CQC COVID-19 Insight reports

COVID-19 Insight reports

CQC

A regular series of insight documents intended to highlight COVID-19 related pressures on the sectors that CQC regulates.  

COVID-19 Insight: Issue 1, 19 May 2020

• Adult social care: reviewing data on outbreaks, deaths and availability of PPE, and in particular highlighting the impact of COVID-19 on staff wellbeing and the financial viability of adult social care services.

COVID-19 Insight Issue 2, 17 June 2020

• How providers are working together across systems in response to coronavirus
• How the care for people from different groups is being managed
• Focus on primary care

COVID-19 Insight Issue 3  15 July 2020

• Better care through collaboration
• Responding to feedback about care services
• The impact of COVID-19 on the use of Deprivation of Liberty Safeguards
• Protecting people's rights under the Mental Health Act

COVID-19 Insight Issue 4  16 September 2020

• Infection prevention and control in Acute hospital trusts, Care homes and GP surgeries
• Provider collaboration reviews
• Data - outbreaks and staff absences in homecare services  / numbers of deaths of people detained under the Mental Health Act

COVID-19 Insight Issue 5 18 November 2020

• Infection prevention and control in care homes
• The experiences of hospital inpatients during the early stage of the pandemic
• Data- data including: outbreaks and staff absences in homecare services; numbers of deaths of people detained under the Mental Health Act; numbers of deaths of people with a learning disability; breakdown of deaths by ethnicity.

COVID-19 Insight: Issue 6 15 December 2020

• Regional data on the designated settings that allow people with a COVID-positive test result to be discharged safely from hospital, 
• Latest data on registered care home provision, and 
• How providers have collaborated to provide urgent and emergency care during the pandemic.

Providers deliver: better care for patients

Providers deliver: better care for patients
NHS Providers 10 October 2019

• This report is part of a new programme of work from NHS Providers - Providers Deliver - to celebrate and promote the work of NHS trusts and foundation trusts in improving care. Using 11 case studies it considers the leadership approaches and frontline initiatives that underpin improvements in quality.

How healthcare providers can prepare for Brexit

How healthcare providers can prepare for Brexit
DHSC 20 September 2019

• What providers and commissioners of healthcare services can do to manage the risks of a no-deal Brexit.

Primary Care Networks: a quiet revolution

Primary Care Networks: a quiet revolution
NHS Confederation 26 July 2019

• A guide for provider organisations on how to engage effectively with PCNs which draws on published guidance, discussions with PCN leaders, and conversations with providers. The briefing also includes case studies that describe the strategic responses to the introduction of PCNs so far from three local providers.
• This briefing paper sets out in 11 chapters the essential knowledge that providers should have on PCNs, including:
• Where PCNs came from.
• What PCNs are (and what they’re not).
• What outcomes PCNs will deliver.
• What has it taken to get PCNs set up.
• What role do CCGs and local medical committees (LMCs) have.
• What new funding and support is available.
• What the emerging picture is.
• What the next nine months holds.
• What happens after April 2020.
• Given all of that, what role should providers play around PCNs.
• Case studies and examples of supporting offers.

Population health framework for healthcare providers

Population health framework for healthcare providers
NHS Providers June 2019

• This framework sets out principles for a population health approach that can be taken by NHS provider organisations, working as part of an integrated health and care system.

Productivity of the English NHS: 2016/17 Update

Productivity of the English National Health Service: 2016/17 updateCentre for Health Economics University of York, 15 April 2019

• NHS productivity is measured by comparing growth in the outputs produced by the NHS to growth in the inputs used to produce them. NHS outputs include the amount and quality of care provided to patients. Inputs include the number of doctors, nurses and support staff providing care, the equipment and clinical supplies used, and the hospitals and other premises where care is provided.
• The report includes costs of different types NHS provider outputs (eg GP consultations, outpatient activity, inpatient activity) taken from a range of sources, and inputs in terms of spend and NHS staff numbers. 
• Changes in unit costs for consultation types in primary care are indicated in table 30 (p35).

