Policy

We've put together a usefull table, giving you an overview of how implementation of this technology will impact on key policy areas, from its impact on quality of care, compliance with National access targets, to improved surgical outcomes. Effective implementation of this technology will support the challenge of ensuring that the NHS continues to improve quality of care during a period in which growth in expenditure on the NHS will be restricted.

Policy Areas & Performance Measures

Policy Area Affected Performance Measure
Measuring for quality improvement (High Quality care for all) Emergency readmission to hospital within 28 days
Quality and Productivity Challenge Length of stay / bed day savings
CQUIN Framework Allocation of providers' contract income to the achievement of locally agreed plans for achieving higher levels of quality
Operating Framework 2009.10 Improved patient experience, improvement in quality, effective use of resources and collaboration
Healthcare acquired infection Reducing the infection risk from use of catheters
Enhanced Recovery Partnership Programme 18 weeks target & length of stay
Measuring surgical outcomes Patient related outcome measures
18 weeks programme All patients receive high quality elective care without any unnecessary delay with a maximum time of 18 weeks from the point of initial referral up to the start of surgery

NHS Operating Framework

Ths operating Framework gives a brief overview of the priorities for the NHS next year. It is accompanied by annexes which provide more detail on the priorities, how they are measured and how the new arrangements for managing the system will work.

Implementation of Doppler guided intraoperetaive fluid management will impact on the following priority areas

  • Reducing the risk of healthcare associated infections
  • Improving access through achievement of the 18-week referral to treatment pledge and improving access
  • Improving quality of care and clinical outcomes
  • Improving the patient experience

To download the operating framework 2010-11: for the NHS in England - this includes Annexes A (Planning process timetable), B (Existing commitments) and C (Vital signs) (PDF, 1322K) Click Here

High Quality Care for All

High Quality Care for All and the local visions developed by Strategic Health Authorities that accompanied it set an ambitious goal of putting quality at the heart of the NHS by making it its organising principle.

The quality agenda demands a shift from a monolithic, top-down, one-size-fits-all service to a more open, localised and responsive system focused on the needs of individual patients, committing the service to providing high-quality services and to continuous improvement in quality.

To learn more about the Next Stage Review implementation Click Here

The Quality Framework

The quality framework supports local clinical teams to improve the quality of care locally by:

  • Bringing clarity to quality - making it easy to access evidence about best practice by asking NICE to develop quality standards
  • Supporting clinicians to measure quality to support improvement
  • Requiring quality information to be published, making it available to the public and making it as important to NHS chief executives as it has always been for NHS staff
  • Rewarding the delivery of high quality care
  • Safeguarding basic standards through a new independent regulator, the Care Quality Commission
  • Staying ahead by ensuring that innovation in medical advances and service design is fostered and promoted
  • Recognising the role of clinicians as leaders and giving them the freedom to drive improvements in quality of care

The Improving Surgical Outcomes Group (ISOG)

The Improving Surgical Outcomes Group (ISOG) is an independent medical group comprising surgeons, anaesthetists, critical care consultants and others involved in operative management and care. The group is concerned with improving patient outcomes and modernising care for patients undergoing major surgery. In June 2005 the Group produced a report entitled 'Modernising Care for Patients Undergoing Major Surgery'. It highlights that 20,000 patients die every year in the NHS following surgery. The report also includes recommendations for how surgical care should be modernised, including the introduction of haemodynamic optimisation. Professor Monty Mythen, of ISOG and Portex Professor of Anaesthesia and Critical Care, University College London has said, "This is just the sort of technique that we are trying to encourage hospitals across the UK to adopt."

To review the ISOG report Click Here

Enhanced Recovery Programme

The Enhanced Recovery Programme is undertaken in partnership with the NHS Institute for Innovation and Improvement, NHS Improvement, the NHS Cancer Action Team, the 18 Weeks Implementation Team, and the Department of Health.

Enhanced Recovery Programmes (ERPs) - often referred to as Rapid or Accelerated Recovery - are evidence-based approaches to care. They are multidiciplinary multimodal care packages that seek to prepare patients for, and reduce the total impact of, surgery, helping them to recover more quickly.

For more information Click Here

Measuring Surgical Outcomes

The Royal College of Surgeons of England is developing improved methods of ensuring high standards in surgical practice through public reporting of operation outcomes.

The College is piloting a system of patient reported outcome measures (PROM's) . Funded by the Department of Health PROMS will be reported in all patients undergoing hip, joint, hernia and varicose veins will be covered and this will account for 250,000 operations a year. This work will combine with the work the college is doing in refining surgeon reported outcomes to give a more holistic picture of what the best surgery can deliver for patients.

The surgical specialties are now identifying the "indicator" operations that would give a sound judgment of skill and are done by enough of their surgeons to be good comparators. Some, such as orthopaedic and general surgery, also have past experience in registering outcome and are consolidating this material. This puts them in a strong position to follow the cardiac surgeons lead.

For more information Click Here

Winning ways: working together to reduce healthcare associated infection in England

This report sets out for the local NHS a clear direction on the action necessary to reduce the relatively high levels of certain healthcare associated infections and to curb the proliferation of antibiotic resistant organisms.

Healthcare associated infection was one of the areas identified as needing intensified control measures in the Chief Medical Officer's "Getting ahead of the curve: a strategy for combating infectious diseases". Information about healthcare associated infection and antimicrobial resistance has been clearly communicated by the Department of Health to the NHS over the last five years. The Government has invested substantial sums in improving the patient environment. Despite the extent of the guidance issued to the NHS, such data as are available show that the degree of improvement has been small. This report sets out for the local NHS a clear direction on the action necessary to reduce the relatively high level of certain healthcare associated infections and to curb the proliferation of antibiotic resistant organisms.

For more information on Winning Ways: click here

Transforming Inpatient Care - Spreading the winning principles and good practice

Winning Principle 2: All patients should be on a defined inpatient pathways based on their tumour type and reasons for admission. Different approaches have been tried and tested that have successfully supported the above principles and realised the following benefits:

  • Promotes length of stay management in contrast to bed management
  • Values patient's time and sets patient expectations
  • Effective and efficient use of bed capacity
  • Reduces length of stay to match the appropriate stay required for treatment and care
  • Shifts care to alternative appropriate care settings
  • Supports changes in clinical practice and clinical decision making
  • Reduction in the duplication of tests
  • Reduction of inappropriate diagnostic tests.

Winning Principle 2 also includes Enhanced Recovery.

For more information Click Here

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