Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

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Healthcare Inspectorate Wales

Our role and how we help drive equality?

Mandy CollinsDeputy Chief Executive

Director of Regulation and Inspection

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

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Our statutory basis as at 2004

• Health and Social Care (Community Health and Standards) Act 2003

• Powers delegated to HIW by the Welsh Assembly Government

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

Part 2 Chapter 4 of the Act

• The availability of, and access to health care

• The quality and effectiveness of health care

• The financial or other management of health care and the economy and efficiency of its provision

• The availability and quality of information provided to the public

• The need to safeguard and promote the rights and welfare of children

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

Our powers enable us to

• Conduct inspections & investigations

• Require documents & information

• Interview people

• Publish reports

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

Our Powers and Responsibilities have kept on growing

2009DOLS

2009Dentists

2009MHAC

2008Substance

Misuse

2007YOTS

2007IR(ME)R

2007Nurse

Agencies

2007Homicide

Investigations

2007Clinical

Reviews ofDeaths

in prison

2006Statutory

Supervisionof Midwives

2006QA

NMC

2006IHC

NHSInspection

& Investigation

Healthcare Inspectorate

Wales

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

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Our statutory basis as at January 2010• The Health and Social Care Act 2003• The Mental Health Act 1983 (Amended by the 2007 Mental

Health Act)• The Mental Capacity Act 2005: Deprivation of Liberties

Safeguards were added to this through amendments made by the Mental Health Act 2007

• Codes of Practice for the Mental Health Act, Mental Capacity Act and DOLS

• Ionising Radiation (Medical Exposures) Regulations 2000 • Ionising Radiation (Medical Exposure) (Amendment) Regulations

2006• The Care Standards Act (2000)• The Care Standards Act 2000 (as amended by the Health and

Social Care Act 2008 (Schedule 5)

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

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Our statutory basis as at January 2010• The Registration of Social Care and Independent Health Care

(Wales) Regulations 2002• The CSA 2000 (Commencement No 8 (Wales) and Transitional

Savings Consequential and Amendment Provisions) Order 2002 • The Children Act 1989 and the Care Standards Act 2000

(Miscellaneous Regulations) (Amendment) (Wales) Regulations 2002

• The Registration of Social Care and Independent Healthcare (Fees) (Wales) Regulations 2002

• The Registration of Social Care and Independent Health Care (Amendment) (Wales) Regulations 2003

• The Protection of Children and Vulnerable Adults and Care Standards Tribunal (Amendment) Regulations 2004

• The Protection of Children and Vulnerable Adults and Care Standards Tribunal Regulations 2002

• The Protection of Children and Vulnerable Adults and Care Standards Tribunal (Amendment) Regulations 2003

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

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Our statutory basis as at January 2010• The Private and Voluntary Health Care (Wales) Regulations 2002   • The Private and Voluntary Health Care (Wales) (Amendment)

Regulation 2007  • The Private and Voluntary Health Care and Miscellaneous (Wales)

(Amendment) Regulations 2006• The Private Dentistry (Wales) Regulations 2008• The Abortion Act 1967• The Controlled Drugs (Supervision of Management and Use) (Wales)

Regulations 2008 (under provisions of the Health Act 2006).• The Employment Rights Act 1996 (guidance developed on the

disclosure of information to HIW during reviews, inspections and investigations)

• The Protection of Children and Vulnerable Adults and Care Standards Tribunal (Amendment no. 3) Regulations 2003

• The Care Standards Act 2000 and the Children Act 1989 (Amendment of Miscellaneous Regulations)(Wales) Regulations 2004

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

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Our statutory basis as at January 2010

• The Safeguarding Vulnerable Groups Act 2006• Nursing and Midwifery Order 2001• Nursing and Midwifery Order 2001 (Consequential Amendments)

Order 2002• Midwives Rules and Standards (NMC 2004)• NMC Circular 32/2007 Standards for Supervised Practice of

Midwives• LSA Guidelines and Standards and LSA National (UK) Policies and

Guidelines (2009)• Local Health Boards (Functions) (Amendment) Regulations 2003

(exempts the LSA function from transfer to LHBs and retains function with National Assembly for Wales)

• The Disqualification from Caring for Children (Wales) Regulations 2004  

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

The organisations we have access to

• NHS commissioners and providers

• Primary and community care practitioners – health visitors, district nurses etc.

• Primary care contractors – GP’s, dentists, ophthalmologists, pharmacists

• Independent healthcare providers

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

HIW

Patients and public

National Health Service andIndependent Healthcare

Welsh Assembly

Government

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

Our basket of tools and approaches have expanded and developed

Clinical Governance

Reviews

Thematic Reviews

Investigations/Special Exercises

Healthcare Standards Assessments

Unannounced Cleanliness spot checks

Unannounced Dignity & Respect Checks

Healthcare Summits

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

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How do we drive equality

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

In the way we undertake our workWe involve lay reviewers on all our workWe involve service users – for example we

have worked with Mencap Cymru, Barnardos, RNID, RNIB, Swansea Chinese Community

We focus on the individual

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

The focus of our workDignity and respect spot checksService reviews that enable benchmarking

across WalesCollecting intelligence – complaints,

incidents, outcome dataListening to the views of public, patients,

service users

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

What we look for includes:

• Organisational fitness for purpose – how well are organisations managed? Is the Board fulfilling its role? Is the board receiving the right information?

• Are environments of care fit for purpose?

• Are patients, service users, carers etc being provided with the information they require? Are they appropriately involved in decisions about their care?

• Are services fit for purpose – is the care provided safe and of a good quality? Is dignity safeguarded? Are patients treated with respect?

• Does the organisation learn from complaints and incidents?

Unequal Wales

25 March 2010

DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

Above all we want to ensure that there is a focus on the individual, that they are treated equally and that there is no

discrimination on any grounds