HIStranet - CQC Auditing Tool

by Leicestershire Health Informatics Service 18. December 2013 11:51

The Care Quality Commission (CQC) is an independent regulator of health and adult social care services provided in England. The purpose of CQC is to ensure that the care provided by service providers such as GP practices, hospitals, dentists, ambulances, care home and home-care agencies meet government standards of quality and safety and also protect the interests of vulnerable people.

The commission took over the work of three previous regulators: the Healthcare Commission, which inspected the NHS as well as private and voluntary healthcare providers; the Commission for Social Care Inspection; and the Mental Health Act Commission. That means it has responsibility for ensuring hospitals, care homes, dentists, GPs and care homes are safe and that they offer high-quality compassionate care. Health and social care providers also have to register with the organisation to operate.[1]

As a requirement of Section 23 (1) of the Health and Social Care Act 2008, the CQC was introduced as part of a wider framework that includes regulation of professionals in a health and social care environment such as nurses, doctors and support staff. The framework is designed to ensure that people who use services are protected and receive the care, treatment and support they need.

The CQC have produced a set of 28 essential standards, each with an outcome relating to the quality and safety of care which is provided to the service users. Service providers have to ensure that they meet the mandatory outcomes which include outcomes such as consent to care and treatment, management of medicines, cleanliness and infection control and care and welfare of people who use services. Inspections of the services can be carried out impromptu and therefore encouraged to continuously refer back to the outcomes to ensure they are being met.

·        The LHIS HIStranet is a tool which can help service providers monitor the quality and safety of the services that are provided and comply with CQC audits. The assessment tool which can be accessed by all staff in your service has the following features: A specially designed Document Library tool which can link policies and documents within the HIStranet site directly to the CQC outcomes.  All CQC related items can then be viewed in its own outcome section in mandatory and non-mandatory areas, easily identifiable and accessible for CQC relevance for audit visits and evidencing. 

·        The Intranet system is typically used to replace the shared drive approach of storing organisational folders and files which can become an overhead in terms of managing and organising the information, easy search functions, tagging capabilities and simple navigation to assist the end user with locating information easily.

·        Auditing tool (which can be used with a workflow and alerts function) to ensure there is evidence to suggest that all members of staff or appropriate bodies have access and read / viewed or contributed to the supporting resources enabling CQC outcomes to be met.

·        Notifications and Alert functionality to prompt for attention on urgent and / or CQC related matters

·        Browser based technology used which provides an interactive end user experience

·        Reporting capabilities for audit requests and evidencing

The CQC also advise that as part of the preparation of the inspection, an assessment tool is used to assess and monitor the quality of service that is being provided. The tool can ensure that all members of staff are aware of the outcomes that need to be met by the service provider which can be monitored using an audit tool or by reviewing and acting on people’s feedback through comment cards or surveys. Breaching these outcomes would mean that the service provider would have to take action to ensure they improve and provide proof that they will. If service providers do not improve CQC can take further action called enforcement action, although this is dependent on the outcome that was breached, the action could involve restricting the services that the provider can offer, stopping admissions or even prosecution.

For more information about LHIS’s HIStranet product which supports CQC document management requirements, please contact info@leics-his.nhs.uk.

For more information about CQC, you can visit their site at http://www.cqc.org.uk/.

[1] http://www.bbc.co.uk/news/health-23005279


Is telehealth what we’ve all been waiting for?

by Leicestershire Health Informatics Service 29. September 2011 09:13

NHS health IT systems have been getting a bit of a bashing lately. They tend to feature in bad news stories in the media and the recent announcement by the Department of Health, that it is planning to breakup the National Programme for IT, hasn’t helped to improve their reputation. Which is why you may be surprised to hear that not all NHS health IT projects have been a disaster; in fact a number of them have significantly improved NHS services, including:

The Spine - a national database which provides hospitals with key health information about us in an emergency 

N3 - the NHS national broadband network which allows fast communications between hospitals, medical centres and GPs

NHS Mail - a secure email account for all NHS staff helping to keep our patient data safe

