Annual report 2013 14

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This annual report sets out NHS Improving Quality's achievements in our first year. Five major improvement programmes have been designed and developed to enable and provoke large scale change across the NHS. Our work to increase improvement capability and capacity across NHS England and the wider health and care system is starting to take shape and over half of all Clinical Commissioning Groups are engaged in our CCG development programme.

The impact of NHS Change Day and the School for Health and Care Radicals in mobilising thousands to deliver positive change has been a major achievement and the completion of many programmes of work started by our predecessor organisations is providing real benefits to the frontline.

- See more at: http://www.nhsiq.nhs.uk/resource-search/publications/annual-report-201314.aspx#sthash.YGFIAS9G.dpuf

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Annual report 2013 14

  1. 1. ANNUAL REPORT 2013/14 Improving Quality NHS
  2. 2. FOREWORD ›› ABOUT US ›› PROGRAMME ACHIEVEMENTS ›› 3 HORIZONS NHS Improving Quality: ANNUAL REPORT 2013/14 CAPABILITY & CAPACITY LIVING LONGER LIVES LONG TERM CONDITIONS SEVEN DAY SERVICES & ACUTE CARE EXPERIENCE OF CARE PATIENT SAFETY NATIONAL PEER REVIEW PROGRAMME CORPORATE DEVELOPMENT, COMMUNICATIONS & CUSTOMER RELATIONS Improving Quality NHS NHS Improving Quality Integrated Care Pioneer Sites Seven Day Services - Early Adopter Sites Long Term Conditions Year of Care Commissioning Programme Clinical Commissioning Groups (CCGs) engaged with the Transforming Care Programme Stop the Pressure Events Transforming End of Life Care in Acute Hospitals Organisations where more than 300 pledges were made for NHS Change Day www.nhsiq.nhs.uk Places where more than 10 people took part in The School for Health and Care Radicals Places where NHS IQ ran a significant masterclass on transformational/large scale change Strategic Clinical Networks working with NHS IQ to implement the intermittent pneumatic compression (IPC) sleeves programme CCGs with over 30% of practices uploading GRASP-Suite data Spread of transformation
  3. 3. FOREWORD Richard Jeavons, Interim Managing Director Five major improvement programmes have been designed and developed to enable and provoke large scale change across the NHS. Our work to increase improvement capability and capacity across NHS England and the wider health and care system is starting to take shape and over half of all Clinical Commissioning Groups are engaged in our CCG development programme. The impact of NHS Change Day and the School for Health and Care Radicals in mobilising thousands to deliver positive change has been a major achievement and the completion of many programmes of work started by our predecessor organisations is providing real benefits to the frontline. These achievements have come against the backdrop of major internal change: managing the transfer of over 200 staff from predecessor organisations and subsequent transition into permanent roles for the vast majority; a portfolio review of all the work carried over from our predecessors; establishing a mechanism for strategic investment partnerships with delivery partners and working through with our hosts NHS England, the procurement, governance and financial processes needed to set up and establish a new national improvement organisation. 54 NHS Improving Quality: ANNUAL REPORT 2013/14 - FOREWORD In our first year, NHS Improving Quality has made significant progress against our objectives. This annual report sets out NHS Improving Quality’s achievements in our first year. These achievements are testimony to a dedicated and skilled workforce which most impressively has risen to the challenges and uncertainties thrown at them. I know everyone is gearing up to make 2014/15 a great year for NHS Improving Quality and invite you to discover more about our work to deliver better outcomes for patients and the public who use the health and care system by reading our business plan for 2014/15.
  4. 4. OUR PURPOSE AND STRATEGY 76 NHS Improving Quality: ANNUAL REPORT 2013/14 - ABOUT US The purpose of NHS IQ is to improve health outcomes for patients across the NHS in England by: • Developing and implementing improvement programmes to deliver the NHS Outcomes Framework • Building improvement capability and capacity throughout the NHS commissioning system • Supporting improvement across the wider NHS ABOUT USNHS Improving Quality (NHS IQ) was founded on 1 April 2013 through a collaboration agreement between the Department of Health and NHS England. This agreement recognised the need for a system wide focus for improvement to be provided by establishing an improvement body within NHS England.
  5. 5. 98 NHS Improving Quality: ANNUAL REPORT 2013/14 - ABOUT US • Source, deploy and manage a range of delivery partners from within the NHS and potentially social care organisations, voluntary sector, academic organisations and the independent sector. • Work with the emerging Strategic Clinical Networks (SCNs) and Academic Health Science Networks (AHSNs), at a national level, to build a framework for local improvement and innovation. • Act as a source of expertise, research, development and ideas for change and improvement in healthcare. • Link with the NHS Leadership Academy to build leadership capability for change. NHS IQ’s way of working is significantly different to its predecessors, reflecting both the post reform NHS structure and the need to enable and provoke large scale change across the NHS. NHS IQ is a relatively small organisation, compared to its predecessors, that is fully aligned to the NHS’s commissioning priorities, as expressed through the NHS Outcomes Framework, with in-house capability to: • Design and commission programmes of improvement and improvement capability linked to the five domain priorities. • Build knowledge and capacity for leading change and improvement across the NHS, particularly in NHS England teams and CCGs. THE DEVELOPMENT OF NHS IQ The 2013/14 business plan for NHS IQ focussed on ten improvement programmes across the five outcome framework domains, capability building for NHS England and a capability building programme for Clinical Commissioning Groups. From a starting point of over 500 NHS employees, just over 200 employees of five predecessor improvement bodies (NHS Institute for Innovation and Improvement, NHS Improvement, National Cancer Action Team, National End of Life Care Programme, NHS Diabetes and Kidney Care) transferred into NHS England as part of NHS IQ. At the same time, NHS IQ also took responsibility for hosting aspects of two Improving Access to Psychological Therapies (IAPT) programmes and NHS Interim Management and Support (NHS IMAS).
