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2015 News Archive

HQIP publish Quality Accounts 2016/17 list

CASC Director features in PPI case study

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CASC are delighted to announce that the voluntary work conducted by Director, Stephen Ashmore at Merridale Medical Centre has been published by HQIP as a best practice case study for involving patents. Stephen has chaired the Patient Participation Group (PPG) since 2014 and has helped the PPG to significantly strengthen governance arrangements for the group in that time. The terms of reference have been revised, new roles and responsibilities have been created and all members must sign a confidentiality agreement. In addition, the PPG expanded their membership to be more representative of the practice population and Stephen has helped the practice use clinical audit and in particular run charts to measure and better understand care delivered to patients. To access the case study, click here.

Congratulations to our junior doctor winners

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On 18th November, over 90 delegates and junior doctors attended our annual clinical audit and quality improvement awards day. The competition is a joint undertaking between CASC and HQIP and is now in its sixth year. Delegates were treated to a range of presentations from the likes of Dr. Ashley McKimm (Head of Innovation and Improvement, BMJ Learning) and Dick Moore (who recently delivered his first TED talk). Over 60 posters were showcased at the event and once again the standard of posters was exceptional. A total of eight awards were handed out and we would like to congratulate all our junior doctor winners (pictured). To see further details of the winners, click here. We have also created a storify that summarises the event and you can access this by clicking here.

CASC planning innovative local audit event

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Based on feedback that the CASC team have gained from our travels in 2015, we are considering running our first national clinical audit conference for over five years. We are concerned that focus appears to be moving away from local clinical audit and we therefore want to run an innovative event focusing on clinical audit and QI at a local-level. In terms of initial plans for the day, we want to give a platform to local experts, so if you consider that you could share useful information and examples of best practice, then please get in touch. We envisage the event will include a debate on national clinical audits and whether clinical audit has been reinvigorated. The event will also include a competition for local clinical audit and QI teams. We are looking at holding the event in April/May 2016 and costs will be approximately £120 (including VAT) per person. If you are interested in speaking at the event, have ideas for particular speakers/topics, or would be keen to take part in the competition, please get in touch via info@clinicalauditsupport.com

Must read: NAGCAE 2014-15 annual report

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Despite very little fanfare, the National Advisory Group for Clinical Audit and Enquiries (NAGCAE) recently published their 2014-15 ten page annual report. CASC consider this a MUST READ document for all working in clinical audit and QI as it clarifies NAGCAE’s working arrangements and details the advice they have supplied to NHS England. The document focuses almost exclusively on national clinical audit and identifies ‘a need to expand the current portfolio of around 60 NCAs’. The document also states ‘even the best of the 60 NCAs that exist have the scope to improve and enhance impact’. Sections 4 ‘increasing the use of NCAs’ and 5 ‘improving the strategic management of NCAPOP’ will be of significant interest to anyone involved in national clinical audits. To read the NAGCAE 2014-15 annual report, click here.

High praise for CASC’s recent SEA training

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CASC are delighted to report that a series of significant event audit (SEA) training workshops commissioned by NHS England have received excellent feedback. The workshops have been primarily aimed at general practice staff expected to use SEA to enhance patient safety and share key learning points. The workshops mix theory, practical tasks and best practice case studies to help practices deliver significant event audit that both meets CQC expectations and also enables GPs to show competence to appraisers and help meet revalidation requirements. Feedback from attendees has been positive with many comments similar to ‘this has really made me think about how we carry out significant event audit’ and ‘chance to review our processes and identify changes we will adopt’. CASC believe SEA could often be used as an alternative to the more lengthy root cause analysis so contact us if you would like to know more about our accredited SEA courses.

Summary of Clinical Audit Awareness Week

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The third annual clinical audit awareness week (CAAW) took place from 9-13 November, with a variety of events taking place across the clinical audit and quality improvement community. CASC supported CAAW in many ways: delivering a training session in London on 10th November and presenting change pyramids as an alternative to action plans at the East Midlands conference on 11th November (pictured). CASC also delivered a twitter-thon on 13th November and we contributed over 30% of #CAAW tweets. Sadly no one managed to crack our twitter treasure hunt but congratulations to Jen Knight who solved the crossword. We also supplied two new podcasts: one from our blogger plus an in-depth review of the recent clinical audit conference in Birmingham on 7th October. To find out more about CAAW, search #CAAW on Twitter.

