1. NHS Quality Assurance Framework
The Quality Assurance (QA) work of the NHSP Programme Centre is overseen by the NHSP QA Board. The Board meets quarterly and its membership is a mixture of executive and non-executive members from Hearing Screening, Audiology, Medicine and Early Intervention backgrounds. In addition there are non-executive members from Health Visiting, Midwifery, Public Health, Voluntary Sector, Children's Services and Newborn Hearing Screening Wales, Scotland and Northern Ireland.
The Quality Assurance framework encompasses the following elements:
- Quality Standards and monitoring programme performance against the standards
- Quality Assurance (QA) Programme
- Quality Improvement
- Risk and Incident management
Click here to access the QA Board Terms of Reference
2. NHSP Quality Standards and Performance Monitoring
The NHSP Programme Centre is responsible for setting and resetting the national NHSP Quality Standards which cover the entire care pathway.
The purpose of the NHSP Quality Standards is to ensure that:
- Families are able to make informed choices about screening uptake
- Screening and diagnostic services are effective and carried out to a high standard
- Results are communicated to parents/guardians effectively
- Families are given comprehensive support post-diagnosis
- Responsibilities for recording and reporting performance are clear
Key performance data is available via a series of reports from the NHSP information system, eSP, and NHPS Trends. NHSP Trends is an on-line system that allows providers and Directors of Public Health/SHA's to benchmark their performance and monitor improvement over time, compare their services with national standards. This can be done at specific screening site and primary care trust level to facilitate national ranking of local programme performance. Please refer to the Guidance notes for Service Providers .
3. Failsafe Processes
A document on Failsafe Processes in the NHSP screening pathway has been developed through the work with the Cross Programme Quality Assurance group of non cancer screening programmes. This document identifies the known risks in the screening care pathway and describes the process taken to mitigate each risk. All the failsafe processes described in this document are already undertaken by the local managers and these processes (tasks) are listed against each of the failsafe points. The document clearly demonstrates the reason for performing these tasks and the importance of ensuring that the tasks are undertaken on a regular basis for quality assurance.
4. NHSP Quality Assurance (QA) Programme
The NHSP Quality Assurance (QA) programme aims to assess each service to ensure that:
- Commissioned services meet the needs of children and families
- Governance structures and strategic partnerships are in place
- The entire care pathway is delivered in line with Quality Standards and family friendly practice
- There is a quality improvement culture in place
The first 2 cycles of the QA programme have involved a peer review programme, during which each local Newborn Hearing Screening Programme and its associated Audiology, Medical and Children's Services (Education and Social Care Services) are visited by a multidisciplinary team of current practitioners.
The recommendations made as part of the QA visit are an important source of information. For the NHSP Programme Centre it gives a national picture of skills gaps, commissioning shortfalls and the need for policy development and, in doing so, provides an opportunity to target support and policy development in an efficient, cost effective manner.
5. Quality Improvement
A quality improvement culture is an integral component of the governance and performance management processes for the screening and hearing care pathway for children.
The NHSP document 'Patient Journey: From Screen to Referral' (login required), Guidance for local programmes, recommends best practice and supports assessment of current screening practice and performance in relation to the national quality standards.
Competent and motivated screening staff, evidence-based protocols and accurate information all underpin a high quality screening service. Monitoring these components helps programme managers develop a greater understanding of what improvements (if any) are necessary in order to provide the highest quality screening service possible. In addition, rigorous audit will help reduce the risk of errors and where errors do occur it will help identify them quickly and manage them effectively and sensitively.
Results from QA peer review visits show that this system is an effective and supportive mechanism for driving quality improvement and identifying candidate services for championing good practice.
There is a need to ensure that self assessment systems are embedded alongside external review so that continuous improvement becomes an inherent part of service delivery and not something that is ‘done to' services.
6. Fourth Cycle of Quality Assurance Programme
The fourth cycle of the Quality Assurance Programme of all local screening programmes in England will be undertaken in the period from April 2012 to March 2013. All services in the care pathway (screening, audiology, medical and early intervention) will be included in the Quality Assurance review. The review will take the form of a desk top exercise by the expert peer review QA team; followed by a number of peer review visits. The following documents describe and support the processes that will be followed.
The following document has two model examples demonstrating how to present and submit the Audiology habilitation case studies which have been requested in the fourth cycle.
7. Quality Assurance Site Reports - 2010/11
In the third cycle of the Quality Assurance programme all NHSP sites submitted self assessment questionnaires and these along with site information were reviewed by a Summary Review Quality Assurance Team. The Review team made recommendations as to whichs ervices within sites would benefit from a peer review visit.
The third cycle QA Site Reports 2010/11 from the Quality Assurance visits to Newborn Hearing Screening Programme Services in England are now available. These reports are based on the self assessment by the site along with additional information.
8. Procedure for Raising Concerns and Complaints
Although we strive to carry out the task of assessing and reviewing services to the best of our ability, we recognise that you may have concerns about the process or the manner in which your service has been reviewed by representatives and members of the QA team.
The Procedure for Raising Concerns and Complaints explains how you can contact us with your concerns and complaints; how quickly you can expect a response from us and how we act upon the comments we receive.
We anticipate that the majority of our work will be performed smoothly and without cause for complaint, however we see complaints as a way of learning and improving our QA programme.