Quality Standards to Quality Assured Indicators

The End-to-End Process

Healthcare Efficiency Through Technology Expo 2013

Overview

• Introducing– NICE and HSCIC

• Background– To NICE quality standards– To the national library of quality assured

indicators

• The journey from quality standards to a national library of quality assured indicators

Introducing NICE

The National Institute for Health and Care Excellence (NICE) is a Non Departmental Public Body - funded by the Department of Health• Responsible for developing:

– Evidence-based guidance & support tools on the most effective ways to diagnose, treat, prevent disease and ill health and care for people receiving social care

– A library of quality standards (and menus of associated indicators)

– NICE Evidence.

Introducing HSCIC

HSCIC is an Executive Non-Departmental Public Body (ENDPB) which came into being on 1st April 2013• Responsible for:

– The collection, linkage and secure storage and publication of the core data resources for health and social care, bringing together into a single place all indicators, the data and details of their methodologies

– IT systems delivery; providing the expertise necessary to support the continuation of existing national systems and services as well as the delivery of new systems and critical services such as information standards

“The Information Centre must establish procedures for the assessment of a quality indicator; and arrange for each quality indicator published in the library to be periodically reviewed.” The Health and Social Care Act Statutory Instruments 2013 No.259

What are NICE quality standards?

Evidence Guidance QualityStandards

A NICE quality standard is a concise set of statements designed to drive and measure priority quality improvements within a particular area of care. Around 6-8 statements per standard – up to 15 in exceptional circumstances.

A comprehensive set of recommendations for a particular disease or condition, particular need or service

How can quality standards be used?

• NICE may be directed to prepare statements of standards in relation to the provision of– NHS service – public health services or– social care in England

• In discharging its duty, the NHSCB/Secretary of State must have regard to the quality standards prepared by NICE

• Organisations improving the quality of health services must have regard to the quality standards prepared by NICE

Quality standards – three interfaces

Social care

Public health NHS

The development approach - EPiC

• Evidence based• Partnership work making best use of

expertise across HSCIC and NICE• informed by Collaboration with key

stakeholders

Key stages in the process

NHS E refers topics to NICE for health-related areas

NHS E approval for use in CCG OIS

HSCIC IAS

Development of NICE menu of indicators

Published quality standard

Development of quality standard

NHS E refers topics to NICE for health-related areas

0 5 10 15 20

ChildrenOther/cross-cutting

CardiovascularMental health

Maternity Cancer

GastrointestinalNeurological

Service deliveryGenitourinary

MetabolicTrauma

MusculoskeletalRespiratory

Infectious disease Skin

Eyes / visionPublic Health

Hearing Blood disorders

Number of referrals

Cate

gory

Development of the quality standard

HSCIC inputs to the quality standard development process

HSCIC Comments on draft NICE topic overview paper for meeting of Quality Standards Advisory Committee

HSCIC Comments on draft NICE quality standard pre-consultation

HSCIC Comments on draft NICE quality standard pre-publication

Measure development

• Measures – Structure, process and outcome measures– based on existing NHS indicators or use sources of

routinely collected data, where possible

• High level quality measures – Use at local level as audit criteria – Inform subsequent national indicator development

• Also highlight related national quality assured indicators – Including those developed by the Health and Social Care

Information Centre Indicators for Quality Improvement Programme

Development of NICE menu of indicators

HSCIC Indicator Assurance Service: towards a national library of quality assured indicators

The Information Centre must establish, maintain and publish a database of quality indicators in relation to the provision of health services and adult social care in England… The Information Centre must establish procedures for the assessment of a quality indicator; and arrange for each quality indicator published in the library to be periodically reviewed.” (Health and Social Care Act: Statutory Instruments)

HSCIC Indicator Assurance Service: towards a national library of quality assured indicators

Putting the indicators into practice

• Quality Strategic Framework Group – CCG OIS responsibility

• Published indicators available on HSCIC Portal and NHS iView

“Information is a source of learning. But unless it is organized, processed, and available to the right people in a format for decision making, it is a burden, not a benefit.” William Pollard

NHS iView

4.1 Patient experience of GP out of hours services, in which a higher value shows greater satisfaction with the service

What next?

Can only demonstrate improvements if we have clear standards, transparent methodologies etc.Problems of snapshot indicators – need for comparison over timeContext needed to understand some indicators eg SHMI

"Not everything that counts can be counted, and not everything that can be counted counts." - Albert Einstein

How can you get involved?

• Public consultation on quality standards and indicators

• Committee members recruited via NICE website

• HSCIC Indicator Assurance Service• Assurance process is only as good as the

people who input into it• MRG peer reviewers• Organisational representation on IGB

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Call us on: 0845 300 6016Email us at enquiries@hscic.gov.uk

To Find Out More About the HSCIC