CASC Jobs report: significant rise in vacancies

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As you may be aware, since July 2009 CASC have published a regular clinical audit job vacancy bulletin. In the corresponding 72 months since this was launched, 170 bulletins have been released listing over 800 vacancies. Every year the CASC team review the data and produce an annual report. Figures for 2014/15 show a significant rise in advertised clinical audit vacancies up from a low of 92 in 2011/12 to a record high of 189 in the last twelve months. Data indicates that the number of temporary vacancies has dropped sharply from a high of 37% in 2012/13 to 18% in 2014/15. The report also identifies that unlike Primary Care Trusts, Clinical Commissioning Groups do not appear to be recruiting clinical audit staff. To read the full report, click here.

June NAGCAE minutes identify threat to NCAPOP

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The June NAGCAE meeting minutes have recently been published and include a number of important updates for those working in clinical audit and QI. Anyone involved in national audits should take a close look at Section 2.2. The minutes state the following: ‘HQIP was still experiencing long delays obtaining NCA data which was having a detrimental effect on the national programme and HQIP’s work. This is resulting in delayed audit reports. Information governance is becoming increasingly complex and threatens the delivery of NCAs’. Section 2.2 identifies that HQIP are looking to engage an information governance expert to support their work and that responsibility to resolving matters lies with the Data Services Panel. To read the NAGCAE minutes, click here.

Book now for junior doctors audit and QI event

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Those of you working with junior doctors on clinical audit and QI projects may wish to book onto our Finals Day event taking place in Leicester on 18th November. This is a joint initiative between CASC and HQIP and showcases the best clinical audit and quality improvement projects submitted to the national competition now in its 6th year. There will be over 50 clinical audit and QI posters displayed and we are delighted that previous winners from 2014 will be back to formally present their work. In addition to the junior doctors we have an excellent line-up of speakers, including Prof Keenan (HQIP Medical Director), Carl Walker (NQICAN chairman), and Dr. Ashley Walker (Head of Innovation and Improvement, BMJ Learning). Dick Moore (who recently delivered his first TED talk and pictured) and James Hilton from the Art of Brilliance will also be presenting. Delegate places cost no more than £150 including VAT) and there are discounts available if you have a junior doctor finalist. For more details, click here.

CASC support for audit awareness week

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Following HQIP’s announcement that the third annual clinical audit awareness week (CAAW) will take place from 9-13 November, CASC are delighted to be able to provide an update of how we will be supporting this event. Once again we have created a crossword (click here) for your clinical audit tea breaks and we will be running another twitter treasure hunt. In addition, over the course of the week we will be releasing podcasts from our blogger Acus Puncto and a review of the recent clinical audit conference in Birmingham. On 10 November the CASC Directors will be delivering a clinical audit masterclass in London and this will be followed by our involvement at the CASNET clinical audit event in Leicester on 11 November. We will also be releasing information on new accredited courses plus we will be taking to Twitter with daily polls and a live Twitter discussion on Friday 13 November from 9-11am. For more details, click here.

‘State of clinical audit’ report published

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The full report for CASC’s annual ‘State of Clinical Audit’ survey is now available with the 18-page document providing a full account of over 100 survey responses received in December 2014. Highlights include: a rise in respondents stating they feel more positive about clinical audit (45.5%) than a year ago (39.9%) and the Sentinel Stroke National Audit Programme being voted ‘the most effective national audit’ for the fifth consecutive year. The proportion of NCA’s rated ‘excellent/good’ dropped below 30% for the first time in our survey and successful patient involvement in clinical audit remains a concern with just 6.4% of respondents classifying patient involvement in audits as ‘good’. To read the full report, click here.

New HQIP website goes live

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On 22nd September the Healthcare Quality Improvement Partnership simultaneously announced and showcased their new website. The new website has been designed following feedback from HQIP’s stakeholder groups and aims to ensure that users are now able to access the information they require quickly and easily. According to HQIP the new website is based around a dynamic filtered search system that allows users to define information by audience type (e.g. patient, clinician, QI professional) or by resource type (e.g. reports or guidance, etc.). HQIP are keen to receive feedback on the new website so please get in touch with them, From a CASC perspective the new website looks clean and professional and we look forward to the opportunity to browse the new resource in the future. For full details of the new HQIP website, click here.

New HQIP QI methods guide now available

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CASC would encourage all staff involved in the delivery of clinical audit and quality improvement to download a copy of the new Quality Improvement Methods Guide that is now available via the HQIP website. The guide was published in June 2015 and is 35 pages in length. Key methods discussed within the guide include: clinical audit, plan do study act, model for improvement, lean/six sigma, performance benchmarking, failure modes and effects analysis, process mapping, statistical process control, root cause analysis, etc. The guide signposts those working in commissioning and using healthcare services to a broad range of quality improvement methods. Take a look, via the HQIP website.

