NHS Stockport Clinical Commissioning Group (CCG) and Stockport Metropolitan Borough Council set out to develop a systematic approach for using NICE Quality Standards to drive quality improvement, acheive integrated commissioning, to align quality agendas and to ensure they were underpinned by evidence-based information.
Aims and objectives
- The aim of the project was to develop a structural approach to enable the CCG and Local Authority (LA) to consider every new quality standard published by NICE, and to ensure a fully integrated and joint approach across the organisations.
The objectives were to support a system for:
- Identifying gaps between local quality of care /services and the quality standard
- Analysing levels of achievement against the quality statements in a standard
- Jointly deciding and prioritising quality improvements
- To alert strategic senior management groups in health and social care to any risks associated with the quality standard
- Informing commissioning intentions.
Reasons for implementing your project
The starting point was that the director of adult social care wanted a structural approach to respond to NICE quality standards first of all within the council but also across the wider health and social care system.
As part of wider integration work between LA and CCG in Stockport it was decided to jointly develop a process and to test it out with the newly launched dementia quality standard.
The development of our local dementia strategy and implementation plan was already designed jointly and is an example of integrated working between health and social care. It felt beneficial to also jointly analyse our commissioning effort for services and care of people with dementia with the NICE Quality Standards on Dementia (QS1 and QS30).
- A small steering group was installed to oversee this work. The membership of this group was as follows:
- Quality officers for adult social care, CCG and public health
- Data analysts LA and CCG
- Representative of HealthWatch
- Communication officer
- The joint commissioner (CCG based) and LA's policy officer for dementia attended this meeting as well (on a temporary basis).
Together we designed a process for analysing and following up new quality standards. We found this a productive approach as it gave us a steer how to work together across health and social care, it avoids duplication and improves partnership working on topics like data collection, quality assurance and commissioning intentions. It also ensures a more joint up approach towards reporting to strategic bodies like the local Health and Wellbeing Board, scrutiny committees and management teams.
How did you implement the project
We installed a local NICE Health and Social Care Standards Steering Group that meets quarterly, discusses the recent published quality standards, decides on membership for small topic specific task & finish groups for relevant quality standards and takes findings & recommendations from these task & finish groups to various forums - depending on the risks, need for action and gaps identified.
We developed the following joint process to approach new NICE Quality Standards. Please see the flowchart.
We anticipate that the main results / benefits:
- Shared learning: better understanding elements and impact on local services from both health and social care perspective and how this might be interlinked
- A joint and more holistic approach: avoiding duplication, more powerful approach to implement change, joint ownership of identified risks / gaps / need for change
- Consistency across health and social care: same message about recommendations regarding quality standards in both CCG and LA
- Efficiency through sharing data, performance monitoring outcomes and consultation outcomes
- Beneficial to combine knowledge re. data analysis, public health information, user engagement reports,, quality assurance across health and social care: we have now better insight in who is capturing what data and have better integrated our data collection processes
- Formal structure: quality standards now formally feed in to development of CQUINs and KPIs in contracts with providers.
Key learning points
If deciding to develop a joint approach:
- ensure you have the backing of senior managers
- make sure you have the right people on the steering group: key people being able to flag up results from task & finish groups to relevant directors, key people that can influence agenda's regarding CQUINs and KPIs, key people responsible for data collection.
We found it inspirational to work together with data analysts, quality leads and user representatives to analyse a NICE Quality Standard and together decide on recommendations and actions and promote outcomes to our health and social care boards and management teams. We felt that by joining this work together we can make a bigger impact, e.g. through communication with providers, changes in contracts etc.
It helped us that we already had some experience in joint working and knew the key people to involve in this piece of work. Also having the right people with connections to health and social care management teams supported us in raising awareness, in getting support for recommendations made and to ensure that actions are followed up.