  6. 6. 1110 NHS Improving Quality: ANNUAL REPORT 2013/14 - ABOUT US team working on thought leadership and mobilisation for change. During the latter part of 2013/14 the National Peer Review Team (formerly part of the National Cancer Action Team) and Improving Access to Psychological Therapies teams were transferred to the medical directorate of NHS England. NHS IMAS remains hosted within NHS IQ and a separate annual report sets out its achievements. The delivery team were subject to a formal change management and consultation process which was completed on 31 March 2014 with the vast majority of delivery team staff securing roles elsewhere in the organisation. As part of this process a separate Connections team was also created, to come into existence on 1 April 2014. Using the allocated administration funds, three core functions – improvement programmes, improvement capability and corporate were established with a separate delivery team funded from programme funds. Recognising that this arrangement was a pragmatic staging post to the final intended form of NHS IQ, the life of the delivery team was guaranteed until 31 March 2014. During 2013 both the structure of NHS IQ and our work programmes were reviewed to ensure NHS IQ focused on leading and enabling large scale change to improve health outcomes. The ten improvement programmes were consolidated and a portfolio review identified how the continuing work from our predecessor bodies aligned to these programmes. The creation of a new Horizons programme within NHS IQ provided a dedicated So for the future, NHS IQ is organised around five interdependent functions: HORIZONS • Looking to the future and across the world to challenge current NHS thinking about large scale healthcare improvement and how it is achieved. CAPABILITY & CAPACITY • Building the knowledge and capacity to lead change and evidence based improvement across the NHS. IMPROVEMENT PROGRAMMES • Designing and commissioning programmes of improvement and capability linked to the five domain priorities. CONNECTIONS • Responding to unexpected developments and urgent requirements by connecting with the NHS and its resources. CORPORATE & DEVELOPMENT • Enabling NHS IQ to achieve its objectives effectively.
  7. 7. 12 PROGRAMME NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS ACHIEVEMENTSPROGRAMME ACHIEVEMENTS 2013/14 NHS IQ has made significant progress in the delivery of its programmes of work throughout 2013/14 and the following pages represent some of the key achievements and highlights during this period. 2013/14 13
  8. 8. 14 The Horizons programme was established in summer 2013. Our messages about ways in which to deliver and lead large scale change and transformation have reached every part of the country and every corner of the globe. Over the past year, we have focused our work on three key areas. HORIZONS ACHIEVEMENTS • During 2013/2014 more than 20,000 health and care leaders heard our messages in a face-to-face setting, about large scale change and transformation, nationally and internationally • Over 40 blogs and publications were completed during the year. These were shared extensively, receiving positive feedback. Our presentations and slide packs were downloaded nearly 30,000 times and shared nationally and internationally • Our twitter reach from members of our team and from the campaigns our team supported was over 250 million 15 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS NHS Change Day took place on the 3 March 2014. Change Day is a frontline led grassroots social movement; the largest of its kind, with a shared purpose of improving health and care. The mission is to inspire and mobilise people everywhere, staff, patients and the public to do something better together to improve the quality of care. This year, NHS Change Day had an unprecedented impact, using a Pledge, Share, Do, Inspire approach. The purpose of Change Day aims to connect with people to think about new ways of making change and innovation and accelerating the spread and adoption of ideas to improve care locally through a call to action. By the end of the campaign we celebrated over 730,000 pledges from staff, patients and leaders everywhere. One quote from a frontline member of staff stated: ‘I read about Change Day last year, and was impressed with the numbers of people who stepped up their commitment to patient care, to the NHS and to their colleagues.’ Change Day was the catalyst for a pretty extraordinary experience for me and the team as our pledge to spread compassion circles put this powerful practice well and truly on the map.” “We fully support the NHS Change Day idea because it enables people to make a very personal promise to improve the way they work.” “ MOBILISING FOR IMPROVEMENT - NHS CHANGE DAY THOUGHT LEADERSHIP, ACTING AS AN AMBASSADOR FOR NHS IQ EXTERNALLY AND SUPPORTING OTHERTEAMSWITHIN NHS IQ Horizons has provided ideas and advice to people who are leading large scale change to stimulate new and ‘disruptive’ approaches in support of healthcare transformation and enable them to achieve their improvement goals.
