Specialised Services - Standards and Quality Clinical Assurance Aim: to seek to provide assurance that the products of commissioning have clinical support from as broad a range of sectors and services as possible
Standards and Quality Outcomes Building on our inheritance Genomic technology in healthcare A report by the Human Genomics strategy Group. January 2012 NHS outcomes framework
Outcomes Domain 1-3 Preventing people from dying prematurely By enabling earlier more accurate diagnosis and prognosis, helping clinicians to select treatments that are more likely to be effective Enhancing quality of life for people with long term conditions By helping to identify those for whom established therapies will be less effective, thus enabling an alternative to be used Helping people to recover from episodes of ill health or following injury By understanding precisely the pathology of a disease so that the right treatment pathway is selected sooner
Outcomes Domain 4-5 Ensuring that people have a positive experience of care By reducing the need for invasive testing procedures and above all by accelerating the process of diagnosis treatment and recovery Treatment and caring for people in a safe environment, and protecting the from avoidable harm By enabling clinicians to check whether a patients genetic profile makes them more likely to suffer an adverse reaction to a certain drug thus avoiding the use of that drug where appropriate
Standards and Quality Specialised Commissioning Clinical Assurance Group Chair James Palmer Transitional Programme lead for Quality and Innovation Membership Medical Director or Clinical leads from cluster SCGs, Public Health leads from cluster SCGs Five Programme Care Group Chairs from the constituent e Clinical Reference Group Chairs
Standards and Quality Clinical Reference Groups 55 Service Specific Clinical Reference Groups Membership 2 Clinical leads from SCG sector, up to 4 further clinicians; Public Health consultant, 2 patient support group reps; senior commissioning manager; single clinical director where formal networks exist; up to 4 further individuals from other national organisations
Standards and Quality Programmes of Care Mental Health Women and chidren s health, congenital and inherited diseases Infection, cancer, immunity and haemotology Traumatic Injury, orthopaedics, head and neck and rehabilitation Digestions, renal, hepatobiliary, and circular systems
Clinical Reference Groups Process Applications for the role of Chair for each of the Clinical Reference Groups sought in December 2011 expressions of interest requested by 8 January, 2012 Appointment confirmed January 2012
Clinical Reference Groups Chair of Clinical Reference Group. A clinical leader in the field of the clinical service from a broad range of professional backgrounds. Experience as a clinical director, network director, medical director, or professional body leader would be desirable. The role is voluntary supported by the host NHS organisation within the professional activity component of the individual s role. On average bi-monthly meetings of the group are held using web-conferencing supported by a national administration. A biannual summit of all chairs is planned. The role will seek consensus from the group membership on support for the key products of specialised commissioning including: specifications; quality dashboards; and unified policies
Draft quality dashboard Serious untoward Incidents Number of serious untoward Incidents Number of serious untoward Incidents External Quality Assurance Scores from EQA schemes the laboratory participates in. EQA scores against the maximum score of 2, per scheme Multi Disciplinary Clinics (MDC) Proportion of clinical genetic clinics that are part of a MDC Number of clinical genetic clinics that are part of a MDC Clinical audits Proportion of clinical audits completed and action plans put in place (the number and type of audits need to be agreed) Number of clinical audits completed and action plans put in place (from the agreed list of audits)
Draft quality dashboard (con/t) Activity audits (laboratory) Proportion of audits participated in by the genetics laboratory (the number and type of audits need to be agreed) Number of audits (from the agreed list of audits) that genetics laboratory participates in. Adherence to UKGTN Testing Criteria (laboratory) Proportion of test requests that did not comply to UKGTN Testing Criteria where TC apply. Number of test requests that did not comply to UKGTN Testing Criteria where TC apply. Pick up rate for genetic testing Proportion of tests that return a positive result for affected patients that have the test to determine a diagnosis. Number of tests ordered that return a positive result for affected patients that have the test to determine a diagnosis. (some tests may need to be excluded e.g. Fragile X)
Draft quality dashboard con/t Poor patient experience Number of complaints to the genetics department Number of complaints to the genetics department Good patient experience Number of communications registering thanks to the genetics department Number of communications registering thanks to the genetics department Laboratory reporting times Proportion of reports meeting turn round times as agreed by the professional organisations (CMGS/ACC) Number of reports meeting turn round time Referral to 1st appointment Proportion of patients that have to wait longer then 13 weeks between date of referral and first appointment with clinical genetics Number of patients that have to wait longer then 13 weeks between date of referral and first appointment with clinical genetics
Draft quality dashboard con/t Patients waiting excessively for genetic test results Proportion of patients receiving test result within 10 working days after the clinic receives the laboratory report Number of patients receiving test result within 10 working days after the clinic receives the laboratory report Do Not Attends (DNA) Proportion of appointments that are not attended Number of DNAs Patients consulted without a referral Patients consulted without a referral Number of patients consulted without a referral Patients consulted by a genetic counsellor Patients consulted by a genetic counsellor Number of patients consulted by a genetic counsellor
Standards and Quality the Future Framework to be finalised; specification, quality indicators, unified policies Moving towards national convergence and consistency