Clinical Governance[1]

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Clinical Governance[1]

  1. 1. Clinical Governance Progress in 2008/09 & Objectives for 2009/10
  2. 2. Systems for Clinical Governance <ul><li>Started local reporting – using feedback forms. Problems regarding quality and quantity of information. </li></ul><ul><li>Clearer emphasis on Clinical Governance in Tier 4, tighter risk management and better reporting. </li></ul><ul><li>Community services more disparate, less controllable risks but less emphasis on governance as a critical activity. </li></ul><ul><li>Culture and leadership in relation to governance needs to be addressed </li></ul><ul><li>Ongoing issue regarding meaningful communication of two information </li></ul>
  3. 3. Risk Management <ul><li>Improved use of the Risk Register – but some way off being a dynamic / helpful system (trust wide issue also) </li></ul><ul><li>Have gradually cleared some of the high risks but concern regarding the length of time and process not really effective </li></ul><ul><li>Taken a more pro-active approach to overseeing ongoing cross system risks but unclear who has responsibility for change. </li></ul>
  4. 4. Improving evidence based practise - progress and concerns in 09/10 <ul><li>Have made inroads in terms of baseline assessments – but problems regarding consistency </li></ul><ul><li>Some information regarding changes and improvements e.g. ADHD, parenting – but pockets of information </li></ul><ul><li>NICE guidelines now more strategic and have implications for delivery and service design – models of stepped care </li></ul><ul><li>Need to evidence better what we are doing – central for audit </li></ul>
  5. 5. Outcome Measurement - CORC <ul><li>Have begun routine collection of outcome data in community services – using SDQs. Some problems regarding consistency and coherence </li></ul><ul><li>Over 300 SDQs have been inputted into the database – concerns regarding who should be putting this in </li></ul><ul><li>Sending information to CORC for analysis </li></ul><ul><li>Not started time 2 recording – likely to be far more challenging </li></ul><ul><li>Cultural issue regarding how does outcome information influence clinical skills – concern regarding how embedded into practise </li></ul><ul><li>Long term applications not funded / resourced </li></ul>
  6. 6. Supervision <ul><li>Search of the literature </li></ul><ul><li>Completed a survey of supervision across CAMHS </li></ul><ul><li>Communications with safeguarding group regarding Baby P and impact on supervision </li></ul><ul><li>Pulling together of policy / guidance regarding supervision </li></ul><ul><li>Considering possibilities regarding training </li></ul>
  7. 7. Objectives for 09/10 <ul><li>Continue with process of improvement, risk management, reporting etc. </li></ul><ul><li>Learn from experience making relevant for staff. </li></ul><ul><li>Linking lesson lessons from IR1s, SUIs, & NICE etc, to service provision, re-design and future planning. </li></ul><ul><li>Establish activities that all staff need to be involved in to improve the services we provide, e.g. audit, supervision, reflections on changes to practise. </li></ul><ul><li>To have a more effective model of Clinical Governance across the whole of CAMHs. </li></ul><ul><li>Improve representation at CAMHS Clinical Governance Group. </li></ul>
  8. 8. Challenges for Clinical Governance <ul><li>How does Clinical Governance fit with Service Line Management, in terms of leadership, general management support structure and clinician contributions. </li></ul><ul><li>What is our model of Clinical Governance – how do service lines and professions fit. </li></ul><ul><li>What time should staff be giving to Clinical Governance and what should the balance of activities be and how should this time be organised. </li></ul><ul><li>How do we manage areas of difficulty which are not subject to IR1s – but need addressing </li></ul><ul><li>How do we prepare / adapt to known challenges e.g. increasing severity and complexity, changes in priority, increased scrutiny. </li></ul>
  9. 9. Risk Register <ul><li>BCH to introduce a new system – commissioned from private sector </li></ul><ul><li>Will introduce a more integrated information system covering complaints, IR1s, Risk Register </li></ul><ul><li>Potential for more dynamic process, better reporting and hopefully more useful </li></ul><ul><li>How do we better use such a system? </li></ul>

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