  9. 9. 16 NHS CHANGE DAY ACHIEVEMENTS • More than 730,000 pledges have been made by individuals and organisations to improve health and care with the top themes being; improving patient experience and patient safety • 82 campaigns launched with the reach of 399,987 pledges of support for their cause in reaching out to others to join them in making a difference • On Change Day itself – 3rd March 2014, there were over 12,000 visits to the Change Day website www.changeday.nhs.uk • Over 86 million Twitter impressions. On the day itself Change Day was trending above high profile media stories • Over 300 pieces of regional media about Change Day covered a population of over 16 million people in England. • Over 22,000 video views on the Change Day YouTube account. • 300 organisations and charities were contacted across health and social care to support campaigns, build relationships and make connections for future work. • Our radio, online and TV coverage had a combined reach of over 37 million people. • An engaging and creative stand at NHS Expo, with a theme of ‘Change Day Street’ which attracted a high number of clinicians, students and emerging leaders culminating in a Change Day celebration, and over 800 individual pledges. Over 200 frontline staff attended and engaged with Change Day at the NHS Expo. 17 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS The school brings together the exciting work of NHS Change Day, Horizon’s and Capability and Capacity programmes. The overarching aim of the school is to equip people across the health and care system with the core skills to become change agents. The school worked to ignite people’s passion in improving services and be an arm of the grassroots change movement through Change Day by providing people with new ways of thinking about improvement. The School demonstrated a new way to provide learning to a huge number of people in a low cost, high leverage way. Thank you for the opportunity to benefit from such an inspirational programme and to engage with so many peers who are clearly motivated to make change and improve care.” “ Clinical Director, The Mary Stevens Hospice I feel energised and enthused for taking my new knowledge forward.Thank you for establishing the School.” “ Head of Medicines Management, Leeds Community Healthcare NHS Trust THE SCHOOL FOR HEALTH AND CARE RADICALS
  10. 10. SCHOOL FOR HEALTH & CARE RADICALS ACHIEVEMENTS • Almost 1,500 people enrolled from 40 countries from Europe to Australasia • Five weekly learning modules were held live between January and March and available 24/7 from ‘change starting with me’ to ‘making change happen’ • A weekly tweet chat using #SHCRchat to discuss and collaborate upon the learning’s from each module and share personal stories and impact • An average weekly twitter reach of 2.6 million on a national and international scale • The opportunity to become a mentor or mentee, with over 90 volunteer mentors signing up, connecting people and building relationships • Over 25,000 shares of the slides and materials on Slide Share, with great feedback about the content • More than 5,000 tweets using #SCHRchat • A weekly Storify capturing the week’s content was created; with more than 1,000 viewings • The use of Pinterest has helped to establish the school’s brand, increase our audience and drive traffic to our website. The board now has 76 followers • At the time of going to press, more than 70 people have followed the learning process through to become “certificated change agents” with a virtual badge. This number will grow significantly 18 19 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS The capability and capacity programme exists to develop the science, knowledge and skills infrastructure that the NHS needs to deliver improvement and transformational change. During this start-up year, work has focused on building infrastructure, relationships and support for new parts of the system such as Commissioning Support Units (CSUs), Academic Health Science Networks (AHSNs) and NHS England. Our role also involves commissioning research and impact evaluation to underpin the improvement programmes. CAPABILITY & CAPACITY • Developing a measurement master class to a brief from Professor Sir Bruce Keogh that was piloted with NHS England National Clinical Directors and their nursing equivalents. A combination of two face-to-face events and three webinars on using measurement for improvement were delivered by UK and international experts and attended by more than 150 delegates. • Linked to this, in collaboration with NHS England and the Healthcare Quality Improvement Partnership, NHS IQ led the design and delivery of an event to prepare the NHS for the publication of consultant-level outcomes data, and share the vision for making this an opportunity to improve patient outcomes. The event was attended by more than 150 members of the clinical leadership community. GROWING SCIENCE ACHIEVEMENTS GROWING SCIENCE THE SCHOOL FOR HEALTH&CARE RADICALS 1,470 enrollees MORE THAN 40ACROSS COUNTRIES PROMOTEDTHROUGH AVERAGEWEEKLY SOCIAL MEDIA TWITTER REACH 2.6MILLION 10,000+views of the slides on SlideShare 90VOLUNTEER MENTORS 