IPT Quality Innovation Prevention And Productivity (QIPP)

Quality, Innovation, Prevention and Productivity (QIPP)

QIPP stands for Quality, Innovation, Productivity and Prevention and has been designed to complement not supplement policies such as World Class Commissioning, the nNational Service Frameworks, the National Institute for Clinical Excellence on CSII and The NHS Next Stage Review: High Quality Care for All Report. QIPP focuses on the NHS working in different ways to ensure that the highest quality care is delivered. It encourages efficiency and focuses on a 'joined up' approach to delivering healthcare.

Click Here for an image that highlights how the different components of QIPP intertwine together (source: NHS Institute for Innovation and Improvement).

QIPP Explained

See below for a full explanation of how implementation of the technology meets its overarching principles.

Quality

Implementation of the technology meets the 'Quality' aspect of QIPP as there will be possible reductions in hospital admissions, it facilitates reduced severe hypoglycaemia, it can delay the onset and slow the progression of various long-term complications - which can have a positive impact on diabetes services across the NHS and patients produce higher coping abilities and thus lower anxiety and depression scores.

The NHS Next Stage Review: High Quality Care for All document describes quality as needing to be consistently safe, clinically effective and personal. This can be categorised into three elements:

  1. Experience - Providing patients and carers with the best possible experience through their pathway. Patients should have access to services that are personalised and should feel that the staff who provide services care about what happens to them. Providing a quality service must induce a high degree of personalisation, compassion, dignity and respect.
  2. Safety - Getting the basics right, first time, every time and making sure that people are not harmed as a result of what is being delivered, is an essential component to delivering high quality healthcare. This relates primarily to patients but does also apply to the staff who are delivering the care and the environment in which it is being delivered.
  3. Effectiveness - Providing the best treatment available, ensuring that all our providers adopt NICE guidance appropriate to their services and we can see that they are providing clinically effective services because they demonstrate it through clinical audit and better outcomes.

Innovation

Implementation of the technology meets the 'Innovation' aspect of QIPP as Trusts become referring centres whereby patients can receive insulin pump therapy as routine clinical care (with patent choice at the forefront of the services delivered), type 1 patients with effective diabetes control can delay the onset and slow the progression of various long-term complications and insulin pump therapy introduces a high degree of service improvement as efficiency places itself high on the agenda.

Ensuring that the technology becomes embedded into the service requires the need to demonstrate the beneficial effect its implementation will have. Innovation is used in a variety of contexts in the NHS, but the focus here must remain on the delivery on a strong service improvement model, which is facilitated by the introduction of this technology and thus a revised model of care for diabetes patients.

Implementation may mean different things to different NHS organisations. It may be that implementation of the technology is taken forward by a local Diabetes Network across more than one hospital in a given area. A PCT may decide to take a regional approach to adoption. Innovation is this context is important - who is going to be the champion for change?

Prevention

This is a key part of the QIPP programme which recognises that if we prevent people becoming ill or getting sicker we will save lives, improve quality of life, add years to people's lives and prevent dependency on health services in the long term. Implementation of the technology not only lowers HbA1c for patients (thus improving quality of life for all), but it also has the potential to provide patients with higher coping abilities and thus lower anxiety and depression scores within a short space of time and associated morbidity.

There is also a case that The NHS Next Stage Review: High Quality Care for All document and nNational Service Frameworks (NSFs) and National Institute for Clinical Excellence (NICE) guidance. In practice this means that commissioned services must reflect the ever-growing expectations of the services being delivered from patients and their carers. Systematically involving patients will help to shape the delivery of the diabetes service and ensure that the is fully embraced. Communicating the benefits of the technology (e.g. introducing better general health for diabetes patients) to all stakeholders will be an important part in realising the benefits of implementation.

Productivity

Productivity is a measure of the output or outcome compared to the input. Quality and productivity are not mutually exclusive and through quality improvement programmes productivity usually gains. Productivity is, to some degree, the spine behind the QIPP agenda and is the strand that will highlight to Trusts if the implementation of the technology has achieved the anticipated benefits.

Essentially, the productivity strand of QIPP will mean that there will be possible reductions in hospital admissions (and therefore resource on local health economies), Trusts become referring centres whereby patients can receive insulin pump therapy as routine clinical care (with patent choice at the forefront of the services delivered) and it provides greater family cohesion and higher treatment satisfaction. There is also the potential to reduce follow-up appointments after a given point in time. Measuring the impact of the productivity strand will be an essential aspect of the implementation of this technology, and building it into the Trusts regular performance reviews will ensure that the process is governed appropriately.

Click Here to download a Service Requirement Document which highlights the de and re-commissioning processes that, if put in place, will be key indicators behind measuring productivity changes as a result of implementation of the technology.

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