1. Patient Safety Conference National Clinical Effectiveness Committee
Dr Kathleen Mac Lellan
7th November 2014

2. Clinical Effectiveness
The extent to which specific clinical
interventions do what they are intended to do.
The Right care
In the Right place
At the Right time
With the Right information
Within available resources
The extent to which specific clinical interventions do what they are intended to do, i.e. maintain and improve the health of patients securing the greatest possible health gain from the available resources (NHS Quality Improvement Scotland (NHS QIS 2005)
Clinical effectiveness is thinking critically about what you do, questioning whether it is having the desired result, making a change to practice. It is based on evidence of what is effective in order to improve patient care and experience.

3. National Clinical Effectiveness Committee (NCEC)
Patient Safety First Initiative
Ministerial Committee – key stakeholders
ToR - Prioritisation and Quality Assurance of National Clinical Guidelines and Audit
Vision
Suite
National Clinical Guidelines
National Clinical Audit
Standards
Clinical Practice Guidance

4. Clinical Guidelines
“Systematically developed statements, based on a thorough evaluation of the evidence, to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances, across the entire clinical spectrum”
Provide guidance and standards for improving the safety, quality and cost effectiveness of care across healthcare services in Ireland
Implementation provides for a model of care that can reduce variability and improve quality of patient decisions
Implementation supports services in providing consistent evidence-based healthcare

5. Endorsement of National Clinical Guidelines
Prioritisation Criteria
Burden of clinical topic
Evidence analysis
Economic impact
Variability in practice
Potential for addressing
health Issues
Clinical guideline Implementation
STEP 1
Clinical Guideline Development Group
Submission of Clinical Guideline
to the NCEC
STEP 3
NCEC
Prioritisation of
Clinical Guideline
STEP 4
Quality assurance
of Clinical Guideline
STEP 5
Decision to recommend Clinical Guideline for endorsement
Dissemination, communication, implementation and audit of National Clinical Guideline
STEP 2
Clinical Guideline Screening Process
Minister for Health
Endorsement of National Clinical Guideline
Feedback to Guideline Development Groups
Quality Assurance Criteria
Feasibility
Scope and purpose
Rigour of development
Stakeholder involvement
Applicability/implementability
Clarity of presentation
Editorial independence
Guideline development group convenes
Via clinical programmes or other institutional links
Methodology & format varies
Guidelines submitted to NCEC (with checklist)
Prioritised +/- appraisal by NCEC
Feedback, if approved, endorsed
Time period, from submission to endorsement- minimum is 3/12 – (though likely much longer due to guideline development group needing to do edits)
Convening of guideline group
Tender or call for specific guideline
On-line liaison & registration to avoid duplication & confusion
Multi-disciplinary & comprehensive representation
Guidelines conform to NCEC template, including literature search, recommendation grading, consultation exercise, etc.
Time period for development 1-2 years
Submitted to NCEC - prioritised, +/- appraisal
Feedback; if approved, endorsed
Time period, minimum 3/12 from submission to endorsement

6. National Clinical Guidelines

7. Supporting Documents

8. Supporting Management Tools

9. National Clinical Guidelines – Implementation
Ministerial endorsement – health policy
HSE governance - Accountability Frameworks, HSE Service Plan, National KPIs (implementation and impact).
Regulation
HIQA - National Standards for Safer Better Healthcare
Professional regulators
Future licensing requirements
Alignment with Clinical Indemnity Scheme
Health insurers
Informed patients

10. Commissioned National Clinical Guidelines Sepsis Management
NCEC Symposium 26th Nov 2014
Commissioned National Clinical Guidelines
Sepsis Management
Chair Dr V Hamilton
Chair NSSC Dr F Fitzpatrick
Maternity Early Warning System
Chair Prof M Turner
Paediatric Early Warning System
Chair Dr J Fitzsimons
Clinical Handover
Chair Ms E Croke (Maternity services)
Chair Ms E Croke and Dr C Henry (Acute hospitals)

11. 2015 National Clinical Guidelines Clinical Practice Guidance
Establish Clinical Audit Function
Build Capacity
(programme of education; social media)
National and International Partnerships
Asthma
Palliative care - cancer pain; constipation
Cancer care – breast, prostate , gestational trophoblastic disease
2015

12. Where will future guidelines come from?
Planning for 2015+
Users – based on need e.g. clinical programmes
Driven by overall health priorities
NCEC Prioritisation Considerations
Patient Safety Issue
Burden of disease
Evidence analysis
Economic impact
Variability in practice
Potential for health improvement
Clinical guideline implementation
Weighting of Criteria
Everything cannot be accomplished at once
Uncertainty about the best use of resources
Specific improvement goals are sought

13.
@NCECIreland