1,800+views of the study guides on SlideShare 5,000+ 1,000 TWEETS USING #SHCRchat TIMES STORIFYhas been viewed nearly 60 OVER PEOPLE HAVE BECOME CERTIFIED CHANGE AGENTS AS PART OF THE SCHOOL ANDTHIS NUMBER IS EXPECTEDTO INCREASE Improving Quality NHSTo find out more about NHS Improving Quality: www.nhsiq.nhs.uk @NHSIQ enquiries@nhsiq.nhs.uk HHTTHTT OOHE SSCHHOHHCCSSEEHH OOOOOL FOFFLLOOOO RRORROO RRRR EEE RRR HHEHHH CCCC HHH AAAADDDICIIII H DDDD H AAAA LT RRRR EAALTTTLLLLTLTLTAAAEEE LLLL RRR CCAAAALLAAAA AR CCCC &CCA&& AAACCC&&& SSSS EEE SS REERRR 1 MOREMORE RRRR MMO 1 CAAAADDDICIDAR RE 4 TTHTH 477 RERE 44 LCCAAAALLAC SSS C enrenr ,1,11 AACA nen 11, ROO 4747,47, olleolle CRO rol 447 rr lll 4 PRO OOO CC C A OCCC CAAA OPR TH OUNTROUNTROUNTROUUN RRTTN CROCROROO HTDEMMOTTEDOMO HROUGH RIESRIESRIES H SSEEI GUOR WEEWEGAREVA GEAVERAAVER 222 CH YKE H YEKLLY 6666 000 SOSOSO PRO 1 SOO PRO 100111 000 OCIAL MOCIAL MOCIAL M TH CCIAL MM MMOTEDTHTED 00 OMO 000,00000000,0000, ,888 MEDIAMEDIAMEDIA HROUGH EEDDIAA , ROUGH 1+++ 11110+0+0 ++0 TTTTTWWWITTTWITWITWIT WE TTT ERAGEAV 0+0008808 00000888 ++ 5 MIL 22ER C M R 22 EAC 55 REA ERERER EK Y ++ 55 000 LION .66ON 0000 .666 00000000 ++00++00 lilili views of the slides on 1 999 SliSSS ewv 100 hahah s of the slides on , 000 S VOLU a slides on haddeeideSideSid S des of he ,0000000, lll views of the study guides on , NTEER 1 S w SSSee s on 1,, reearar +++ hahah s of the study guides on iddeeS d haideSideSid S u h s o t s u Sddi 88800000+ S ee ides on 5 aree RI ##Sarar onn #S#S de ++ ORT 55 FYY chch S US 0 HCCRRchSHCRSHCR S U 1 TWEETEET 00 ,0 00 WE 0 1 T 00W 00,T 0,0 tt SING + athaha GS N 000 ++00 OVER 9999999 OVE 666 R EE90 U 000 0 MMEEMM LU 9090VOVOL 90 R 0006 UNTEER NNT E ORSOOTT R NN E EE NT RSRS a Sh SSS yd l ORIFYORIFYORIFYeen viewn viewew d e rbeen view IFYYTORRSTSTST ,TIME 00011,T MM 00,000EES 111T MM ,000 000000000 o find out mor 66666666o find out morTo e about NHS Impr THE60PEOPPEOP 6060000about NHS Impr T60P OP 6060ou m tbd out mor ving Q T OO CHOOL ANDSCHOOL AND LE HAV B CVE BECPLE HAV SN m nvr goNHS Impr : MBER IS EXPEC TIFIED CHANGE AOME CER TH S MM RTHIS NU RT F EOME CEOME CER yaQ yualitQ TED G S EX CT G R IS EXPEC E AAD CHANGE ACHANGD CHANGE A O INCREASE T O INCREASENCR A ET TS AS PS PARARS AS PPARENT HNNH T OFT OFO SHHS @NN ww @ wwww NHSIQNHSIQ e N S Q n s uk eukn s q nhsnhsiq nn u r es@n s qenquiries@nhsiq g uknh uknhs yQ Improving QualityI rImmprovving Qualityin Qualitying QualityQualityua HNNH litylitl ty SHHS The use of research, measurement and evaluation are fundamental to the way NHS IQ works, underpinning its ability to understand and demonstrate the benefit of its work.
  11. 11. 20 21 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS Equipping clinicians, educators, researchers and commissioners with the tools, knowledge and skills they need to identify and deliver improvement is our third major priority. • Launch of NHS England PDF learning tool on the NHS Change Model. • Established a partnership between Jönköping County Council, Qulturum, University of Jönköping, Jönköping Academy for Health and Welfare Improvement (Sweden), and NHS IQ to share and build global improvement capability. • To support transformational change in leaders across the NHS we co-designed and led a study tour to Jönköping for AHSN and CCG leaders and NHS England commissioning development team. Funding was made available for five attendees from CCGs and AHSNs, with organisations funding additional places. Six organisations joined the tour. As a result NHS England are looking to engage in a strategic partnership with Jönköping, the AHSNs are sharing their learning across all AHSNs and the CCGs are embedding their new knowledge in their work and plan to return next year. • Established strategic partnerships with the Health Foundation, to develop sustainable networks that will deliver improvement and transformational change. • Designing and delivering a comprehensive range of programmes for commissioners, CSUs and providers including Leading Transformational Change, Quality and Service Improvement • Contributed to the design of the framework for Commissioning Support Services • Supporting nine of the 14 Keogh trusts with a diagnostic, and in three, bespoke support ACHIEVEMENTSGROWING SKILLS Leading several projects to help improve the way the NHS uses, manages and shares improvement knowledge and expertise. • Developing a Knowledge Hub (Khub) – a modern, informative website is essential for sharing knowledge efficiently. Initial scoping work for Khub is complete with the specification, procurement and implementation phases to follow in 2014/15. • In partnership with NHS England, developing a series of NHS IQ improvement digests to support Clinical Commissioning Groups in commissioning high quality care in line with national priorities. • Better Care, Better Values monthly publication for commissioners. ACHIEVEMENTS GROWING KNOWLEDGE Matthew Bazeley, deputy managing director at NHS Central London CCG described the impact of support as facilitating an “acceleration of our change effort”. He added “the offer and support were invaluable” and “it has felt like you’re part of our project team”.