CASC surveys now underway

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CASC have embarked on an initiative to gain feedback from learners who have successfully gained accreditation via our training courses. This is an ambitious project, not least as many learners gained accreditation over five years ago and may now not work in healthcare for a variety of reasons. We have set up a series of SurveyMonkey questionnaires to collect the relevant data and these have now been sent to all those who gained the Open College Network certification on either Advanced Clinical Audit, Train the Trainer in Clinical Audit or our distance-learning course. If you have not received a link but attained the accreditation for one of these courses and would like to give feedback, then please contact us via info@clinicalauditsupport.com

RCA guide nears completion

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CASC are delighted to report that following on from the 2014-15 training sessions commissioned by HQIP focusing on how to maximise the impact of clinical audit via root cause analysis techniques, the associated guide is nearing completion. The guide is set to be in excess of 40 pages and features ten RCA tools and techniques, including: brainstorming, cause and effect (fishbone), change analysis, the five whys, nominal group technique, process mapping, pareto analysis, run charts, etc. The guide also includes a useful further reading list and a number of RCA templates. In addition to the publication of the guide, CASC and HQIP will be running two webinars.

CASC call for clinical audit ‘antiques’!

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CASC recently delivered a training session in Harrogate and visited the White Hart Hotel – where both Tracy and Stephen received their initial audit training from PMK Associates in 1994-95. It led us to reminisce on many of the excellent materials and resource that were available for medical/clinical audit in the 1990s. Believe it or not, the British Medical Journal featured Audit in person in every issue and this excellent article by Firth-Cozens and Venning from 1991 entitled “Audit officers – what are they up to?” includes a conclusion that is as valid and intelligent today as it was over two decades ago! We’d particularly like to track down any of the following audit antiques: copies of Audit Trends magazine, old Eli Lilly National Clinical Audit Centre protocols, Clinical Audit Association materials, e.g. copies of NETWORK newsletter and materials from previous Auditorium events! If you have any of these to hand, please get in touch! Click here to read the Audit in Person article from 1991.

CASC observe a rise in audit vacancies

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As many of you will be aware, over the last five years CASC have published a fortnightly clinical audit jobs bulletin and corresponding annual report focusing on the clinical audit jobs market. CASC are pleased to announce that we have observed a significant increase in clinical audit vacancies in 2014-15 compared to 2013-14 with the jobs bulletin number 168 being a good example of this with 12 vacancies, including 6 offering over £30,000. We also note that recent HQIP adverts for new staff: a Senior Project Manager for the Consultant Outcomes Publication (£46K to £57K) and a NCAPOP Project Manager (£30K to £48K). As usual, CASC’s annual report on clinical audit jobs will be published over the summer.

Significant departures at HQIP and NICE

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Experienced clinical audit and quality improvement staff across the country will doubtless at some time or other have contacted HQIP’s Quality Improvement and Development Team (QID) or NICE’s Clinical Audit Team. In recent times there have been some important changes with Liz Smith (Quality Improvement and Development Facilitator) retiring in January and Kate Godfrey (pictured and Director of Operations for QID) leaving in May. We have also been informed that Kirsty MacLean-Steel (Audit Programme Manager at NICE) is taking up a new role at NCEPOD and that the NICE Clinical Audit Team will cease to exist in the coming weeks. For more information on support for clinical audit from NICE, please click here.

CQC speaker outlines the importance of clinical audit

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On 25th March 2015, CASC were fortunate to observe a keynote presentation by Karen Bennett-Wilson (Head of CQC Inspection for Mental Health and Learning Disabilities) as part of Leicestershire Partnership Trust’s annual clinical audit conference. Mrs. Bennett-Wilson repeatedly stressed the importance and value of clinical audit and she noted that when the CQC ask ‘is the service effective?’ they focus attention on national clinical audit data and the local audit projects. Further, Mrs. Bennett-Wilson identified that the CQC were increasingly looking for evidence of re-audits that show improvements in patient care. To conclude her keynote talk, Mrs. Bennett Wilson discussed common findings from recent CQC inspections and these included: evidence that some Trusts do not participate in national audits and limited local audit functions with particular failure to learn from findings and conduct re-audits particularly noted.

