What to expect from CHI

Primary Care Team

Jocelyn Cornwell & Emilie Roberts

CHI’s aim

To bring about demonstrable

improvement in the quality of NHS patient care

throughout England and Wales

CHI’s principles

patient centred independent, rigorous & fair developmental evidence based open and accessible apply the same expectations to ourselves

Issues & challenges for PCTs? new complex shared services deficits performance targets commissioning and providing services old structures to deal with mergers moving goalposts

Issues for CHI

PCTs are complex, heterogeneous, dispersed and developing organisations

PCTs can exercise different levels of responsibility: they can commission and provide quite markedly different ranges of services

what CHI sees in these reviews may be as much a legacy of the PCT’s past as a testament to progress

PCT Boards have responsibility for, but no direct control over, a significant proportion of the services they provide

the public has a relatively low level of background knowledge of primary care trusts. “What does PCT stand for?” we have been asked on more than one occasion

the language of clinical governance is still new to some practitioners

commissioning and health improvement as well as provision

What does a PCT clinical review involve?

For more detailed information on PCT clinical governance review methods go to

www.chi.nhs.uk

1. click on the clinical governance reviews tab at the top of the page

2. scroll down to the link “clinical governance reviews of primary care trusts”

The review methods

refined methods for use in PCTs

expert panel consultation with

patient organisations and primary care field

two seminars

pilot process feedback from

PCTs evaluation revised process

How do we pick you for review?

reviewing in clusters randomised system generally 2 months notice

provided all PCTs listed on

www.chi.nhs.uk all PCTs will be reviewed

A CHI clinical governance review

identifies best practice and areas for improvement

is an independent assessment of systems to assure quality of patient care

looks at 3 levels: patients & carers; the practice & service level; corporate level

does not: assess individual performance or named

practices examine every service area

Components of clinical governance (1)

1. Public & patient involvement

2. Risk management 3. Clinical audit 4. Clinical effectiveness 5. Staffing and staff

management6. Education, training and

CPPD7. Use of information

Processes for quality improvement

Staff focus

Information Components will be scored from 1-4.

Components of clinical governance (2)

CHI is also developing its approach toassessing clinical governance in

relation to:

strategic capacity PCT commissioning health improvement prescribing & medicines management patient experience

Partner organisatio

ns

The CGR process

3 months

17 weeks

notification

pre review phase

preparation, preliminary

meetingsite visits, feedback

reporting

Action planning &

ongoing monitoring

Confidence table

Amount of evidence and sources

A number of sources: data; documents; interviews; observation Several items of information from the same source type (e.g. interviews) from different areas or organisations

One interview or observation confirmed by an independent sourceSeveral items of information from the same source type (e.g. interviews) from the same area or organisation One interview or observation only 

Reporting

Report Verbal feedback

Report Verbal feedback

? Report Verbal feedback

Report? Verbal feedback 

Degree of confidenceVery confident

Confident

Some confidence

Little confidence

Review teams ‘triangulate’ evidence to be confident in their judgements:

Reporting

more consistent feedback published final report – 5 days for

comments PCT provided with detailed evidence tables

(not published) press release to inform the public

PCT publishes action plan once agreed with StHA and CHI to address action points

Performance ratings

PCTs will be given scores for each component of clinical governance

clinical governance will feature as a key element in future performance ratings

more news to follow

Do you have further questions about CHI?

Email info@chi.nhs.uk

Finsbury Tower, Bunhill Row

London EC1Y 8TG

Tel: 020 7448 9200

www.chi.nhs.uk