  12. 12. 22 23 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS Drawing on the experience and credibility of NHS IQ’s delivery team in supporting CCGs, a new practical support offer was launched in April 2013 to provide CCG leaders and their local system partners with the tools and approaches for addressing large scale challenges. The support offer features a core programme of up to seven one-day tailored and practical workshops, with facilitated action learning and coaching, to CCG-led local alliances of system partners. The programme focusses on locally determined change priorities and has been made available to all CCGs across England. • By the end of March 2014 over half of CCGs were underway or have made a firm commitment to take-up this support. • A purpose built web-based learning management system has been launched to support participants, featuring programme resources and e-learning materials. Through evaluation, CCGs have told us that they value: • Our clinically-led approach • Our use of evidence-based models and approaches relevant to the NHS • The quality of facilitators drawn from our core team and faculty of clinicians, commissioners and improvement experts • The focus on supporting the whole system in realisation of benefits for patients. ACHIEVEMENTSCCG TRANSFORMING CARE PROGRAMME: BUILDING CCG CAPABILITYTO LEAD TRANSFORMATIONAL CHANGE OF THE CARE DELIVERY SYSTEM This programme exists to reduce the number of people who die too soon from illnesses that could have been prevented or treated. ACHIEVEMENTS The team has worked in collaboration with NHS England and other partners to identify a focus on people with serious mental illness. Estimates suggest that there would be up to 12,000 fewer deaths from CVD each year if people with serious mental illness had the same outcomes as the general population. At the beginning of 2014, NHS England, with support from NHS IQ, has developed a national CQUIN to support the identification of physical illness in people with serious mental illness. LIVING LONGER LIVES CARDIOVASCULAR DISEASE (CVD) OUTCOMES STRATEGY NHS HEALTH CHECK PROGRAMME ACHIEVEMENTS NHS IQ’s work has focused on the following areas supported by the following outcomes: • NHS IQ has produced material to support the spread of innovative better practice around the promotion and uptake of NHS Health Checks and the transfer to intervention for those having passed through the NHS Health Check programme. The work was specifically focused on the seldom seen and seldom heard groups. Outcome: Six case studies have been produced to date and placed on the national NHS Health Checks website.
  13. 13. ACHIEVEMENTS GRASP-AF - (Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation) is a simple but effective audit tool to help GPs improve the management of stroke risk in Atrial Fibrillation (AF). The GRASP-AF tool is now being actively used by 2,591 practices in 157 CCGs across the country - an 8% increase from April 2013 to 2014. In the last three years the number of GP practices using the toolkit has risen from around 300 to over 2,600. Nearly 330,000 patients with AF are now managed by practices using the GRASP-AF toolkit. In the practices using GRASP, the use of oral anticoagulation in those at high risk of stroke has risen by an average of 4.6%, which is estimated to have prevented around 360 strokes per year and saved over £4.2 million per year in acute stroke care. An economic analysis of cost-effectiveness of the management of AF in primary prevention of stroke commissioned by NHS IQ in 2013-14 suggests that the annual net saving to the NHS in England from averted strokes in AF associated with current prescribing patterns is estimated at £148 million. If anticoagulants were prescribed for people with AF in accordance with European Society of Cardiology guidelines we estimate that there would be a further net saving to the NHS of £71 million a year. The economic analysis is due to be published in 2014. IMPROVE CLINICAL ENGAGEMENT IN THE BIG KILLERS 24 25 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS ACHIEVEMENTS • NHS IQ have produced material addressing issues around the delivery of NHS Health Checks to people in prison. Outcome: NHS IQ have produced four case studies on prisons and a final prison report which are available on the NHS Health Checks website. • NHS IQ have worked with the national NHS Health Check programme to support the Share, Listen, Act conference in February 2014. Outcome: The conference had 431 delegated attend including stakeholders from Local Authorities, private sector, third sector and other public sector bodies. 96% of attendees rated the conference as excellent. NHS IQ ran two workshops which were rated good/excellent by 86% and 91% of attendees respectively Thank you for producing this hugely informative report and case studies.This is incredibly useful and NHS IQ and contributors are offered our thanks and congratulations for your support on a highly important subject.” “ Jamie Waterall, NHS Health Check National Lead, Public Health England
  14. 14. ACHIEVEMENTS Improve public awareness and early diagnosis - Through 2013/14 the NHS IQ Living Longer Lives team has been supporting the award winning ‘Be Clear on Cancer’ programme working closely with partners in the Department of Health, Public Health England, Cancer Research UK and NHS England. We have seen increased public awareness of cough/hoarseness as a symptom of lung cancer from 41% to 50%, plus an increase of 30% in the number of urgent referrals for suspected lung cancer. I am delighted that results suggest that hundreds of patients received potentially life-saving surgery following the first national campaign for lung cancer. Be Clear on Cancer, alongside continued work to improve access to diagnostics and treatments, is helping to move things in the right direction for lung cancer.” “ Sean Duffy, National Clinical Director for Cancer at NHS England 26 27 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS ACHIEVEMENTS IPC sleeves - The Living Longer Lives team at NHS IQ has secured £1million to ‘pump-prime’ the widespread adoption of intermittent pneumatic compression (IPC) sleeves by all stroke units in England as part of a major national programme to improve outcomes for stroke patients. Stroke patients have a high risk of developing Deep Vein Thrombosis (DVT), but the recent ‘CLOTS 3’ study showed that the use of IPC sleeves led to around a 30% relative reduction in DVT and an improvement in overall survival to six months. NHS IQ’s programme, which is being championed by the National Clinical Director for Stroke at NHS England, will contribute towards meeting the Government's ambition to prevent avoidable mortality by saving an estimated 800-1000 lives per annum.
