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Using national clinical audit data to improve quality. Nick Black Chair National Clinical Audit Advisory Group NNAP & NDAU Collaborators’ Meeting 21 January 2011. White Paper (July 2010). “…there will be a relentless focus on clinical outcomes.
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Using national clinical audit data to improve quality Nick Black Chair National Clinical Audit Advisory Group NNAP & NDAU Collaborators’ Meeting 21 January 2011
White Paper (July 2010) • “…there will be a relentless focus on clinical outcomes. • Success will be measured, not through bureaucratic process targets, but against results that really matter to patients…”David Cameron, Prime Minister
White Paper (July 2010) • “The Department will extend national clinical audit to support clinicians across a much wider range of treatments and conditions…”
National clinical audit Clinical audit is the assessment of the process and/or the outcome of care. Its aim is to stimulate and support national and local quality improvement interventions and, through re-auditing, to assess the impact of such interventions.
Quality assurance cycle Establish criteria Set standards Quality assessment Quality improvement interventions National Clinical Audit Stimulate quality improvement
NCA portfolio in England (2010-11) • 54 NCAs meet the three criteria • intention to achieve participation by all relevant providers in England • data collected on individual patients • provides comparisons of providers (eg Trusts) • Funding • DH National Clinical Audit & Patient Outcomes Programme (NCAPOP) funds 27 • Variety of other funders: DH; charities; NHS Trusts; Special Health Authorities; NPSA
Quality assurance cycle Establish criteria Education Regulation Revalidation Legislation Incentives Redesign Set standards Quality assessment Quality improvement interventions National Clinical Audit Stimulate quality improvement
Improving quality: how will it happen? • Clinicians and managers: redesign services; education • Patients/public: informed choice • PCTs/GPCCs: commissioning; reimbursement (CQUIN; Best Practice Tariff) • Royal Colleges/GMC: revalidation • NHS Litigation Authority: risk management • Care Quality Commission: regulation • Trusts: public accountability (Quality Accounts) • NHS Commissioning Board: performance management (NHS Outcomes Framework)
Current policies • Expand the NCA portfolio • Improve quality of NCAs • Improve NCA output • Public disclosure of information from NCAs • Encourage use of NCA data for quality improvement
The future • NCA for too long the poor cousin of research • Inadequate funding • Insufficient scientific rigour • Little professional esteem/status • Opportunity to realise the potential NCAs can offer for driving quality improvement