To update the Committee on the Quality Assurance Framework and the processes and systems in place to ensure quality services are being commissioned and directly provided

The Committee received an update on the Quality Assurance Framework and the processes and systems in place to ensure quality services were being commissioned and directly provided.

The Director of Quality and Clinical Leadership (DQCL) gave a presentation highlighting aspects of the report in the agenda papers.  This included the importance of ensuring the patient experience was accurately captured and used to generate service improvement. 

The Committee also received a demonstration on work being undertaken to collate data and allow it to be explored to identify themes which could in turn then be further analysed.

It was also noted that the Committee would need to consider what role it wished to play in commenting on the “quality accounts”, reports that all providers of NHS services were now to be required to publish on the quality of health care services they were delivering.

In the ensuing discussion the following principal points were made:

·         The communication of information and the difficulty in targeting information without the danger of information overload was discussed.  The DQCL acknowledged the complexities but said consideration was given to how best to ensure effective communication, referring to both the Communications Strategy and the Customer Services Strategy.

·         The DCQL commented on the way in which providers were being encouraged to respond to concerns expressed by patients immediately, on the spot, where it was easily practicable to make a change to address that concern, rather than directing concerns through a formal complaints type process.  Demonstrating that changes would be made promptly, encouraged patients to express their views.

·         The DCQL confirmed that targets were not seen as an end in themselves.  The focus was on the quality of services.

·         Asked if arrangements were in place to audit the systems in place the DCQL replied that there were monthly clinical review meetings, with additional meetings called if a provider was not performing to the standard required.  She commented on the way in which anecdotal evidence about services, of which providers had previously been wary, was now being used to improve services, mindful that what patients told others about the service could often be more open and revealing.

·         It was asked if there was a risk that a rigid quality framework would stifle innovation.  The DCQL said that many providers were innovative and the focus on continuous service improvement encouraged innovation, as did the need to respond to financial pressures.

·         A concern was expressed that the monitoring arrangements outlined at section 7 of the report were too onerous, involved duplication and were taking the place of effective management arrangements.  The Director of Public Health commented that he considered the structure in place in Herefordshire to be quite streamlined compared with other Primary Care Trusts.

·         In the light of the significant failings identified in the findings of the independent inquiry into mid-Staffordshire NHS Foundation Trust assurance was sought that recommendations on clinical safety were being acted upon and that the Hereford Hospitals Trust was compliant.

The DCQL replied that the monthly Clinical Quality Forum ensured that recommendations on clinical safety were being acted upon by providers both within the County and by those outside the County from whom services were commissioned.

·         Mr Woodford, Chief Executive of the Hospitals Trust, reported that national patient safety alerts were acted on and monitored.  Some alerts were complex to respond to and needed time to implement.

RESOLVED:

That (a)  the work to ensure quality assurance be welcomed;

         (b)a seminar be arranged on Quality Accounts;

         (c)  a further report be made when timely, within six months, reviewing quality performance and highlighting any areas of concern.