Managed Clinical Network (MCN) Showcase Working in Partnership with MCNs 8 October 2009

1. Managed Clinical Network (MCN) Showcase Working in Partnership with MCNs8 October 2009 Hilary Davison Director of Guidance and Standards Martin Moffat Project Lead: CHPs/Shifting the Balance of Care Lorna Thompson Programme Manager, SIGN

2. NHS Quality Improvement Scotland (NHS QIS) NHS QIS’ vision is of an NHS that achieves excellence in the care of every patient every time. It leads the use of knowledge to promote improvement in the quality of healthcare for the people of Scotland and performs three key functions:

3. Integrated cycle of improvement 3 strands of equal importance • Advice, guidance and standards • Support for implementation and improvement • Assessment, measurement and reporting Next steps • Greater focus on implementation and improvement • Supported by measurement • Greater integration and matrix working

4. Future Developments • The new strategic direction is evolving, but aspects of this cycle have been incorporated into the NHS QIS work programme. • Dissolution of NHS QIS and creation of Healthcare Improvement Scotland (HIS) • Greater emphasis on self evaluation • Proportionate, risk based scrutiny activity • Ability to demonstrate links between scrutiny and improvement

5. To measure performance against agreed standards and the core principles • To support improvements in care and services • To learn from challenges and share strengths, and • To report openly. The development of a draft Quality Assurance Programme (QAP)

6. Support material – work in progress Production ofdraft process mapsto aid MCN steering groups with QAP development and accreditation processes.

7. Aims and objectives included: • Laying the foundations of the QAP • Standard setting • Accreditation of the MCN, and • Ongoing review and assessment of performance – • reporting procedures for local, regional and national • networks. MCN QAP development and accreditation process information sessions

8. The MCN production crew at NHS QIS! Resources available • MCN Co-ordinator • Clare Echlin, Acting Head of the Standards Development Unit, and • Margaret McAlees, MCN Administrator. Work in progress… • The NHS QIS MCN website and shared space • The NHS QIS MCN newsletter • Draft process maps and most importantly… • YOU!

9. Quality assurance (QA) and performance assessment Work in progress… • National MCNs – joint letter issued by NSD (Deirdre Evans) and NHS QIS (Hilary Davison) to national managed clinical network lead clinicians and network managers in November 2008 outlining a simplified method of annual reporting. • Engagement between NHS QIS and National Services Division (NSD) – NHS QIS attendance at NSD mid-year reviews to look at the QA and performance assessment measures of national MCNs, and • Joint review of Yorkhill and Tayside national MCN offices.

10. Next steps… Including… • Production of a final version guidance for consultation • Development of NHS board guidance and correspondence for distribution to NHS board Chief Executives and other key stakeholders • Clarification of the reporting procedure and content, e.g. key inclusions, monitoring service achievements against standards of care and added value – applicable to local, regional and national networks, and • Establishing a model for the review of, and provision of feedback for, annual reports.

11. Martin Moffat Project Lead: CHPs/Shifting the Balance of Care Shifting the Focus

12. Shifting the Focus • Shifting the Focus Strategy(October 2007) • Stage 2 - CHPs/Shifting the Balance of Care Project(January 2009) Two year launch-pad project: • Scope potential areas and opportunities where NHS QIS support might add best value. • Build on the outputs from the Delphi Consultation Pilot – initial phase of the project. • Begin the process of putting in place quality improvement support to assist CHPs in delivering agreed outcomes and improving outcomes.

13. Shifting the Focus Supporting Partnership Working • A key theme emerging from our work so far – particularly in relation to: • The Patient Journey and flow of patients through the system - Referral management and processes - Primary, secondary and social care interface - better communication and exchange/sharing of information • Supporting CHPs to deliver outcomes • These areas are of particular relevance to the work of MCNs

14. Shifting the Focus CHP Regional Focus Groups • Three regional CHP focus groups have been established. • The focus groups will be a vehicle to: • test potential models of quality improvement support • building on the outputs from the Delphi study and other feedback. • help inform our CHPs/Shifting the Balance of Care work programme so that it is meaningful and adds value to CHP priorities and challenges.

15. Shifting the Focus CHP Regional Focus Groups Days Autumn 2009 • CHP Focus Groups have already begun to consider concepts of quality improvement support around: - Patient/Client Pathways- Quality management • Making the most of Community and Specialist Services - Supporting CHPs to deliver outcomesthrough effective partnership working - Quality assuring good practice • Evaluating and sharing good practice (service development and redesign solutions) across CHPs - Tackling health inequalities • Effective partnership working is the ‘success factor’ crucial to all of these theme areas.

16. Shifting the Focus Next Steps • Report on the outputs from the CHP Focus Groups by the end of the year. • Develop and share a Shifting the Focus Stage 2 work programme. • MCNs Managers’ Network will be among the stakeholder groups we consult with.

17. Lorna Thompson Programme Manager, SIGN SIGN Implementation Programme

18. World leaders in implementation support Vision

19. For more information: Ali El-GhorrImplementation Adviserali.elghorr@nhs.net

20. Implementation- The Plan…

21. Examples:Forthcoming Guidelines

22. Depression guideline linking with: • HEAT target • Scottish Government Mental Health Collaborative • Local depression ICP developers • NHS Education • NHS QIS ICP implementation toolkit • Also networking and awarenessraising using a standard set of slides

23. Obesity guideline: • Started to develop implementation approach alongside guideline development • Linking with Government • Linking with Regional Planning Groups • Developing resource implications tools • Raising awareness in Primary Care

24. Likely Future • Fewer new guidelines taken on • Staff trained in implementation support • Targeted implementation strategy for each guideline • This work links with NHS QIS Implementation Support Directorate

25. Integrated Cycle of Improvement Guidance and advice (eg SIGN guideline or clinical standards) Assessment, measurement and reporting (eg peer review or audit) Implementation and improvement support package