GM Area Team NPSA Conference 2013 COMMISSIONING FOR IMPROVEMENT: GREATER MANCHESTER HARM FREE CARE CQUIN 12/13

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1 COMMISSIONING FOR IMPROVEMENT: GREATER MANCHESTER HARM FREE CARE CQUIN 12/13

2 Greater Manchester Large Scale Improvement 2.6 Million people NHS Greater Manchester = 1 cluster PCT (from 10 PCT s) (will become the NCB Area Team) 12 Clinical Commissioning Groups ( 460 GP practices) 9 Acute Providers (8 integrated with community services) 1 Community Trust 3 Mental Health Trusts 1 Specialist Cancer Trust Independent Sector Providers (Care Home and domiciliary care) 10 Local Authorities

3 Clinical Commissioning Value Driven Patient focused outcome from both commissioner and provider Provision of expert nursing commissioning resource to assist with hearts and minds of culture change Measurement for Improvement A CQUIN that focused on improving nursing care and patient experience A supportive commissioning approach that enables providers to achieve improvements Assessment of baseline was the 95% achievable by any provider? ( 4 out of 9 Acute very close in March 2011) Across Organisational Boundaries Application of safety thermometer to all settings has promoted discussion about harm free care across the GM economy Care home sector a very willing partner in achieving safe care.

4 Systemic Engagement CCG Engagement Large Scale Change Programme Key component of commissioning nursing strategy Involving all providers Quality & Safety Lead contract discussion Systemic approach to one goal across GM Expert Nursing to support trusts Community action CHC Leads Board level and sub structure discussions Systemic discussion triggered Local Authorities

5 Delivery of the CQUIN Labour Pains Response to the CQUIN Some providers ( we re not doing it it s impossible) Some commissioners ( we commission it already they didn t they just thought they did) Surprising response from the Independent Sector (Great idea - when can we start) Huge variety in understanding but it got people talking and it is keeping them talking too

6 Sample Size Sample Size now Sample Size Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec Harm Free (from old and new harms) Improvement towards Harm Free Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12

7 Commissioning for Improvement Strategic Leadership Engaging Values and Behaviours that lead change. Sharing learning and best practice to support the GM Health Economy. Large Scale Change Accountability in Care Strive to improve quality of care too reduce harm Enhance patient experience through developing local workforce Spread of Innovation Commissioning for Improvement Focus on Care Focus on outcomes that mean the most to patients. Shared purpose on enhancing experiences of care through Compassion in Practice Nursing Strategy Enabler to Care Display integrity, honesty and courage Commissioning to enable excellence in care Greater Manchester Harm Free Care Strategy and Independent Sector Case Study published in CQUIN Guidance for NHS Safety Thermometer 2013/14

8 Harm Free Care in the Care Home Sector Introduced Harm Free Care Concept to Oldham Independent Sector Intentional Rounding Strengthened Partnership working with local Care Homes (nursing) NHS Safety Thermometer Asked to sign up as A call to action Greater Manchester Harm Free Care Strategy Implemented the NHS Safety Thermometer as a Quality improvement tool Promoted Harms through local events in oldham.

9 Developing a Caring Culture Using the 6C nursing strategy to find a common and shared purpose. Delivering High Quality Care and Measuring the Impact. Translating the vision locally. A call to action encouraging buy in through commitment and not duty. Using a quality Framework to improve patients care and experience. Using the NHS Change Model to shape improvement programmes. Translating a shared purpose into real change. Develop sustainable change. 95%Harm Free Care. Using harm free care data to steer quality improvement. Sharing best practice across the GM foot Print.

10 13/14 Plan ( and beyond) NCQF intentional Rounding pilot Continue with continuous improvement Accepted as Academic Health Science Network Programme Members Pilot of Medicines Safety Thermometer Implementation of the Nursing Vision and the 6C s Meaningful Moments Intentional Rounding Tool with CHARM

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