| HQS
Consultancy - examples of current and recent projects
British
Association of Day Surgery
During 2001/2 HQS worked with the British Association of Day
Surgery (BADS) on a quality programme, specifically developed
for day surgery services.
The
project with BADS gave HQS the opportunity to develop quality
standards for a specific clinical service. This follows the
HQS strategy to ensure that standards are clinically relevant
and to develop bespoke service-based programmes.
The
standards were developed with input from BADS' council members
and are based on the structure of the existing HQS standard
for acute day care, augmented to reflect the particular requirements
for high quality day surgery services. The next stage was
to pilot these. Organisations represented on BADS council
were canvassed and four trusts volunteered: the day surgery
services at City General Hospital - Stoke on Trent, Princess
Alexandra Hospital Harlow, King's College Hospital and Milton
Keynes General Hospital. In order to get the pilot units started
an introduction and training session was held in December
2001, where HQS took representatives through the process involved
in working to demonstrate achievement of the standards to
a team of peer reviewers. Pilot organisations then completed
self-assessments and prepared action plans for any gaps where
standards were not in place.
Peer
review surveyors to assess the pilot sites' compliance with
the standards were recruited through BADS and took part in
a training day at HQS in May. This ensured familiarity with
the process and enabled a practice run at the interview techniques
needed in order to carry out peer review audit. Three of the
services undertook a pilot survey, carried out over one day,
with two peer reviewers on each, supported by an HQS client
manager.
The
general findings from the surveys were of enthusiastic staff
teams committed to providing a high quality, efficient service.
Clinical practice was judged to be of a very high standard
but not always supported as well as it should be by documentation
that would help improve the efficiency and consistency of
the service. One of the key findings was the importance of
having input from day surgery at a strategic level in the
trust, given the importance of day surgery in delivering the
NHS plan.
The
experience of the pilot services has informed revisions to
the standards and process and the BADS/HQS Day Surgery Service
Accreditation Programme is now available.
Cornish accreditation scheme for nursing and residential care
homes
In 2001 HQS worked with Cornwall Healthcare Trust to develop
a locally-based accreditation scheme in Penwith, West Cornwall,
for nursing homes and residential care homes providing services
for older people with a psychiatric disorder. HQS acted in
a consultancy capacity to work with a local steering group
on every stage of the project from standards development through
to the design and implementation of the assessment process.
The first step was to develop the standards to be used. The
seven standards cover:
— Care of clients
— Lifestyle and activities
— Environment for care
— Management of the establishment
— Communication
— Staff experience
— Quality
They
are derived from the results of local focus group discussions,
the expertise of the professionals involved from the community
mental health team and the nursing and residential care home
sector and existing publications such as the Audit Commission
report 'Forget Me Not' and 'Home from Home' the HQS standards
for nursing and residential care homes.
HQS
then ran a workshop day for the homes on implementing the
standards and preparing for external review. The next stage
was to train local assessors for the scheme. There was concern
about who would be appropriate assessors, ensuring that there
was no conflict of interest. It was therefore decided to approach
Age Concern, who already run a very successful local advocacy
service, to ask if the charity would be interested in managing
the assessment element for the accreditation scheme. Age Concern
was confident that volunteer assessors of the right calibre
could be recruited and was very keen to be involved. HQS facilitated
a two-day recruitment and selection event, attended by 20
applicants, of whom 17 were selected as assessors for the
scheme.
The
accreditation scheme is now established and has already demonstrated
the commitment of healthcare providers in the area to quality.
Help the Hospices
Help
the Hospices needed assistance to help organisations to prepare
for the introduction of new inspection regimes by the National
Care Standards Commission. HQS was commissioned to develop
a set of guidelines for the policies and procedures required
by the national minimum standards and other standards which
hospices needed to implement. The range includes: complaints
management, human resources, record and information management,
resuscitation, medicines policies and infection control
The
resource pack produced contains:
— a set of outline guidance on the content for the required
policies and procedures, based on legislation and best practice,
which hospices can adapt to take into account local circumstances
— a set of template documents to aid in the development
of new policies and procedures, ensuring they have the same
format and introducing documentation control and systematic
review.
HQS
led the project, working with staff and associates who have
expertise in areas such as palliative care, risk management
and human resources.
(Copies
of the resource pack are available from Help the Hospices,
Hospice House,
34 - 44 Britannia Street, London, WC1X 9JG)
National
Cancer Action Team
The
National Cancer Plan was launched in September 2000 together
with comprehensive standards for all cancer services. The
monitoring of the standards is achieved by regular peer review
visits to all cancer units, centres and networks. HQS assisted
the Cancer Action Team in developing the regional approach
to this process.
Working
closely with the London and West Midlands regions involved
the training of peer review assessors and guidance on the
development and management of the peer review process. HQS
subsequently completed an evaluation of the first peer review
assessment against the cancer service standards in the London
region. This has since been used to refine the process for
future visits.
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