NHSLA Risk Management Conference Manchester 9th November 2004

1
Policy Practice Performance

2
Introductions

• Alison Bartholomew, Risk Management Director,
  NHSLA
• Joanne Kinborough Mata, Director of Development
• Education NHSLA Schemes, Willis

3
Agenda

• Background
• Consultation questionnaire
• Proposals benefits
• Focus groups
• Way forward
• Changes

4
Background 1

• 1995 CNST Standards introduced
• April 04 Review instigated
• Nov 04 Strategy agreed
• Dec 05 Approach announced
• Feb April 05 Consultation exercise
• July 05 Findings published, proposals outlined
  benefits shared
• Summer 05 Focus Group feedback

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Background 2

• DH Standards for Better Health
• Cabinet Office DH Reducing Burdens initiative
  
• Concordat between bodies inspecting, regulating
  and auditing healthcare
• Healthcare Commission Annual Health Check
• National guidance good practice
• Claims data
• Trusts feedback

6
Consultation questionnaire
Alignment with Standards for Better
Health Tailor to the risk profile of
trusts Inconsistency between assessors Assessmen
t process too rigid Over-reliance on documentary
evidence Documentary evidence most appropriate
way to assess Standards too prescriptive Standar
ds not explicit enough
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Progress

• Summary of topics to be included in the new
  standards
• Levels of assessment
• Assessment process
• Focus Groups

8
Format of Standards

• Summary
• -v-
• Detailed

9
Format of Standards
10

• 
  Performance
• Practice
• Policy

11
Focus Group feedback

• Do you feel this event was an appropriate method
  of obtaining input from Scheme members on the
  revised NHSLA Standards and assessment process?

12
Way Forward - Revised standards assessments 1

• Input from trusts
• Consultation with other national bodies
• Involve patients public
• Complete an impact assessment

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Way Forward - Revised standards assessments 2

• Pilot phase e.g. acute specialist trusts
• completed consultation questionnaire
  (optional)
• all Level 0 Level 1 due an assessment
  (mandatory)
• assessment at higher level (subject to certain
  conditions)
• Finalise standards and assessment process
• Workshops

14
Changes 2005/06 Data collection

• Trust annual exercise ended
• NHSLA obtain data from Health Social Care
  Information Centre, DH Monitor

15
Changes 2005/06 Publish assessment reports

• NHSLA Factsheet 4 now includes details of scores
  achieved in each criterion in addition to overall
  level
• All NHSLA assessment reports published on website

16
Changes 2006/07 Assessments

• Reduce frequency of assessments for Level 2 3
  trusts from 2 to 3 years
• Suspend the assessment of all Acute trusts
  (during pilot phase)
• Suspend the assessment of most PCTs (pending
  restructuring)

Assessments of MH LD trusts, Ambulance trusts
and Maternity services continue as usual, subject
to bullet 1 above
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Changes 2006/07 - Mergers

• New organisation allocated an assessment level
  immediately post merger
• Level will normally be determined by the level of
  the lowest component trust
• Level will usually be valid for 2 years
• New organisation may choose between a formal
  assessment and interim visit in the first year
  post merger

18
Changes Revised standards assessments

• Postpone development of revised PCT Standards
  (pilot version June 07)
• Defer start of formal assessments against the
  revised standards until the beginning of 2007/08
  2008/09
• Extend period of existing assessment validation
  for trusts due to be assessed during pilot year
  of relevant standards

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