including the number and timing of antenatal visits required and evidence based justification for the scope and content of each. • draw upon the evidence based recommendations of the antenatal subgroup of the National Screening Committee".

  17. ANC scope • Populations • baseline care of all pregnancies. • Comprehensive advice on the antenatal care of the healthy woman with an uncomplicated singleton pregnancy • Settings- all NHS

  18. ANC scope • guidance on antenatal visits • antenatal screening • educational aspects of antenatal care that are relevant to the antenatal health of the woman. • communication issues that influence the ability of women to make informed decisions

  19. ANC scope-what’s excluded • The investigation and management of complications arising in pregnancy • Any aspect of intrapartum and postpartum care

  20. ANC guideline group GDG: Group leader: Peter Brocklehurst 2 midwives 2 GP’s 2 obstetricians a paediatrian a radiolographer 2 consumer representatives NCC-WCH methodological support 1st GDG meeting June 02 1st Draft consultation: Apr 03 Publication: Oct 03

  21. Timetable ANC • 1st GDG meeting June 02 • 1st draft consultation: 14 Apr-11 May • 2nd draft consultation: 16 Jun-11 July • Publication: 23rd Oct 2003

  22. Guidelines and NICE TA • Guidelines incorporate NICE’s TA recommendations, • Rhesus anti D prophylaxis.

  23. Guideline + NSF • Complement the recommendations of the NSF. • It will support the implementation of the NSF.

  24. NICE guidelines • 3 formats • Full • NICE short form • Patient version • Audit standards  CHAI • Research recommendations

  25. Up to date information about the NCC-WCH and guidelines is available from http://www.nice.org.uk/ Thank you

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