1. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 1 Healthcare Inspectorate Wales Our role and how we help drive equality? Mandy Collins Deputy Chief Executive Director of Regulation and Inspection

2. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 2 Our statutory basis as at 2004 Health and Social Care (Community Health and Standards) Act 2003 Powers delegated to HIW by the Welsh Assembly Government

3. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW Part 2 Chapter 4 of the Act The availability of, and access to health care The quality and effectiveness of health care The financial or other management of health care and the economy and efficiency of its provision The availability and quality of information provided to the public The need to safeguard and promote the rights and welfare of children

4. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW Our powers enable us to Conduct inspections & investigations Require documents & information Interview people Publish reports

5. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW Our Powers and Responsibilities have kept on growing Healthcare Inspectorate Wales NHS Inspection & Investigation 2006 IHC 2006 QA NMC 2006 Statutory Supervision of Midwives 2007 Clinical Reviews of Deaths in prison 2007 Homicide Investigations 2007 Nurse Agencies 2007 IR(ME)R 2007 YOTS 2008 Substance Misuse 2009 MHAC 2009 Dentists 2009 DOLS

6. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 6 Our statutory basis as at January 2010 The Health and Social Care Act 2003 The Mental Health Act 1983 (Amended by the 2007 Mental Health Act) The Mental Capacity Act 2005: Deprivation of Liberties Safeguards were added to this through amendments made by the Mental Health Act 2007 Codes of Practice for the Mental Health Act, Mental Capacity Act and DOLS Ionising Radiation (Medical Exposures) Regulations 2000 Ionising Radiation (Medical Exposure) (Amendment) Regulations 2006 The Care Standards Act (2000) The Care Standards Act 2000 (as amended by the Health and Social Care Act 2008 (Schedule 5)

7. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 7 Our statutory basis as at January 2010 The Registration of Social Care and Independent Health Care (Wales) Regulations 2002 The CSA 2000 (Commencement No 8 (Wales) and Transitional Savings Consequential and Amendment Provisions) Order 2002 The Children Act 1989 and the Care Standards Act 2000 (Miscellaneous Regulations) (Amendment) (Wales) Regulations 2002 The Registration of Social Care and Independent Healthcare (Fees) (Wales) Regulations 2002 The Registration of Social Care and Independent Health Care (Amendment) (Wales) Regulations 2003 The Protection of Children and Vulnerable Adults and Care Standards Tribunal (Amendment) Regulations 2004 The Protection of Children and Vulnerable Adults and Care Standards Tribunal Regulations 2002 The Protection of Children and Vulnerable Adults and Care Standards Tribunal (Amendment) Regulations 2003

8. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 8 Our statutory basis as at January 2010 The Private and Voluntary Health Care (Wales) Regulations 2002 The Private and Voluntary Health Care (Wales) (Amendment) Regulation 2007 The Private and Voluntary Health Care and Miscellaneous (Wales) (Amendment) Regulations 2006 The Private Dentistry (Wales) Regulations 2008 The Abortion Act 1967 The Controlled Drugs (Supervision of Management and Use) (Wales) Regulations 2008 (under provisions of the Health Act 2006). The Employment Rights Act 1996 (guidance developed on the disclosure of information to HIW during reviews, inspections and investigations) The Protection of Children and Vulnerable Adults and Care Standards Tribunal (Amendment no. 3) Regulations 2003 The Care Standards Act 2000 and the Children Act 1989 (Amendment of Miscellaneous Regulations)(Wales) Regulations 2004

9. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 9 Our statutory basis as at January 2010 The Safeguarding Vulnerable Groups Act 2006 Nursing and Midwifery Order 2001 Nursing and Midwifery Order 2001 (Consequential Amendments) Order 2002 Midwives Rules and Standards (NMC 2004) NMC Circular 32/2007 Standards for Supervised Practice of Midwives LSA Guidelines and Standards and LSA National (UK) Policies and Guidelines (2009) Local Health Boards (Functions) (Amendment) Regulations 2003 (exempts the LSA function from transfer to LHBs and retains function with National Assembly for Wales) The Disqualification from Caring for Children (Wales) Regulations 2004

10. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW The organisations we have access to NHS commissioners and providers Primary and community care practitioners – health visitors, district nurses etc. Primary care contractors – GPs, dentists, ophthalmologists, pharmacists Independent healthcare providers

11. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW

12. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW Our basket of tools and approaches have expanded and developed Clinical Governance Reviews Thematic Reviews Investigations/Special Exercises Healthcare Standards Assessments Unannounced Cleanliness spot checks Unannounced Dignity & Respect Checks Healthcare Summits

13. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW 13 How do we drive equality

14. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW In the way we undertake our work We involve lay reviewers on all our work We involve service users – for example we have worked with Mencap Cymru, Barnardos, RNID, RNIB, Swansea Chinese Community We focus on the individual

15. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW The focus of our work Dignity and respect spot checks Service reviews that enable benchmarking across Wales Collecting intelligence – complaints, incidents, outcome data Listening to the views of public, patients, service users

16. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW What we look for includes: Organisational fitness for purpose – how well are organisations managed? Is the Board fulfilling its role? Is the board receiving the right information? Are environments of care fit for purpose? Are patients, service users, carers etc being provided with the information they require? Are they appropriately involved in decisions about their care? Are services fit for purpose – is the care provided safe and of a good quality? Is dignity safeguarded? Are patients treated with respect? Does the organisation learn from complaints and incidents?

17. Unequal Wales 25 March 2010 DRIVING IMPROVEMENT THROUGH INDEPENDENT AND OBJECTIVE REVIEW Above all we want to ensure that there is a focus on the individual, that they are treated equally and that there is no discrimination on any grounds