  15. 15. NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS 28 NHS Improving Quality’s ‘Long Term Conditions and Integrated Care’ improvement programme has developed learning and resources for improvement and change, to ensure consistent high quality care throughout the individual’s journey, regardless of condition. ACHIEVEMENTS • Sites across the country were invited to bid to become 'pioneers' of integrated care and support, working to transform the way health and care is being delivered to patients. Norman Lamb, Minister of State for Health and Care, announced the 14 successful pioneer areas on 1 November 2013, and attended the programme’s formal launch, organised by NHS Improving Quality, on 3 December. • Since then, the pioneers have been working to transform the way health and care is being delivered to patients. They are showcasing innovative ways of creating and spreading change across health and social care, drawing on expertise from a range of national partners and other organisations, including NHS Improving Quality’s Integrated Care and Support programme team. 29 INTEGRATED CARE AND SUPPORT PIONEERS LONG TERM CONDITIONS & INTEGRATED CARE ACHIEVEMENTS • NHS Improving Quality has joined forces with a number of national partners from across health and local government to launch the National Collaboration for Integrated Care and Support. The Collaboration aims to make health and social care services work together to provide better, more person- centred support at home and earlier treatment in the community to prevent people losing their independence or needing unplanned hospital care. ELECTRONIC PALLIATIVE CARE COORDINATION SYSTEMS (EPaCCS) ACHIEVEMENTS • Providing a shared locality record for health and care staff, EPaCCS allow rapid access across care boundaries to key information about a person approaching their end of life, including their expressed preferences for future care. From a starting point of 15% in 2012, now over 30% of CCGs have a ‘live’ EPaCCS. If current predictions are realised we will deliver the ambition of 70% rollout across England for EPaCCS by 2015.
  16. 16. NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS 30 ACHIEVEMENTS The Long Term Conditions Year of Care (LTC YoC) commissioning model programme has the potential to change the payment system for up to 20-25% of the total health and social care budget in England and better incentivise providers to improve the efficiency and effectiveness of services for patients. • Improved relationships in local areas to support this way of working • Supporting Early Implementer teams to plan the link between current integrated care services and new funding systems, to enable shadow testing in 2014/15 • Recovery, rehabilitation and reablement (RRR) clinical audit and step- by-step guide to provide the evidence to support changes in early discharge from acute care • Whole population analysis and mapping of activity and financial information flows to support development of a draft national LTC YoC commissioning framework • Initial estimates completed for the local tariff that a health economy might assign to a Year of Care currency 31 LONG TERM CONDITIONSYEAR OF CARE COMMISSIONING PROGRAMME TRANSFORMING END OF LIFE CARE IN ACUTE HOSPITALS ACHIEVEMENTS • We have provided a number of networking events across the country, as well as a supported partnership end of life care education and training programme ‘Train the Trainers’. Over 40 new sites having come on board since 2013. MENTAL HEALTH AND DEMENTIA ACHIEVEMENTS • We have provided support to investigate dementia diagnosis and post diagnostic support services, and to identify if there are any common factors influencing diagnosis rates.
  17. 17. 32 33 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS NHS IQ received 70 expressions of interest from across England and selected 13 sites. Following site visits by an NHS IQ multidisciplinary team with members of the Forum of NHS England, local programmes have now been launched. Average GI bleeding mortality rate is reduced by 10% by having access to 24/7 endoscopy, interventional radiology and surgery working together as a multidisciplinary team.” “ SEVEN DAY EARLY ADOPTER COMMUNITIES SEVEN DAY SERVICES TRANSFORMATIONAL IMPROVEMENT PROGRAMME (SDSIP) Sir Bruce Keogh officially launched the SDSIP on Saturday 16 November 2013 in Birmingham. The event which was supported by NHS IQ, was well received with over 350 delegates attending from across the health and care economy. SEVEN DAY SERVICES & ACUTE CARE SEVEN DAY DIAGNOSTIC SERVICES Endoscopy services NHS IQ in conjunction with the British Society for Gastroenterology (BSG) have developed ‘The Productive Endoscopy Unit Toolkit’, a resource that will support all endoscopy services to work towards a seven day service, increase productivity, improve safety and support earlier diagnosis. Healthcare science services NHS IQ conducted an online survey of 365 healthcare scientists across England in 2013. Key findings included: • Majority of staff believe they should offer services seven days a week • Less than 50% of departments consult with service users regarding the need for services seven day a week • 50% of services had expanded services across seven days, using predominantly on-call systems for specific diagnostic tests rather than whole department service provision Erika Denton, National Clinical Director for Diagnostics DISSEMINATION OF LEARNING AND SHARING GOOD PRACTICE ACHIEVEMENTS • Following the launch of the programme (December – March) the NHS IQ dedicated seven day services website has had over 6,198 views and the Acute Care pages where models such as ‘Enhanced Recovery Seven Days a Week’ are sited received 4,237 views during this time period. The enhanced recovery work has been endorsed by Royal Colleges and can be found at: www.nhsiq.uk/enhancedrecovery. • An active Twitter feed (#7Dayservices) has had a reach of over 70,000. Social media ‘Storify’s’ have also been produced. Healthcare science services NHS IQ conducted an online survey of 365 healthcare scientists across England in 2013.