EU Exit actions for medical devices and clinical consumables

EU Exit actions for medical devices and clinical consumables
NHS Improvement 11 February 2019

• Information for NHS providers about the extensive planning and contingency measures that have been put in place for the healthcare system nationally and the additional actions that we are asking providers to undertake as a priority as part of the wider preparations for a ‘no deal’ EU Exit.
• Includes Guidance for heads of procurement on the implementation of EU Exit actions: February 2019

Impact of the CQC on provider performance

Impact of the Care Quality Commission on provider performance: room for improvement?
Kings Fund, Alliance Manchester Business School 27 September 2018

• An evaluation of the CQC approach to inspecting and rating health and social care providers across four sectors (acute care, mental health care, general practice and adult social care) that describes eight ways in which regulation can affect provider performance.
• The report examines whether Intelligent Monitoring datasets can predict the outcome of inspections and whether, on the basis of routine data, reported performance in A&E services, maternity services and general practice improves following an inspection.

General Practice

• The analysis found that the quality indicators used in CQC’s Intelligent Monitoring datasets had little or no correlation with the subsequent ratings of general practices. The model did not correctly predict any of the 270 practices that received an ‘outstanding’ rating, or the 172 practices that received an ‘inadequate’ rating. 
• The analysis found that, in the six months after practices were inspected, prescribing behaviour generally improved slightly for practices rated ‘inadequate’ or ‘requires improvement’, but worsened slightly for those rated ‘good’ or ‘outstanding’.

Making sense of the community services data set

Making sense of the community services data set [blog]
Nuffield Trust 29 August 2018

• This blog post reflects on the new community services data (CSDS) now available for October 2017 to April 2018 and the challenges making sense of them.

[Lord Cater's review into] Unwarranted variations Mental health services and CHS

NHS operational productivity: [Lord Cater's review into] Unwarranted variations Mental health services and community health services
NHS Improvement 24 May 2018

• Following wide ranging engagement this review has identified critical and unwarranted variations in all key resource areas across mental health and community health services. The review estimates that elimination of unwarranted variation could save the NHS nearly £1 billion in efficiencies by 2020/21. 
• Four key areas are staff, contract specification, technology and delivery. Structural issues identified include delayed transfer of care, wound care, community hospitals, Lifetime healthcare costs and Integrated care.

Contents

Flow in providers of community health services: good practice guidance

Flow in providers of community health services: good practice guidance
NHS Improvement November 2017

• Good practice for providers of community health services around reducing Delayed Transfers of Care (DTOC), and NHS Improvement expectations of them over the next six months. NHS Improvement lays out six essential measures and three wider measures of good practice for consideration. 
• Cross-system working 
• 1. Facilitate system-wide data-sharing 
• 2. Actively engage in the operational management of discharge across all local organisations 
• 3. Develop a ‘discharge hub’ referral and co-ordination service as part of an integrated discharge team 
• Addressing challenges in resolving patient choice 
• 4. Effectively implement their patient choice policy 
• 5. Ensure the services they deliver are well understood 
• Boosting operational focus in providers of community health services 
• 6. Collect and share data for Red2Green days, creating a feedback loop between senior operational staff and the clinical workforce 
• Good practice for providers of community health services to consider :
• 1: Enabling staff to work in different settings 
• 2: Assisting patients to identify the best care packages for them
• 3: Taking steps to make nursing and therapy roles more attractive​

Provider maturity model in primary care

Provider maturity model
Healthy London October 2017

• The provider maturity model is a development tool that was designed with primary care providers across London to support the development of at scale organisations.

Acting without delay - How the independent sector is working with the NHS to reduce delayed discharge

Acting without delay - How the independent sector is working with the NHS to reduce delayed discharge
NHS Partners Network, NHS Confederation 14 June 2017

• A series of case studies which demonstrate how strong partnerships between the NHS and independent sector providers are tackling the issue of Delayed discharges and transfers of care (DTOCs).
• Includes: virtual wards, complex care provided in care homes, use of spare capacity in independent hospitals, better use of intermediate care, specialist rehabilitation to improve patient recovery.

