Building the new NCAPOP STI/HIV Audit proposal

Hugo McClean, Chair BASHH National Audit Group

Goals of this presentation

• Background to HQIP NCAPOP audits• Current BASHH/MedFASH & BHIVA proposals• Development to support new joint proposal• Know how to obtain further information/help

* Healthcare Quality Improvement Partnership: http://www.hqip.org.uk/

** National Clinical Audit and Patient Outcomes Programme

Summary

• HQIP will procure a NCAPOP STI/HIV Audit• Separate BASHH/MedFASH & BHIVA proposals

accepted by HQIP/DH, but ...• BASHH/MedFASH & BHIVA to submit a new joint

proposal• Development project needed to support new joint

proposal ... engagement with key stakeholders• (No guarantee that contract will be awarded to

proposers!)

Question

• Why do people want to continue to live in the UK?

o Low tax rates

o Weather

o Community strengths

o Quality of healthcare

o Affordability of healthcare

o Cost of living

Runnymede 2011

Regulatory organisations requiring statutory and mandatory clinical audit activity• Care Quality Commission:

– STI management is included in regulated activities– Annual Provider Compliance Assessment requires evidence of use of audits in quality

improvement

• Department of Health/ NHS standard contracts:– “The Provider shall participate in the national clinical audits within the relevant

National Clinical Audit Patients Outcome Programme (NCAPOP)”

• Department of Health/Quality Accounts:– Requirement to take part in, publish and act on, national audits

• NHS Litigation Authority, Clinical Negligence Scheme for Trusts – “All organisations must have an approved documented process … making sure … all clinical

audits are undertaken, completed and reported on in a systematic manner”

• GMC & Revalidation:– “Evidence of effective participation in clinical audit or an equivalent … that measures the care

with which an individual doctor has been directly involved”

HQIP – provides national audit programmes

• Established in 2008• Aim: increase impact of clinical audit has on healthcare

quality (medical, mental & social care)• Consortium of the Academy of Medical Royal Colleges, the

Royal College of Nursing and National Voices (formerly the Long-term Conditions Alliance)

• Funded by DH• Manages NCAPOP ... 29 audit projects • Nov 2011: 11 new audit topics accepted by HQIP, including

STI/HIV programme

HQIP/DH criteria for audit

• HQIP criteria for best practice in audit• Quality Accounts• With NCAAG* to test proposals for new

national audit topics

*NCAAG: National Clinical Audit Advisory Group (DH)http://www.hqip.org.uk/

PreparationPrioritiesSettings

StandardsEngagement & agreement: key

stakeholdersOrganizations

fund auditsPatient

involvement

Performance measurementMethodsSampling

Data collection/ pre-existing databasesReporting

Impact

Change implementationAgreed action plans

ResponsibilitiesResources

CommunicationMonitoring

Sustaining improvement

SupportRe-audits

Communication

HQIP criteria for good audit practice

Current audits vs future HQIP auditsCriteria

(Basic criteria for inclusion in Quality Accounts)

BASHH audits

HQIP NCAPOP audits

Led by clinically appropriate body Stakeholder views Performance measured against defined clinical standards Individual patient data collected Results disseminated Results publicly by open report Report at trust level or lower Patients involved in governance Provide support to trusts/clinicians to implement findings

Work to date• May 2011: Separate proposals submitted by

BASHH/MedFASH & BHIVA for new NCAPOP audit topics• Aug 2011: Acceptance of both proposals by DH

– … new single audit programme spanning scopes of both• Aug 2011- May 2012: Collaboration

– High level Development Project agreed and submitted to HQIP to support new joint proposal

• May 2012: Development Project accepted by HQIP• Current to end Jan 2013: Development Project in action• Feb 2013: Completed new proposal. Procurement begins

Project outline• Aim: to prepare a new topic proposal for a national audit

programme covering:– Detection and Management of STIs, including HIV infection, in adults

• Objectives: – Engage with stakeholders: • patients and service users, service providers including NHS,

independent and third sectors, primary care, public health, other professional bodies, managers and commissioners

– Propose a scope for the programme, including priority topics and settings

– Specify the aims and objectives for a future audit programme over 3 - 5 year time frame.

Project candidate priority audit topics• STI testing across range of services, measuring:

– Access– Uptake– Methods of testing – Partner notification– Access to test results– Timeliness of HIV test results– BASHH management guidelines

• Assessing quality of routine care of people with HIV, including:– Reducing onward transmission – Adherence to BHIVA treatment guidelines

• Measuring patients’/service users’ experience and outcomes

HQIP/DH commissioning process

Ratification new joint proposal by DH

Development of specifications

Contract notice advertised in OJEU

PPQs, shortlisting, specifications finalized (Jan 2013)

Capable parties submit full tenders … contract … 29 weeks

Contacts/help

• BASSH website: http://www.bashh.org/groups/national_audit_group

• BHIVA website: http://www.bhiva.org/AuditandClinicalStandards.aspx

• HQIP website: http://www.hqip.org.uk/• Email:

– hugo.mcclean@chcphull.nhs.uk– hilary@regordane.net– rlowbury@medfash.bma.org.uk– ann.sullivan@chelwest.nhs.uk

Thanks:MedFASH/Ruth LowburyHilary CurtisAnn SullivanMediScript (Faarid & Mitul)

Tell us what you think …• Key topics/indicators to measure • Settings: not just GUM for STIs!• Operational issues – e.g. data

collection and scope for using existing data sources

• Transparency– Requirement to publish outcomes at

site/clinic level– HIV infection: possibility of data

linkage across settings via NHS number