Ensuring corporate and quality assurance
Commissioners should ensure that the services they commission represent value for money and offer the best possible outcomes for patients. Commissioners need to set clear specifications for monitoring and assuring quality and productivity in the service contract.
Commissioners should ensure that they consider both the clinical and economic viability of the service, and any related services, and take into account patients' and carers' views, and those of other stakeholders, when making commissioning decisions.
Commissioning biologic drugs for the treatment of inflammatory disease needs to:
- be effective and efficient
- be responsive to the needs of patients and carers
- provide treatment and care based on best practice, as defined in relevant NICE guidance
- deliver the required capacity
- be integrated with other elements of care for people needing biologic drugs, for example physiotherapy or occupational therapy services
- define agreed criteria for access, local protocols and the care pathway for people needing biologic drugs
- be patient-centred and provide equitable access, ensuring that patients are treated with dignity and respect, are fully informed about their care and are able to make decisions about their care in partnership with healthcare professionals
- consider and respond to recommendations arising from any audit, or serious untoward or patient safety incidents
- demonstrate how it meets requirements under national equalities legislation
- demonstrate value for money.
Local quality assurance
Any mechanisms for quality assurance at a local level are likely to refer to the following:
- Service and performance targets, including estimated activity levels and case mix, waiting and referral-to-treatment times (ensuring that patients and carers do not experience unnecessary delays), outcomes measures, complaints procedures.
- Clinical governance arrangements, including incident reporting and continuation rules.
- Clinical quality criteria, appropriateness of referral, consenting procedures, clinical protocols.
- Audit arrangements: commissioners may wish to consider the local or regional identification of a clinical audit lead for biologic drugs. A robust system will assist in monitoring the uptake and delivery of biologic drugs and may highlight issues such as inappropriate prescribing, and enable these to be mitigated and prevented in the future. NICE produces a number of clinical audit tools for biologic drugs, which can be further adapted to meet local circumstances.
- Recording all patients receiving biologic drugs using the appropriate database or register.
- Pharmacovigilance to ensure detection and reporting of any adverse side effects of biologic drugs in the short or long term.
- Health, safety and security: infection prevention, waste management, confidentiality procedures, legislative requirements, risk management.
- Patient and service user experience using the national patient survey; taking into account perspectives and perception of service provision to help shape services; engagement to inform commissioning decisions; complaints.
- Patient outcomes using appropriate and validated patient reported outcomes measures (PROMs).
- Staff competencies: individual and team baseline requirements, monitoring and performance, continuing professional development (CPD) for nurse specialists.
- Information requirements, including both patient-specific information (NHS number, provision of high-quality information to patients/carers) and service-specific information (referral-to-treatment times, workload trends, number of complaints).
- The process for reviewing the service with stakeholders, including decisions on changes necessary to improve the service.
- Achieving targets associated with national equalities legislation.
General information on quality and corporate assurance can be obtained from the following sources:
- NHS Alliance online resources. NHS Alliance is the representational organisation of primary care and primary care trusts, and provides them with an opportunity to network and exchange best practice. The alliance supports its members with an open-access helpline, in-house and joint publications and briefings, internal newsletters and a website.
- The DH commissioning framework provides guidance on the commissioning process in the context of the NHS reform agenda.
- NHS Institute for Innovation and Improvement support for commissioners, includes Commissioning for Health Improvement products to accelerate the achievement of world class commissioning; The Productive Leader programme to enable leadership teams to reduce waste and variation in personal work processes, and Better care, better value indicators to help inform planning, to inform views on the scale of potential efficiency savings in different aspects of care, and to generate ideas on how to achieve these savings.
- 10 Steps to your SES: a guide to developing a single equality scheme. This guidance has been developed to assist NHS organisations that have a duty, as public authorities, to comply with the race, disability and gender public sector duties, and in anticipation of new duties in relation to age, religion and belief, and sexual orientation.
Specific information on quality and corporate assurance for commissioning biologic drugs for the treatment of inflammatory disease can be obtained from the following sources:
- The British Association of Dermatologists biologic interventions register (BADBIR), British Society for Rheumatology biologics register (BSRBR) and British Society for Paediatric and Adolescent Rheumatology (BSPAR) register the number and outcomes of patients taking biologic drugs in dermatology and rheumatology
- The Inflammatory Bowel Disease Standards Group: Quality care: service standards for the healthcare of people who have inflammatory bowel disease
- Skills for health works with employers and other stakeholders to ensure that those working in the sector are equipped with the right skills to support the development and delivery of healthcare services.
This page was last updated: 16 October 2012
- Biologic drugs for the treatment of inflammatory disease in rheumatology, dermatology and gastroenterology
- Commissioning biologic drugs for the treatment of inflammatory disease in rheumatology, dermatology and gastroenterology
- Specifying a service for people who need biologic drugs for the treatment of inflammatory disease in rheumatology, dermatology and gastroenterology
- Determining local service levels for biologic drugs for the treatment of inflammatory disease
- Assumptions used in estimating a population benchmark
- The commissioning and benchmarking tool
- Ensuring corporate and quality assurance