Where next for commissioning?

Provider voices: Where next for commissioning?
NHS Providers June 2017

• A series of interviews with providers from across the NHS discussing the commissioning landscape.
• Includes a potted history of commissioning in healthcare.
• Five key interlinked and overlapping themes emerge from the interviews:
• the value of commissioning getting closer to people...
• ..and understanding local place: the importance of scale and geography
• the need to accept the emerging diversity of approach to commissioning structures
• the rapid blurring of the purchaser-provider split and a lesser focus on the internal market 
• the need to focus on commissioning as a strategic function.
• "As the NHS moves to collaborative local system working via sustainability and transformation partnerships and accountable care organisations and systems, we need a full and proper debate about how commissioning (and provision) needs to adapt to this new, emerging, world."

The Model Hospital from NHS Improvement

The Model Hospital
NHS Improvement updated April 2017

• The Model Hospital is a digital information service designed to help NHS providers improve their productivity and efficiency. It is an easy-to-navigate tool that can be used by anyone in the NHS from board to ward to explore and compare productivity, quality and responsiveness data to identify opportunities to improve.
• The Model Hospital is broken down into five 'lenses' which offer different perspectives from which to review hospital activity:
• board-level oversight
• clinical service lines
• operational
• people
• patient services
• Access is currently provided to NHS provider trusts only.

NHS efficiency map

NHS efficiency map
HFMA, NHS Improvement, updated 15 March 2017

• A tool that promotes best practice in identifying, delivering and monitoring cost improvement programmes (CIPs) in the NHS. 
• The map contains links to a range of tools and guidance to help NHS bodies improve their efficiency.
• The map is split into three sections:
• Enablers for efficiency
• 1. Board capability and governance
• 2. Management capability
• 3. Best practice CIP management
• 4. Controls and reporting
• 5. System leadership
• 6. Digital maturity
• Provider efficiency
• 7. Optimal use of workforce
• 8. Clinical workforce
• 9. Clinical support services
• 10. Getting it right first time
• 11. Procurement and non-pay
• 12. Estates
• 13. Corporate support
• 14. Productive series
• 15. The Model Hospital
• 16. Commercial income
• System efficiency
• 17. Urgent and emergency care
• 18. Chronic disease and frailty
• 19. Integration with social care
• 20. Commissioning for value and RightCare
• 21. Prevention and self-care

Learning from deaths in the NHS: national guidance

Learning from deaths in the NHS: national guidance
National Quality Board, 15 March 2017

• The National Quality Board has published a framework to help standardise and improve how NHS providers identify, report, investigate and learn from deaths. 
• Also published with the guidance is a suggested Dashboard which provides a format for data publication by Trusts.

CQC registration update for new care models

Registration update for vanguards and other new care models
CQC 21 December 2016

• This update is intended for providers who are, or who are considering, providing new care models to understand their duties and responsibilities around CQC registration.

Single Oversight Framework - Shadow segmentation

Single Oversight Framework: shadow segmentation
NHS Improvement 21 October 2016

• NHS Improvement have segmented providers according to the level of support each trust needs across the five themes of quality of care (finance and use of resources, operational performance, strategic change &leadership and improvement capability)  in order to attain CQC "Good" or "Outstanding" ratings.
• This shadow (or indicative) segmentation of the sector comes ahead of the first formal
  segmentation in November 2016.
• The framework replaces the Monitor 'Risk Assessment Framework' and the NHS Trust Development Authority 'Accountability Framework'.

Single Oversight Framework for providers

Single Oversight Framework for providers
NHS Improvement 30 September 2016

• The Framework will help NHS Improvement identify NHS providers' potential support needs across five themes:
• quality of care
• finance and use of resources
• operational performance
• strategic change
• leadership and improvement capability
• NHS Improvement will segment individual trusts according to the level of support each trust needs.
• The framework applies from 1 October 2016, replacing the Monitor 'Risk Assessment Framework' and the NHS Trust Development Authority 'Accountability Framework'.