  18. 18. 34 35 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS ACHIEVEMENTS • Since November 2013 over 800 copies of NHS IQ NHS services – open seven days a week: every day counts publication has been disseminated across the country. It is one of NHS IQ’s most in demand publications and is on its third re-print. It is available on the seven day services website pages where the publication has received over 6,447 views. www.nhsiq.nhs.uk ACUTE CARE The CYP transition to adult services work stream is one of the six national priorities for the National Clinical Director (NCD) CYP and Transition and is, therefore, endorsed and part of the overall strategy for NHS England. CHILDREN &YOUNG PEOPLE (CYP) &TRANSITIONTO ADULT SERVICES NHS Improving Quality has been supporting NHS England in developing this work programme through bespoke task and finish scoping work. REHABILITATION ACHIEVEMENTS • Critical elements of an effective transition model have been defined • An expert clinical group has been established. A review of a service specification has been undertaken and 90% completed to ensure the needs of this group are identified. The work of the Experience of Care (EoC) team during 2013-14 has been behind the scenes, supportive of other programmes, operational in nature and about design and development. During 2014-15 the dedicated and transformational work programmes of the team will be brought to life. Bespoke pieces of work that were led by the team include: • Loss in pregnancy report - The EoC team led a project to extensively research and review the known good practice and shortcomings in service provision. • Commitment for Carers - As part of the refresh of the National Carers strategy, the EoC team co-ordinated, organised and managed a four-week long national participation exercise that attracted in excess of 300 responses to inform a suite of commitments and a national report. EXPERIENCE OF CARE • Supporting strategic clinical networks (SCN) - The EoC team provided leadership and co-ordination for a number of engagement activities with the SCN staff, National Clinical Directors, charitable and voluntary organisations and patient and carer leaders to support a coordinated approach to addressing national priorities during the transition year 2013-14 • Enhanced recovery - The EoC team conducted a number of interviews to gather patient stories to strengthen the patient voice and promote the Enhanced Recovery programme and to bring to life the Enhanced Recovery publication.
  19. 19. Driven by NHS reforms, the NHS Outcomes Framework and grounded in recommendations from Professor Don Berwick (Berwick Report, August 2013), the NHS Improving Quality Patient Safety Team have been engaged in extensive ‘listening and learning’ activities with people across the health and care system on what matters to them on improving patient safety in England. The aim is to deliver a large scale improvement programme to create one of the safest healthcare systems in the world. DELIVERINGTHE PATIENT SAFETY IMPROVEMENT PROGRAMME PATIENT SAFETY ACHIEVEMENTS • NHS IQ has been working with NHS England and other partners to create a national network of patient safety collaboratives, where the creation of local learning systems focuses on the continual improvement and delivery of safer care, based on local priorities. Following approval at the NHS IQ Programme Board in October the Patient Safety Collaborative proposal has been approved by the NHS England Board on 24 January. A design event has taken place with key stakeholders to inform the programme design. ACHIEVEMENTS • The NHS IQ patient safety team have continued to work with the Virtual College to offer a suite of five e-learning modules, to support healthcare professionals in ensuring diabetes is treated safely. During 2013/14, NHS IQ has continued to support the development of new modules and to work with Virtual College and NHS England to promote the modules across the NHS. Over 200,000 health professionals have registered to complete one or more modules. • NHS IQ, in partnership with the University of Lincoln and NHS England (Midlands and East) have delivered a student nurse conference on preventing pressure ulcers with an associated social media reach of 320,000. 36 37 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS
  20. 20. CASE STUDY 38 39 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS The partnership ran an innovative whole university student nurse conference on preventing pressure ulcers. Aimed at eliminating unnecessary suffering and reducing significant costs to the healthcare system, this idea started with a single tweet between a first year student nurse and a Chief Nurse (Midlands & East). Held in October 2013, the conference aimed to educate, motivate and inspire the new generation of nurses in acting to prevent avoidable pressure ulcers. Adopting social and other media, active publicity and a planned communication strategy we succeeded in spreading the learning widely. • #stopthepressurelincoln reached approximately 320,000 individuals on Twitter, secured around 2 million timeline deliveries • A grass roots movement developed as a result encouraging other similar events across England. These were linked to Stop the Pressure www.stopthepressure.com national campaign (originating in Midlands & East), and NHS Change Day 2014 www.changeday.nhs.uk A PARTNERSHIP BETWEEN THE NHS IQ PATIENT SAFETY TEAM, UNIVERSITY OF LINCOLN AND NHS ENGLAND (MIDLANDS AND EAST) Awards • Stop the pressure-Lincoln - shortlisted for the Student Nursing Times ‘Partnership of the Year award’ – award on 1st May 2014 • Abstract accepted and poster being presented at the Quality & Safety Forum in Paris in May 2014
