Improving the experience of care for people using adult health services: Developing the NICE Guidance and         Quality ...
Overview• Background of the National Clinical  Guideline Centre (NCGC)• How the Patient experience in adult  NHS services ...
National Clinical Guideline Centre(NCGC)• Formed in April 2009 - merger of 4 national  collaborating centres; Royal Colleg...
NCGC current work programme  Clinical                  Primary               International Guidelines                 rese...
Patient Experience guidance and  quality standard• Commissioned by NICE in 2010 to develop  guidance, recommendations and ...
What are NICE guidance andquality standards• Guidance underpin recommendations for the  care of individuals within the NHS...
Collaborative development ofGuidance and Quality Standard• Underpinned by an agreed scope• Driven by a multidisciplinary g...
Technical TeamIs comprised of:             Their function:   GDG Chair                 Undertook evidence   Information...
Role of the GDG• Attended 7 all day development meetings• Contributed constructively, acknowledging the  equal standing of...
Guidance Development - Sources of evidence• Review of existing patient experience frameworks• Patient Experience Scoping S...
GDG evidence interpretationA powerful combination of :• Patients (40% of the group)• Clinicians• General Practitioner• Spe...
Identified themesThe following key themes were identifiedwhich underpinned 67 recommendations;1.Knowing the patient as an ...
1. Knowing the patient as an individual• Patients appreciate being recognised and  treated as individuals by health care  ...
2. Essential requirements of care• Recognition of all aspects of patient needs: respect,  patient concern, nutrition, pain...
3. Tailoring health care services foreach patient• The importance of:   – an individualised approach to services taking in...
4. Continuity of care andrelationships• Highlighting the need for appropriate  communication enabling continuity of care b...
5. Enabling patients to actively participate in their care• The understanding that patients need and appreciate clear  and...
Quality standardWhat is a quality standard?A quality standard defines best practicethrough 14 specific, concise qualitysta...
Examples of quality statements• Patients are treated with dignity, kindness,  compassion, courtesy, respect,  understandin...
To conclude:• Guidance and quality standard are the evidence  and expert consensus base to create sustainable  change.• Pr...
NCGC international involvement• Oman Evidence translation and  Utilisation Programme• Collaboration with the Belgium Healt...
NCGC website: www.ncgc.ac.ukNICE website: www.nice.org.uk                         NCGC
Thank you for listening!         Thank you to the GDGFor more information please contact me:                Liz Avital    ...
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Improving the experience of care for people using adult health services: Developing the NICE Guidance and Quality Standard.

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Improving the experience of care for people using adult health services: Developing the NICE Guidance and Quality Standard.

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  • The NCGC is a governance collaboration, funded by NICE and hosted by the RCP
  • (excluding adult mental health services)
  • Health professionals from wide range; GP, older age health, allied health, academic Number of patients is specific to this guideline – normally have 2
  • 3 areas of qualitative data; cancer, CVD and diabetes
  • Developed from recommendations
  • This guidance provides the evidence and expert consensus base to create sustainable change. in changing health care professionals’ behaviours and directing commissioning to meet this challenge, resulting in the cultural shift required to produce care that is effective, acceptable and appropriate for patients.
  • Improving the experience of care for people using adult health services: Developing the NICE Guidance and Quality Standard.

