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 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 the views of people who smoke and those of other stakeholders when making commissioning decisions.
A smoking cessation service for people having elective surgery needs to:
- be effective and efficient
- be responsive to the needs of people who are motivated to quit and are referred for an elective admission
- provide treatment and care based on evidenced-based practice, as defined in NICE public health guidance PH10 on smoking cessation services and NICE public health guidance PH1 on brief interventions and referral for smoking cessation
- deliver the required capacity
- be integrated with other elements of care for people requiring smoking cessation support
- define agreed criteria for referral, local protocols and the care pathway for people requiring smoking cessation services
- 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
- use accurate data recording and reporting systems
- audit performance data routinely and independently in line with NHS Stop Smoking Services: service and monitoring guidance, October 2007/08
- use the national branding www.gosmokefree.co.uk to enhance public recognition of NHS stop smoking services as an entity
- reflect policies as recommended in NICE public health guidance PH1 on brief interventions and referral for smoking cessation
- demonstrate how it meets 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 based on the characteristics of the local population of people who smoke. Aiming to treat at least 5% of the estimated local population of people who smoke or use tobacco in any form each year. Aiming for a smoking quit success rate of at least 35% at 4 weeks, validated by carbon monoxide monitoring.
- 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 the proportion of eligible people requiring smoking cessation support who are provided with care, and monitoring of patient outcomes and complications (see audit criteria for NICE public health guidance PH10 on smoking cessation services for further information).
- Health, safety and security: infection control, confidentiality and data protection procedures, legislative requirements, lone working for home visits.
- Equipment: testing and calibration, for example carbon monoxide monitors as per manufacturer specifications.
- Patient satisfaction: patient perspective and perception of service provision, detailed in NICE public health guidance PH6 on behaviour change.
- Patient outcomes: reduction in local smoking prevalence and known local smoking-related diseases.
- Staff competencies: competent against the national standards for smoking cessation training in three levels of service provision, as described in the Health Development Agency's Standard for training in smoking cessation treatments or its updates.
- Information requirements, including both patient-specific information
- 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.
- Delivering the 18 week patient pathway provides a range of resources to support the key NHS objective to deliver an 18 week patient pathway from GP referral to the start of treatment by the end of 2008.
- 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 a smoking cessation service for people having elective surgery can be obtained from the following sources:
- NICE PH5 workplace interventions to promote smoking cessation provides guidance for NHS and non-NHS professionals and employers who have a role in - or responsibility for - supporting and encouraging employees who smoke to quit.
- Better metrics is a pragmatic project that provides clinically relevant measures of performance to support the development of measurable local targets and indicators for local quality improvement projects.
- The Quality and outcomes framework (QOF) was designed to deliver substantial financial rewards for high-quality care. The framework sets out a range of national standards based on the best available research evidence.
- The NHS Centre for Smoking Cessation and Training (NCSCT) will provide national training standards, evidence based training and professional development systems for the NHS
This page was last updated: 02 March 2012
- Commissioning a smoking cessation service for people having elective surgery
- Specifying a smoking cessation service for people having elective surgery
- Determining local service levels for a smoking cessation service for people having elective surgery
- Assumptions used in estimating a population benchmark
- The commissioning and benchmarking tool
- Ensuring corporate and quality assurance