1. RESPIRATORY SERVICES & RESPRIATORY SERVICE FRAMEWORK
Dr Muhammad Sartaj
Consultant Public Health,
Public Health Agency

2. Content Quality of Respiratory Services
Role of Revised Respiratory Framework
Respiratory Diseases &Examples of standards for Asthma
Implementation and Way forward

3. Focus on Quality not Performance
to identify individual failures. Systems should not rely on single sources of data but should use a range of information. Consumers should be prominently involved, and the results of assessments should be transparent and freely accessible to the public.

4. Bring clarity to quality
Bring clarity to quality. This means being clear about what high quality care looks like ….
Quality is systemic. It is not the responsibility of any one part of the system or, indeed, any one part of the HSC Commissioning. Rather, it is a collective endeavour, requiring collective effort and collaboration at every level of the system in order to safeguard patients and drive continuous quality improvement.
Institute of medicine 2001 definition

5. PATIENT AND CLIENT FOCUS
Quality of Service
SAFETY
EFFECTIVENESS
PATIENT AND CLIENT FOCUS

6. Productivity and value
Quality Chain
Leadership
Internal Quality
Staff satisfaction
Productivity and value
Patient Satisfaction
Adaptation of the service-profit chain at Sears, Harvard Business School, January-February 1998, pp83-97

7. Where to begin?
“If I had to reduce my message for management to just few words. I would say it all to do with reducing variation”
W Edward Deming.

8. What is a Respiratory Service Framework
Framework is subject to review and refinement in the light of new evidence.
‘Respiratory service framework sets standards in relation to the prevention, diagnosis, treatment, care, rehabilitation and palliative care of individuals and communities at a greater risk of developing respiratory diseases’
DHSSPS 2014
Each standard is supported by levels of KPI to be achieved over 3 years

9. AIM OF THE FRAMWORK Improve health and wellbeing;
Reduce inequalities in health;
Promote social inclusion;
Transparent standards of care, on behalf of public;
Reduce variation in treatment and care;
Link public health with quality and safety of care;
Safeguard vulnerable individuals and groups; and,
Improve partnership working with other agencies/sectors.

10. Key Stakeholders The public; HSC organisations and other providers;
Commissioners – HSCB/PHA and LCGs;
Voluntary, community and independent sector;
RQIA; and,
DHSSPS/Minister.
Tra
Travellers life expectancy is around 20% lower than the general population. Only 10% of the Traveller population are over 40 years and only 1% are aged over 65 years

11. Patient/client Pathway
Prevention / Promotion
Protection /Lifestyle
Assessment & Diagnosis
Treatment
Ongoing Care / Chronic Disease
Management
End of Life Care /
Palliative Care
Discharge/Completion of Care

12. Structure of Framework
Overarching Health Promotion and Patient and Public Participation standards
Disease specific standards
Standards relating to all conditions

13. Health Development
Smoking
Weight
Physical activity
Immunisation

14. Specific diseases COPD Asthma Community acquired pneumonia
Obstructive Sleep Apnoea
Long Term Ventilation
Cystic Fibrosis
Bronchiectasis
Interstitial Lung Disease

15. Standards relating to a number of diseases
21-Sections
46-Standards,
168-KPI's
Pulmonary rehabilitation
Acute Oxygen therapy
Transitional services
Social and emotional support
Training
Medicine Management
Information

16. 2-Sections 8-Standards, 38-KPI's
Standards for Asthma
2-Sections
8-Standards,
38-KPI's
Cover Adult and Paeds Asthma
Eight Overarching standards
Diagnosis
Self-management
Ongoing management
Management of acute sever asthma
Difficult asthma

17. Implementation Structures
Regional Respiratory Forum
Patient Reference Group
Project Groups
5 Trust Respiratory Forums
Regional Paediatric Asthma, Allergy & Anaphylaxis Group

18. Next Step a phased approach to implementation.
To fully implement all standards for which there is already a data source in year 1
For the remaining standards, appropriate steps to be taken to establish data sources and baselines.
Performance levels for these standards are to be determined once baselines had been established.

21. Service Frameworks
Joan O’Hagan
22 April 2015

22. Asthma: The Problem 182,000 people in Northern Ireland have asthma
146,000 adults and 36,000 children
30 deaths adults(2012)
972 emergency hospital admissions for adults (2012/13)
680 emergency hospital admissions for children and young people (2012/13)
Inconsistent care across Northern Ireland

23. Role of Asthma UK Northern Ireland
Member of Regional Respiratory Forum and all sub-groups to influence as appropriate
Commissioned by DHSS/PS to obtain user/carer views to inform development of standards for the first framework (in partnership with NICHS)
Contributed to development of Easy Access version
Commissioned to independently monitor certain standards in first framework
Continue to seek and champion user views to identify gaps in revised framework

24. Future role of Asthma UK Northern Ireland
More of the same
Target service specifically/implementation
Focus on NRAD recommendations
Hopefully commissioned by PHA to independently monitor standards in the course of this revised framework

25. Any questions?