nhs | presentation to [xxxx company] | [type date]1 senates - the interface with scns and ahsns...
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NHS | Presentation to [XXXX Company] | [Type Date]1
Senates - the interface with SCNs and AHSNs
Nigel AchesonMedical DirectorNHS England (South)
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SCNs and Clinical Senates
4 in the South
• South West• Wessex• Thames Valley• South East Coast
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• Cardiovascular (cardiac/stroke/diabetes)
• Maternity/children and young people
• Mental health/dementia/neurological conditions
• Cancer
• [ Respiratory]
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SCN 2014/15 priorities
Themes:
• Early diagnosis
• Parity of esteem
• Optimisation of pathways
• Reducing avoidable admissions
• Reducing variation
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AHSNs
5 in the South:
• South West Peninsula
• West of England
• Wessex
• Oxford
• Kent, Surrey and Sussex
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AHSN licence agreement focus upon:
• Wealth creation
• Spread and adoption of innovation
• Building upon a culture of collaboration
between stakeholders
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AHSN 2014/15 priorities • Clinical workplans include:
• Pharmacy
• Mental health
• Long term conditions
• Enhanced recovery
• Urgent care
• Informatics/telehealth
• Patient safety collaboratives
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New financial year, new NHS England Chief Executive – Simon Stevens
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Simon Stevens speech 3rd April 2014
• Out of hospital care
• Personalisation (eg using genomics)
• Reducing variation and assurance of quality
• Early diagnosis, prevention and intervention
• Co-production and self care
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Some “big” issues
• Smoking/Hypertension/Obesity/Diabetes
• Parity of esteem
• Primary care transformation
• Variation in quality
• Urgent care
• End of life care
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Some issues to address…
• Dogma
• You can’t close my…..
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New England Journal of Medicine, 2014
• Paper from Ontario, Canada relating to the
surgical safety checklist – little impact on mortality
• Atul Gawande – “government mandate without
serious effort to change the culture and practice of
surgical teams results in limited change”
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Specialised commissioning
• 143 new service specifications and adopted 60
highly specialised service specifications
Only the beginning – equity of access, quality of
services (clinical and cost-effectiveness, patient
experience, patient safety)
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• Need to develop pathways and networks to
ensure both quality and access to specialised
service
• This will require changes in how and where
specialised services are provided
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• Engaging patients, staff, the wider public and
other stakeholders will be critical if high quality
services are to be developed and improved
• Senates will play important roles in improving the
quality of care through such transformation
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The Four Key Tests (in 14/15 Mandate)
• Strong public and patient engagement
• Consistency with current and prospective need for patient choice
• A clear clinical evidence base
• Support for proposals from clinical commissioners
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What guidance has been published?
Sets out a broad framework of
roles and responsibilities for
commissioners in how they
should plan for major service
change, work with providers,
local authorities, patients and
the public
How are proposals assured?
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The aim of clinical assurance through the
Senate is to establish whether the proposed
changes are supported by a clear clinical
evidence base and will improve the quality
of the service provided
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National Clinical Advisory Team (NCAT) assurance
of service change proposals:• 1 Independent clinical assurance of reconfiguration
• 2 Early advice
• 3 Review and investigation of clinical services (eg re safety)
• 4 Evidence collection
• 5 post-hoc advocacy
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Senates will undertake functions 1 and 2
Independent clinical assurance of
reconfiguration
Early advice
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• Investigation of issues of clinical safety (function 3) lies
with other bodies
• Evidence collection (function 4) is undertaken by a
range of organisations including NICE, Royal Colleges
and NHS Evidence
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• The post-hoc advocacy role (function 5) is not a
function for Clinical Senates to undertake in
isolation
• Any communications or advocacy requirements
should be considered by NHS England as part of
its broader assurance process
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Senate roles
1 Clinical advice to commissioners to help inform
proposals (by ?SCNs or Senate if outwith SCN groups)
• Strategic clinical advice to commissioners on relevant clinical
guidance/best practice
• Advice to support commissioners in developing a case for
change, options appraisal and proposed clinical models
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A proportionate approach
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2 Independent clinical advice as part of the NHS
England service change assurance process
• Independent clinical advice by means of a formal report to
be considered as part of the NHS England assurance
process for service change proposals
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Service change assurance exists to give confidence
to patients, staff and the public that proposals are
well thought through, have taken on board their
views and will deliver real benefits
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Next steps
• Development of common products for use by Clinical
Senates (principles for managing reviews, ToR, review report
pro-forma)
• Associate Directors for SCNs and Clinical Senates and
Clinical Senate Managers to examine the potential for
shared working
• Service change proposals are shared regularly with clinical
senates