OCNWMR report praises CASC training courses

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At the start of the year OCNWMR conducted a review of CASC’s accredited courses and produced a subsequent monitoring report. The review of management and administration, staffing and resources and procedures and policies found CASC to be fully compliant. Previous actions requested by OCNWMR had been effectively implemented by the CASC team and the report concluded ‘The Internal Verification process is working well. The courses provided by Clinical Audit Support Centre Ltd. are an excellent example of good practice in on-line assessment and the learner achievement is of a high standard. The support provided by the CASC assessor is supportive, informative and constructive and the internal verification robust’. Whilst delighted with this feedback, CASC plan to make a number of subtle changes in coming months to improve our accredited training further. If you are interested in finding out what courses CASC offer, click here.

Twitter watch: doctor signs for clinical audit

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With 36% of respondents to stating via our clinical audit annual survey that they have their own twitter account it is clear that more and more clinical audit and QI information is appearing on social media. CASC have held a Twitter account for a number of years and we regularly search twitter for useful information. With this in mind we would encourage you all to take a look at the inspired work of Dr. Tapas Mukherjee that has gained prominence on social media. Dr. Mukherjee conducted an audit at Glenfield Hospital (Leicester) in 2012 and subsequently created a five-minute music video to highlight the results of the audit and improve practice. The video has won a number of awards, gained attention from BBC, ITV and TIME magazine and been viewed over 75,000 times. To take a look, click here.

NAGCAE recommend independent review of NCAs

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For those of you involved in national clinical audit, it is worth reading item 5 in the December 2014 NAGCAE minutes entitled ‘NCA Quality Assessment Framework’. This relates to the ‘audit of audit’ work carried out by HQIP at the end of 2014 whereby all NCA suppliers were invited to complete a self-assessment survey – click here for more details. NAGCAE’s response in their minutes is: ‘members were concerned about some for the value judgements that were included in the summary reports of each NCA. It was suggested that such subjective judgements be removed’. The NAGCAE minutes continue: ‘NAGCAE reiterated their previous view that while this initiative was a reasonable first step, the process of assessing NCAs needed to be made more rigorous, based not only on self-assessment but also on an independent review in a standardised way’. The minutes conclude with NAGCAE offering to help and advise on how a more transparent, rigorous approach could be developed and implemented. To read the minutes, click here.

CASC produce short film to support #hellomynameis campaign

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Many of you will be aware of the inspirational #hellomynameis campaign led by Dr. Kate Granger. The campaign emerged as a result of Dr. Granger’s personal experiences of healthcare and her repeated observations that many healthcare professionals who she encountered did not introduce themselves to her. CASC are delighted to announce that as part of the junior doctor finals day in November we worked with Kate and her junior doctors colleagues to create a short film that highlights the need for healthcare staff to introduce themselves to patients (something Kate describes as an ‘always event’). The film is accessible by clicking here and we both encourage and challenge all clinical audit and QI professionals to raise awareness of Kate’s campaign.

What Black and Keenan said at the national audit conference

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Prof Nick Black (Chairman of NAGCAE, pictured) provided similar messages to those he has given in previous years: e.g. - people at the ‘top’ in the NHS now understand what audit is and value it, national audits must continue to improve with a particular need to make NCAs more valuable at a local-level and ‘I think the future of clinical audit is bright’. Prof Black also re-iterated his view that all Trusts should have a board-level Chief Quality Officer and asked ‘what would the public think if they knew few Trusts had non-executive directors with experience of managing quality’? Over the course of the conference, Professor Keenan (HQIP Medical Director) delivered a number of excellent and honest talks. Highlights included his overview of the recent HQIP ‘Audit of audits’ that has identified many themes including ‘patchy patient involvement in NCAs’, ‘only 10% of NCAs relevant to primary care’, etc. He stressed that HQIP are working hard to improve the quality of NCAs. Danny also stated that local audit professionals have a vital role to play in terms of helping HQIP: (a) suggesting feedback and ideas to improve national audits and (b) suggesting ideas in terms of how HQIP can help local clinical audit professionals.

CASC deliver final two RCA for clinical audit workshops

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On 20th and 21st January the CASC team visited Manchester to facilitate the final two HQIP commissioned workshops focusing on how to maximise the impact of root cause analysis on clinical audit. Both workshops proved a great success thanks to keen and eager participants prepared to consider how RCA problem solving tools such as the fishbone diagram, five whys and run charts could be add value to clinical audit. CASC have now facilitated 8 workshops in Birmingham, Bristol, Leeds, London and Manchester with 98% of respondents stating that they would recommend the training. If you would like this course delivered in-house then please get in touch. CASC are now working on a guide book to accompany the training and further details relating to this will be featured via the CASC website

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