  21. 21. 40 41 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS During 2013/14 the Peer Review Programme was hosted by NHS IQ prior to a transfer to the NHS England Medical Directorate on 1 March 2014 under the leadership of the Clinical Director for Specialised Services, James Palmer. While the programme has continued to focus on the quality assurance of cancer, the programme also took on reviewing paediatric diabetes services and major trauma centres. During 2013/14 the programme has continued to deliver this important work, which was cited in both the Frances and Keogh overview reports. NATIONAL PEER REVIEW PROGRAMME This is due in no small part to the commitment and support of front line clinicians (1,305 reviewers) and Patients and Carers (373 Reviewers) giving their time to the programme. It has been agreed that the programme will be an accredited accreditor for the Care Quality Commission (CQC). Information from the Peer Review programme is already shared with CQC and used as part of CQC intelligence and on their inspection visits. Programme Cancer Paediatric Diabetes Major Trauma Review cycle dates April 2013 - March 2014 October 2013 - September 2014 November 2013 - April 2014 Cycle type Targeted visit programme Comprehensive visits to all services Comprehensive visits to all services No. planned visits to clinical services 293 131 26 Visits completed to clinical services 291 60 22
  22. 22. 42 43 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS CORPORATE DEVELOPMENT, COMMUNICATIONS & CUSTOMER RELATIONS CORPORATE ACHIEVEMENTS • Implementation of an estates strategy has realised savings of over £1million. Cost of the overall estate (including sites inherited from predecessor organisations) have been reduced from £1.67 million (2013/14 costs) to approximately £600k (2014/15 costs). • Managed the HR transition process into the new NHS IQ structures. The programme was managed in accordance with NHS England Organisational Change Policy, to deadline and minimising redundancies. • Produced a detailed proposal to accelerate progress towards setting up strategic investment partnerships with AHSNs and we are continuing to work with NHS England and the NHS Business Services Authority to identify the fastest and most effective solution to meet the needs of the NHS improvement agenda. • Worked with NHS England governance leads for finance and procurement, legal and governance issues, intellectual property and HR in order to develop further the NHS IQ governance arrangements as the commissioner of improvement activity within the NHS England hosting context. • Work has been completed on the review of the commercial activity portfolio that was inherited from the NHS IQ predecessors. ACHIEVEMENTS • A comprehensive return on investment system (Commissioning and Delivery System) has been implemented which incorporates PMO and reporting functionality in order to automate programme highlight reporting. • A review of inherited legacy body intellectual property has been completed and action taken to register previously unregistered IP. CUSTOMER RELATIONS ACHIEVEMENTS • Since April 2013, NHS IQ has presented at and/or had a stand presence at around 100 health or social care events. • The customer relations team have received and dealt with nearly 3,000 enquiries via our website, enquiries email address and phone line. • To help NHS IQ identify future programmes and models of work we have carried out a stakeholder survey in September (sent to 900 recipients) to help identify what had worked previously with the former national improvement organisations, what should continue and what can be improved upon. Of those who responded over 79.6% had heard of NHS IQ.
  23. 23. 44 45 NHS Improving Quality: ANNUAL REPORT 2013/14 - PROGRAMME ACHIEVEMENTS Statement Access to best national and international practice in leading improvement Access to practical tools and resources to help you deliver improvement in your organisation Building change and improvement expertise for the NHS workforce Leading large scale change Working as an implementation site with an expert service improvement team e.g. seven day services pilot site or integrated care pioneer site Question: To what extent would you be interested in NHS IQ supporting and/or developing the following areas of work with you? % interested or very interested 93.1% 88.3% 78.6% 67% 56.3% COMMUNICATIONS ACHIEVEMENTS • A digital programme was implemented to consolidate 62 legacy websites and tools and streamline NHS IQ’s digital approach. The programme is expected to realise savings of over £1 million. • Web statistics for 2013/14 have increased significantly over the year (from 13,000 in July 2013 to 72,000 in March 2014). In addition, presence on social media has continued to increase month on month. As at 31 March 2014, NHS Improving Quality had nearly 9,000 followers on Twitter, with a Twitter Klout Score1 consistently above 50, and more than 1,000 followers on LinkedIn. • An internal communications plan has been developed and is now being implemented. 1 A Klout Score is a number between 1-100 that represents our online social influence 100,000 90,000 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0 JUL 13 AUG13 SEP13 OCT13 NOV13 DEC13 JAN14 FEB14MAR 14 Unique website page views Unique website visitors Views of SlideShare content NHS IQ MONTHLY WEB STATISTICS 2013/14
  24. 24. 46 ACHIEVEMENTS • The communications team has responded to 30 Freedom of Information requests. • An external monthly e-newsletter has been developed and is distributed to our partner organisations and stakeholder groups. The newsletter was forwarded over 800 times. • New publications and information leaflets continue to be developed to support key programmes of work. For example, so far we have supported: seven day services, end of life care, diagnostics, enhanced recovery, experience of care and productive endoscopy. • There is continued communications support provided to programmes, most recently focusing on NHS Change Day, seven day services, integrated care, safety and improving capability. • Growing the profile of service improvement and transformation through a series of national events, national key note speaker and conference chairing opportunities, publications and reports.
  25. 25. @NHSIQ www.nhsiq.nhs.uk To find out more about NHS Improving Quality: enquiries@nhsiq.nhs.uk Improving Quality NHS Published by: NHS Improving Quality Publication date: April 2014 - Review date: April 2015 © NHS Improving Quality (2014). All rights reserved. Please note that this product or material must not be used for the purposes of financial or commercial gain, including, without limitation, sale of the products or materials to any person.

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