Good afternoon so we are here to talk about the Quality Working Group this afternoon and
could I just ask you to briefly introduce yourselves?
Yes good afternoon my name is Dr Paul Husselbee and I am a GP and I am Clinical Chief Officer
of NHS Southend CCG or NHS Southend Clinical Commissioning Group.
Hi Iím john Stewart and Iím the director for the Quality Framework at NHS England.
My role involves really helping to build the National Architecture or infrastructure for
quality, to support improvement across the system, for example: that involves making
sure we have the right standards in place, for the right measures.
That we are harnessing the powers of transparency, that we are using the right financial levers
and incentives to really drive quality in the interests of patients.
So what exactly is the Quality Working Group?
The Quality Working Group was set up by the National Commissioning Assembly, 211 member
CCGís in that and the Quality Working Group made up of 46 people, both Clinical Commissioning
Group staff and members, and National Directorates from NHS England.
All coming together in one group to put quality at the heart of everything we do.
And why is quality so important to us?
So I think we need to be clear what we mean by quality to start with, and I think in this
country we are really lucky that we have a really simple and clear definition of what
we mean by quality.
That definition really began and fell out of Lord Darziís review of the NHS back in
2008 and for him it involved three component parts.
Firstly care that was safe.
Secondly, care that was effective and thirdly, care that provided as positive an experience
for patients as possible and I think that definition really is powerful because I think
what it does is, it begins to unite the ambitions of all staff working in the NHS with the hopes
of patients and the expectations of the public.
And John itís important to remember that for Quality care all those three components
have got to come together equally, without any one of them it is not quality care.
Absolutely.
And how do we measure this quality though, how do you measure it?
So having a definition of quality is fine, itís a great start, but being able to measure
how we are doing is absolutely key.
So, the way we have done that is to really develop at a national level, something called
the NHS Outcomes Framework and what that tries to do is fundamentally kind of articulate
what we are striving to achieve for patients using that three part definition of quality
as the starting point.
So for example: the first domain of the Outcomes Framework is around what the NHS is doing
to reduce premature mortality.
Domain 2 relates to improving the quality of life, for people with Long Term Conditions.
Domain 3 relates to how well the NHS is supporting people to recover from episodes of ill health.
and then of course when we are providing that care and treatment, we need to make sure that
firstly, we are delivering that care in a way that delivers as positive an experience
for patients as possible, so domain 4 of the Outcomes Framework, and finally, that we of
course keep people safe and they are protected from avoidable harm, Domain 5 of the Outcomes
Framework.
And can you give us some examples of what the Quality Working Group has been working
on in the last 12 months?
I mean the quality working group in the last 12 months has really done quite a lot of work
in helping develop web based resources, in helping develop tools; working with Care Quality
Commission and helping them develop the hospital inspection regime.
So really done quite a lot of things over the past 12 months but, the really big and
most important thing that we have done is help to develop the 7 ambitions that will
form part of the strategy over the next 5 years.
So those 7 outcome ambitions and the Quality Working Group has been helping to set out
how Clinical Commissioning Groups can set those levels of ambitions and we have developed
a how too guide.
4 Clinical Commissioning Groups were used to develop that guide before the planning
guidance came out and that how too guide was published with the planning guidance in December
2013.
And now what we need to do is help CCGís use that guide to develop those levels of
ambition over and for the next 5 years.
And Paul, I think thatís absolutely right and I think I wouldnít underestimate just
how instrumental the Quality Working Group was in trying to firmly establish improvement
in outcomes at the heart of this yearís planning guidance, which will extend the next 5 years
and the work around identifying the areas that we should set ambitions against.
Yes and I think we can be really proud of the work we are doing.
So why is the Quality Working Group, why is that group so important to this?
I think the Quality Working Group firstly brings together a unique mix of people from
different levels of the Commissioning system, CCGís with those commissioning services at
area team level, alongside those in the National Support Centre of NHS England, who are responsible
for developing some of the supporting policy and infrastructure.
I think we have made a really great start and I think we have managed to get the focus
on outcomes and outcomes based commissioning firmly on the agenda of both CCGís and NHS
England, but I think there is much more still to do.
I think we need to help bring about a real shift in mind-set that is very different way
of thinking about delivering better services for patients, and I also think we have got
a big task going forward to really understand what some of the barriers are to really kind
of succeeding in becoming an outcomes based organisation, whether they are financial barriers
or otherwise.
So a lot of work still to do.
John, I agree with you, for me there is one important thing and if we are to do the best
for our patients then we need to ensure that quality is at the absolute heart of everything
that we do, and thatís where the Quality Working Group can play a very important role.