Ensuring corporate and quality assurance
Commissioners should ensure that the services they commission represent value for money and offer the best possible outcomes for clients, their families and communities. Commissioners need to set clear specifications for monitoring and assuring quality 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 service users' views and those of other stakeholders when making commissioning decisions.
Needle and syringe programmes (NSPs) need to:
- be effective and efficient
- be responsive to the needs of clients, their families and communities
- provide services based on best practice, as defined in NICE public health guidance PH18 on needle and syringe programmes
- deliver the required capacity
- be integrated with other elements of care for people who use drugs
- define agreed criteria for referral, local protocols and the care pathway for people who inject drugs
- be client-centred and provide equitable access, ensuring that clients are treated with dignity and respect, are fully informed about their care and are able to make decisions about their care in partnership with relevant professionals
- consider and respond to recommendations arising from any audit or from serious untoward or client safety incidents
- demonstrate how they meet requirements under 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, complaints procedures.
- Clinical governance arrangements, including incident reporting.
- Clinical quality criteria: appropriateness of referral, consenting procedures, clinical protocols.
- Audit arrangements: frequency of reporting, reporting route and format, and dissemination mechanisms; arrangements should include auditing, equipment return rates, training, number of referrals to specialist services, number of staff vaccinated against hepatitis B, and monitoring of patient outcomes and complications (see audit support for NICE public health guidance PH18 on needle and syringe programmes for further information).
- Health, safety and security: infection prevention, health and safety training for staff, safe disposal of used equipment, waste management, confidentiality procedures, legislative requirements, needle stick injury protocols and hepatitis B vaccination for staff.
- Equipment: plans on how equipment will be stored and distributed throughout the area.
- Client 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.
- Outcomes: numbers receiving hepatitis C testing, numbers vaccinated against hepatitis A and B, numbers referred for opioid substitution therapy (OST), numbers who take up offer of OST, numbers who stop injecting, reduced numbers of drug -related deaths.
- Staff competencies: individual and team baseline requirements, monitoring and performance.
- Information requirements, non-identifiable data, aggregate data on the distribution and return of injecting equipment plus limited information on the client profile in line with data collected for National Drug Treatment Monitoring System and the Needle Exchange Monitoring System.
- The process for reviewing the service with stakeholders, including decisions on changes necessary to improve or to decommission the service.
- Achieving targets associated with equalities legislation.
General information on quality and corporate assurance can be obtained from the following sources:
- The National Patient Safety Agency (NPSA) oversees the implementation of a system to report and learn from adverse events and near misses occurring in the NHS. The publication ‘Seven steps to patient safety' provides an overview of patient safety and gives updates on the tools that the NPSA is developing to support patient safety across the health service.
- 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 NSPs can be obtained from the following sources:
- The National Treatment Agency for Substance Misuse is a special health authority established by the Government to improve the availability, capacity and effectiveness of treatment for drug misuse in England.
- Royal College of General Practitioners Certificate in the Management of Drug Misuse includes an online harm reduction module. The certificate is endorsed by the National Treatment Agency for Substance Misuse and is available for pharmacists, nurses, drug workers and other healthcare professionals.
- NHS North West Community Pharmacy Enhanced Services Harmonisation of Accreditation defines the core competencies for pharmacists wishing to provide a specified enhanced service.
- Implementing care closer to home - providing convenient quality care for patients: a national framework for Pharmacists with Special Interests published by the Department of Health and NHS Primary Care Commissioning; provides guidance and a competency framework.
This page was last updated: 02 March 2012
- Needle and syringe programmes
- Commissioning needle and syringe programmes
- Specifying needle and syringe programmes
- Determining local service levels for needle and syringe programmes
- Assumptions used in estimating a population benchmark
- The commissioning and benchmarking tool
- Ensuring corporate and quality assurance