    1. 1. Improving the experience of care for people using adult health services: Developing the NICE Guidance and Quality Standard. Liz Avital Associate Director NCGC NCGC National Clinical Guideline Centre
    2. 2. Overview• Background of the National Clinical Guideline Centre (NCGC)• How the Patient experience in adult NHS services (CG138) guidance was developed.• Main themes and examples of recommendations and quality statements NCGC
    3. 3. National Clinical Guideline Centre(NCGC)• Formed in April 2009 - merger of 4 national collaborating centres; Royal Colleges of Physicians, Nursing, General Practitioners and Surgeons• NCGC develops clinical guidelines on behalf of the National Institute for Health and Clinical Excellence (NICE)• One of the largest centres in the world developing clinical and cost effective evidence focused on improving patient experience and outcomes NCGC
    4. 4. NCGC current work programme Clinical Primary International Guidelines research work Quality Evidence Improvement updates NCGC
    5. 5. Patient Experience guidance and quality standard• Commissioned by NICE in 2010 to develop guidance, recommendations and quality standards outlining a level of service that people using adult national health services should expect to receive.• Guidance for all staff (including non-clinical staff) involved in providing health services, as all interactions can have a profound effect on patient experience of care NCGC
    6. 6. What are NICE guidance andquality standards• Guidance underpin recommendations for the care of individuals within the NHS (usually population/setting specific).• Guidance and quality standards outline a level of service that people using adult NHS services should expect to receive• Has an important role in influencing provision of high quality, effective relevant care• By design they address variations in practice, optimising care delivery and experience NCGC
    7. 7. Collaborative development ofGuidance and Quality Standard• Underpinned by an agreed scope• Driven by a multidisciplinary guideline development group (GDG); – 10 health professionals – 6 patient representatives• Supported by a technical team• Consultation with and incorporation of feedback from stakeholders NCGC
    8. 8. Technical TeamIs comprised of: Their function: GDG Chair  Undertook evidence Information Scientist reviews / synthesis Research Fellow  Presented the Health Economist evidence to the GDG Project Manager  Wrote the final Guideline Lead document. NCGC
    9. 9. Role of the GDG• Attended 7 all day development meetings• Contributed constructively, acknowledging the equal standing of each group member.• Helped technical team refine and develop review questions• Considered and debated evidence.• Developed recommendations based on the evidence and GDG consensus• Helped write the guideline• Debated and prioritised areas for quality standards NCGC
    10. 10. Guidance Development - Sources of evidence• Review of existing patient experience frameworks• Patient Experience Scoping Study – focused thematic qualitative overview, identifying key themes• Review of NHS Survey Results• Review of existing NICE guidelines extracting recommendations related to patient experience• Selected systematic literature reviews for specific interventions (eg. Decision Aids) NCGC
    11. 11. GDG evidence interpretationA powerful combination of :• Patients (40% of the group)• Clinicians• General Practitioner• Specialist Nurses• Allied Health Professionals• Public Health Specialists• Academic researchers• Technical team membersRapid synthesis of multiplesources distilling into evidenceand consensus shapedrecommendations.These inform the developmentof indicators for measuringwhat ‘quality looks like’. NCGC
    12. 12. Identified themesThe following key themes were identifiedwhich underpinned 67 recommendations;1.Knowing the patient as an individual2.Essential requirements of care3.Tailoring healthcare services for each patient4.Continuity of care and relationships5.Enabling patients to actively participate in their care. NCGC
    13. 13. 1. Knowing the patient as an individual• Patients appreciate being recognised and treated as individuals by health care providers. It is an essential component of the patient experience.• Recommendation: Develop an understanding of the patient as an individual, including how the condition affects the person, and how the person’s circumstances and experiences affect their condition and treatment. NCGC
    14. 14. 2. Essential requirements of care• Recognition of all aspects of patient needs: respect, patient concern, nutrition, pain management, personal needs, patient independence , consent and capacity• Recommendation:All staff involved in providing NHS services should; • treat patients with respect, kindness, dignity, compassion, understanding, courtesy and honesty • Respect the patient’s right to confidentiality • Not discuss the patient in their presence without involving them in the discussion NCGC
    15. 15. 3. Tailoring health care services foreach patient• The importance of: – an individualised approach to services taking into account patients views and preferences – involving family members and carers – Acknowledging the place for feedback and complaints• For example:Adopt an individualised approach to healthcare services that istailored to the patients needs and circumstances, taking intoaccount their ability to access services, personal preferences andcoexisting conditions. Review the patient’s needs andcircumstances regularly. NCGC
    16. 16. 4. Continuity of care andrelationships• Highlighting the need for appropriate communication enabling continuity of care between service providers. Ensuring continuity of care appreciating the impact this has on the patient.• Recommendation: Assess each patient’s requirement for continuity of care and how that requirement will be met. This may involve the patient seeing the same healthcare professional throughout a single episode of care, or ensuring continuity within a healthcare team. NCGC
    17. 17. 5. Enabling patients to actively participate in their care• The understanding that patients need and appreciate clear and accurate communication, information, the opportunity for shared decision making.• The necessity for evidence based patient education programmes• For example: All staff involved in providing NHS services should have demonstrated competency in relevant communication skills. When discussing decisions about investigations and treatment, do so in a style and manner that enables the patient to express their personal needs and preferences. NCGC
    18. 18. Quality standardWhat is a quality standard?A quality standard defines best practicethrough 14 specific, concise qualitystatements, plus measures to provide thepublic, health and social careprofessionals, commissioners and serviceproviders with definitions of high-qualitycare NCGC
    19. 19. Examples of quality statements• Patients are treated with dignity, kindness, compassion, courtesy, respect, understanding and honesty• Patients are made aware that they have the right to choose, accept or decline treatment and these decisions are respected and supported.• Patients have their physical and psychological needs regularly assessed and addressed, including nutrition, hydration, pain relief, personal hygiene and anxiety. NCGC
    20. 20. To conclude:• Guidance and quality standard are the evidence and expert consensus base to create sustainable change.• Produce care that is effective, acceptable and appropriate for patients.• The generic nature of this guidance makes it internationally transferable and applicable to other healthcare environments. NCGC
    21. 21. NCGC international involvement• Oman Evidence translation and Utilisation Programme• Collaboration with the Belgium Health Care Knowledge Centre• International model of support NCGC
    22. 22. NCGC website: www.ncgc.ac.ukNICE website: www.nice.org.uk NCGC
    23. 23. Thank you for listening! Thank you to the GDGFor more information please contact me: Liz Avital Liz.Avital@rcplondon.ac.uk NCGC

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