Assessment for improvement [Name] [Title] [Date / Event] V4.5

2 Our statutory roles Assessment of the provision of health care including public health in the NHS & independent sectors Annual ratings for NHS trusts Regulation of the independent sector through licensing and annual inspections Consideration of complaints which NHS trusts have not resolved Investigations into serious service failures Coordination of healthcare inspection activity

3 Purpose of our assessments The Healthcare Commission aims to promote improvement in health and healthcare Our assessments will emphasise the steps to improvement, rather than criticism of the past

4 The start of a journey… From…To… Planned Nationwide plans Centralised inspection Assurance Visit based Focus on organisations Scores for performance Responsive Local plans More local self- assessment Improvement More information based Focus on services & outcomes for populations Scores for improvement & performance

5 …for all healthcare Transition……towards integration a risk-based approach more self assessment existing requirements mapped to standards reports in line with those for the NHS single set of standards single approach to assessment a consistent focus on promoting improvement From April ‘05, our inspection of independent healthcare will use: From April 2006, subject to legislation, our inspections will move to:

6 Principles for a new approach Assessments that are relevant to patients, public and providers No unnecessary burden – build on organisation’s own responsibilities – intelligent use of information – partnership with other agencies inspecting, regulating & auditing healthcare: the ‘concordat’ – focus inspection where it is most valuable Fair judgements, reported clearly to each of our audiences

7 Our assessments Annual review Core standards Getting the basics right Developmental standards Making & sustaining progress National targets Local targets Progress against developmental standards Existing targets Use of resources Core standards Other regulatory findings

8 Core standards assessment Guidance: on how we will judge compliance and the systems trusts will need to make sure they meet the standards Declaration: from the trust and its local partners on how far they have complied with the standards Corroboration: cross-check the declaration with the results the trust has recently achieved Spot checks: where we have concerns about compliance, and also at random: assess whether standards breached Reporting and follow up: we will report whether the trust has the basics in place - or effective plans to correct breaches Core standards Getting the basics right

9 Further core assessments Core standards Getting the basics right Existing targetsUse of resources The 20 targets to which the NHS is already committed Influences a trust’s ability to maintain and improve services Methods familiar from the current performance ratings using results from the Audit Commission, Monitor & auditors For example: A&E access choice for planned care screening for retinopathy practice based registers Covers: the financial position financial management financial governance value achieved from resources Both of these core assessments will be reported separately within our annual review. Other regulatory findings… … including those by other agencies, will be used when checking trusts’ declarations, for example. We are also exploring how the conclusions of other regulators could additionally have a direct input into our annual review of trusts.

10 Making & sustaining progress Improvement reviews An in-depth review, focusing on: An aspect of the patient pathway… – a service, across organisations – a population group, e.g. children – a condition, such as diabetes A domain of the developmental standards Leadership and organisational capacity Developmental standards Making & sustaining progress R eviews will often be carried out in partnership with other agencies.

11 Improvement reviews Programme for 2005/06 Topic – focus on patient pathway Heart failure / implementation of NICE guidance YY Children's hospital services (NSF) Y Joint Area Reviews (Children's Services) - Ofsted-led YYYY Adult Community Mental Health Services - with CSCI YY Substance Misuse - with NTA YY Public health - Sexual health Y Public health - Tobacco control Y Older People's services - with CSCI and AC YYYY Admissions to hospitals (Acute Hospital Portfolio) YY Diagnostic services (Acute Hospital Portfolio) YYY Medicines management (Acute Hospital Portfolio) YYY Acute Primary care Mental health Ambulance Specialist Developmental standards Making & sustaining progress

12 Improvement reviews Piloting in 2005/06 Topic – focus on developmental standards Safety – HAI & cleanliness YY Access - the role of commissioners YYYYY Public health – planning and delivery YYYYY Acute Primary care Mental health Ambulance Specialist Topic – focus on governance Leadership and organisational capability YY Developmental standards Making & sustaining progress

13 Sustaining progress Leadership and organisational capacity An assessment of the developmental standards within the governance domain Will tell patients and the public… Will support trusts by: …whether a trust can both: sustain the basics and keep making progress beyond them highlighting where they need to strengthen their capability; providing early warnings of potential failures; and identify and share successes Developmental standards Making & sustaining progress

14 National and local targets National targets The Department of Health will specify indicators to measure progress for each kind of trust. We will confirm data collection arrangements by April 2005 so that national target indicators can included in the annual review for 2005/2006 Local targets Local targets will be for trusts to negotiate with their local partners. This process is new and it may take time to ensure consistency across the country. For this reason local targets will not be included in the annual review for 2005/2006 Developmental standards Making & sustaining progress

15 Reporting the Annual Review the dashboard – part one Core standards Getting the basics right

16 Reporting the Annual Review the dashboard – continued Developmental standards Making & sustaining progress

17 Timeline 2005/2006July 2004November 2004Spring 2005 DH published Standards for Better Health Phased implementation Start of 12 week consultation across England on our proposals for new systems of assessment Report back on the results of consultation: Summary on website Event participants receive a copy

18 How you can get involved For more copies of the consultation documents: call our help desk on All consultation materials are available at:

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