QIPP FOCUS
Dr Janet Williamson, National Director for NHS Improvement, discusses the organisation’s expertise in practical service improvement.
D
elivering the Quality, Innovation, Productivity and Prevention (QIPP)
agenda, which is the large-scale improve- ment programme currently underway in the NHS, will be the key component that will help to drive the delivery of the £20bn of savings required across the NHS by 2015.
The NHS needs to achieve these efficiency savings by evaluating existing services and the delivery of them with a focus on im- proving quality, innovation, productivity and prevention. Every saving made will be reinvested in patient care by supporting frontline staff, funding innovative treat- ments and giving patients more choice. The QIPP programme is all about ensuring that each pound spent is used to bring maxi- mum benefit and quality of care to patients.
NHS Improvement’s approach and work has been nationally recognised by regula- tory bodies such as the National Institute for Health and Clinical Excellence (NICE) and NHS Evidence and aligns closely to as- sist the NHS in meeting and supporting the QIPP national agenda and the delivery of the five key domains within the NHS Out- comes Framework 2011-2012.
NHS Improvement’s leading-edge im- provement work across specialties such as heart, lung, cancer, diagnostics and stroke has identified and generated more than 200 good practice examples from across the country. Our strength and expertise lies in practical service improvement, with over a decade of experience in clinical pa- tient pathway redesign. The organisation demonstrates some of the most leading- edge improvement work in England, which supports improved patient experience and outcomes.
The improvement work with over 240 sites across the NHS has enabled a substantial repository of quality case studies and de- tailed examples of good practice, some of which have been recommended by and added to the NHS Evidence Library. These practical improvements have made a dif- ference to services along the patient path- way which are clinically-led and patient- focused, to achieve the best outcomes.
Such work challenged the existing breast surgical pathway model by testing, with the 13 national clinical spread networks, the
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delivering of major breast surgery (exclud- ing reconstruction) as a day case or a one night stay. Other examples of improvement work underway have been with regards to atrial fibrillation and the detection and op- timal therapy in primary care.
Opportunistic screening by pulse palpation of patients over 65 has been used in 18 re- gions to improve detection of atrial fibril- lation. Quality is improved by the optimal treatment of patients with atrial fibrillation reducing risk of stroke. Productivity is in- creased by the reduction in costs associated with stroke and its complications.
Additional workstreams have also seen improvement work focusing on enhanced recovery for elective surgery programmes, which uses evidence-based interventions to improve pre-, intra-, and post-operative care. This has resulted and enabled early recovery, discharge from hospital, and more rapid return to normal activities.
NHS Improvement has many tools and mechanisms to help drive initiatives and support improvement work in the NHS, such as:
• The NHS Improvement System: a com- prehensive, online tool to support shar- ing of quality improvement resources in NHS services. The system is free of charge to all NHS organisations in Eng- land.
• The Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation (AF) (GRASP-AF) tool, which should be used as part of a systematic approach to the identification, diagnosis and op- timal management of patients with AF to reduce their risk of stroke. It has been identified that potentially 8,000 strokes
every year could be prevented by using the GRASP-AF detection tool.
Further improvement tools consist of the ‘Cardiac and Stroke Data Walls’ that pro- vide an overview of the current data land- scape with supporting information about data collection and usage, and the sustain- ability toolkit, which is an interactive re- source that can help NHS staff improve ex- isting cardiac pathways and sustain those improvements.
Additionally, NHS Improvement has also identified ‘four winning principles’ which include reducing length of stay, and ap- plying enhanced recovery practice and principles and averting admissions, that if applied can make a significant impact and difference to the management and experi- ence of the in-patient pathway.
To help the NHS sustain improvement across these specialties pathways, an EQIPP website has been produced, along- side the NHS Improvement website. It has been purposely designed to help visi- tors and users to navigate and explore the examples where achievements have been made across the pa- tient pathway.
Many of the improve- ments are generic, so can be adopted and adapted to other clini- cal areas and settings.
Dr Janet Williamson FOR MORE INFORMATION
To access the resources at NHS Improvement EQIPP visit
www.improvement.nhs.uk/qipp For more on the improvement workstreams across the clinical pathways visit
www.improvement.nhs.uk
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