Choose and Book - the national electronic referral service gives patients a choice of place, date and time for their first outpatient appointment in a hospital

The Secondary Uses Services - provides access to anonymous patient-based data for healthcare planning

The Picture Archiving and Communications Service– which enables health professionals to acquire, store, retrieve, present and distribute medical images such as x-rays in a matter of minutes rather than days

The Electronic Prescription Service – the EPS is being rolled out right now and will enable GPs to send prescriptions electronically to a pharmacy of the patient's choice

Health IT can and does provide data, save costs, ensure information stays secure and improve services for patients - and those same qualities are what the latest health IT pioneers are looking for in their quest to move towards a greater use of telehealth in the NHS. Telehealth involves using technology to help people manage their health condition in their own home (as opposed to telecare which tends to be used to describe social care in the home provided by local authorities). 

NHS Yorkshire and the Humber is at the forefront of the UK’s latest advances in NHS telehealth provision. In their booklet Teleheath: leading innovation in healthcare they state that telehealth technologies can play a major role in delivering new models of care and enable patients to manage their health in their own home or community. Seen as a cost effective and innovative alternative to hospital and GP surgery attendance, telehealth is also being used in the north east in settings such as care homes and prisons. NHS Yorkshire and the Humber a running a range of different telehealth projects that are yet to be fully evaluated, but the results for one of them look very promising. Evaluation of the Hull Heart Failure Telehealth Project by the University of Hull suggests that by telemonitoring 140 patients with heart problems they are averting approximately 14 hospital admissions per month. This translates into substantial savings for the local NHS and massive improvements for patients who have not had to face the terrifying experience of being rushed to A&E with heart failure.

Interestingly more recent research into using telehealth to reduce hospitalization of patients with heart problems actually improves on the University of Hull data. The article Automated home telephone self-monitoring reduces hospitalization in patients with advanced heart failure, published in the Journal of Telemedicine and Telecare this month, compared hospitalisation form three groups of patients with advanced heart failure. One group of patients received usual care, another group received a multi-disciplinary team approach, and the group who were given home telephone self-monitoring had reduced levels hospitalization of around 50% when compared to both of the other groups.

But what we are all waiting for is the outcome of the largest randomised control trial of telecare and telehealth in the world to date. The results from the Whole System Demonstrator (WSD) Programme, a recent research project funded by the Department of Health, are under evaluation and expected to be published later this year. In the meanwhile you can read a quick intro to the project in their booklet, Whole Systems Demonstrators: An Overview of Telecare and Telehealth which details the equipment used in the telehealth trials including blood pressure monitors, weighing scales, pulse oximeters to measure blood oxygen levels and/or heart rate, blood glucometers to measure an individual’s blood sugar level and spirometers to measure the volume of air inhaled and exhaled by the lungs.

The WSD programme is a broad study exploring telehealth options for people with heart failure, diabetes and chronic obstructive pulmonary disease (COPD) – three of the common long-term conditions that affect millions of patients in the UK. People with long term conditions are the most frequent users of healthcare services. They account for 29 percent of the population, but use 50 percent of all GP appointments and 70 percent of all inpatient bed days. If telehealth can help them to manage their condition and reduce their need to visit their GP or be admitted to hospital, it could have a major impact on the NHS economy.

All in all, it’s starting to look more and more like telehealth could be exactly what patients and the NHS are looking for.  If the WSD programme results confirm the expected improvements in patient satisfaction, together with cost savings to the NHS, then expect to see telehealth coming to a living room near you soon! 

More telehealth links:

Telehealth stories

Telehealth story podcasts from patients and health professionals on the Patient Voices website

Mainstreaming telehealth to enable QIPP

A series of videos recorded at an NHS Confederation workshop in 2010 about how telehealth can help NHS organisations to meet their quality, innovation, productivity and prevention (QIPP) targets


About the author

Rupal Patel, blogging for NHS Leicestershire Health Informatics Service, your one-stop-shop for information management and technology. Writing about some of the work we do, discussing IT issues, introducing some of our terriffic staff and generally shedding a little light on the world of health informatics. Visit our website at: www.leics-his.nhs.uk

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