National Conference of Community Hospitals Association - ‘Leading Best Practices Today, Shaping the Healthcare of Tomorrow’

On the 10th October, the National Conference of Community Hospitals Association (CHA) convened for its first gathering since 2017. The conference brought together healthcare professionals, policymakers, and international guests. The two day event focused on "Leading Best Practices Today, Shaping the Healthcare of Tomorrow."

Colleagues from the Member Programme Team and our National Audit for Care at the End of Life Team were invited to attend the two day conference.

The Member Programme Team

Sarah Handby, Senior Project Manager, and Danny Iyoha, Project Manager, attended from the Member Programme Team. They ran workshops, showcasing the Network's community hospitals data, focusing on Emergency Care and Intermediate Care. They also facilitated structured discussions around the data requirements for community hospitals and explored how the Network can support this moving forward.

The whole conference highlighted all the amazing work done in community hospitals around the UK, and also internationally.

Sarah Handby had this to say:
”It was wonderful to speak with so many members of the Network and hear how they have used the data to support service improvement in their local area and share ideas for future iterations.”

If you have any suggestions on how we can support community hospitals within our member programme, please contact the team at nhsbn.members@nhs.net.

The National Audit of Care at the End of Life (NACEL) Team

In addition to plenary sessions, the conference featured workshops led by Joylin Brockett, Senior Project Manager at NHS Benchmarking Network and Dr Mary Miller, NACEL Clinical Lead and Consultant Palliative Medicine at Oxford University Hospitals Foundation Trust. The workshops attracted 40 participants and provided an introduction to the National Audit of Care at the End of Life (NACEL), covering eligibility criteria, driver diagrams, exclusion criteria, and audit elements which include:

• Four data streams

• A NACEL portal

• Data and Improvement Tool (DIT)

• Data Dashboards

Participants were particularly engaged in the live demonstration of the Data Improvement Tool (DIT). Examples of the case note review, bereavement survey (quality survey), staff survey and hospital level data on community results were shared which showed that community hospitals are doing better than the national picture on most metrics.

Participation figures for NACEL 2024 so far… Key questions posed during the workshops:

Feedback from participants highlighted strong interest in the data presented and excitement about potential quality improvement initiatives. However, there were also calls for consideration regarding the clarity of language used.

Takeaways:
A key takeaway from the conference was the lack of a national definition of a community hospital. Professor Chris Whitty noted that there are about 100 community hospitals in the UK, but no one keeps a complete list of them. Without this list, it is hard to know the impact of these institutions.

Commissioning for community hospitals varies widely across regions. Some facilities are classical locally embedded cottage hospitals with beds serving a rural community. A minority are part of acute Trusts, and many do not have inpatient beds focusing on acute healthcare and social care issues, but may not provide care at the end of life. This diversity underscores the need for a cohesive national strategy, which the CHA aims to develop.

The conference also emphasised the huge ambition for data and quality improvement within community hospitals. A special interest group supported by Q has been established, with recordings available on the CHA YouTube channel (@CommHospUK) for those unable to attend.

End of Life Clinical Audit Celebrated in National Awards

National Audit of Care at the End of Life (NACEL) is in the spotlight this week, as part of a national campaign to underline the importance of clinical audit and quality improvement in enhancing patient care. They have been announced as a commended entry in the Patient & Public Involvement category of the Clinical Audit Heroes awards, which are an integral part of Clinical Audit Awareness Week.

They were recognised for a project which directly sought the views and experiences of bereaved people in the design of an audit tool. The judges were impressed, not only with the support available to patients and carers, but also the on-going process of feedback. There was involvement from the very beginning, and this was clear from the impact demonstrated.

Jessica Moss, Quality Improvement Lead for NACEL at the NHS Benchmarking Network, said: “We are delighted to be recognised in the Clinical Audit Heroes awards. By taking an evidence-informed approach to improvement, clinical audits help to target change where it will have the greatest impact. Thank you to all the participants in the bereaved persons focus groups for sharing their experiences as well as The Patients Association (@PatientsAssoc) and Nikki Archer for collaborating with us on this project.”

Clinical Audit Awareness Week is hosted by the Healthcare Quality Improvement Partnership (HQIP) in collaboration with the quality improvement network N-QI-CAN, and runs from 24-28 June 2024. It is designed to celebrate the role of clinical audit and quality improvement in improving healthcare services.

More specifically, clinical audits review and measure healthcare, often in relation to local and national standards and targets. They are an effective way to determine if services are performing as they should and, if not, identify where changes are needed. They also help healthcare providers and patients alike to understand how their service is performing, and where improvements could be made. As such, the work of clinical audit teams is essential, both as drivers of improvement in their own organisations and in supporting scrutiny of our health system at a national level.

Chris Gush, CEO of HQIP, explains: “Without clinical audit, we would lack the necessary insights to understand what is working well and, crucially, what is not. By measuring our healthcare services and tracking the differences that improvement activities make, clinical audits are directly contributing to saving and improving patients’ lives.”

For more information on the national clinical audits that are commissioned by HQIP on behalf of NHS England, go to www.hqip.org.uk/national-programmes; to see their findings, view the reports published on a wide range of clinical disciplines, ranging from asthma and diabetes to cancer and cardiovascular disease.

Find out more about Clinical Audit Awareness Week and the Clinical Audit Heroes awards on the HQIP website.

You can also join in the celebrations on social media using #CAAW24.

NB: HQIP is an independent organisation that works in partnership with patients and healthcare professionals to influence and improve healthcare, through clinical audit and evidence-informed quality improvement. They commission the National Clinical Audit and Patient Outcomes Programme (NCAPOP) on behalf of NHS England.

Clinical Audit Awareness Week is a national campaign spearheaded by Healthcare Quality Improvement Partnership (HQIP) and the National Quality Improvement (including Clinical Audit) Network (N-QI-CAN). More information is available at: www.hqip.org.uk/clinical-audit-awareness-week. The social media hashtag is #CAAW24.

 Enquiries: communications@hqip.org.uk.

Blog post: International Collaborative Summer School

The International Collaborative for best care for the dying person Summer School took place on 13th and 14th May 2024. The international group were hosted by Cudeca Hospice (Malaga, Spain) in their state of the art educational centre. The school was hosted by Dr Marisa Martín Roselló and her team who were superb hosts, supporting learning, discussion and collaboration in the warm sunshine. The international collaborative brings together a global group of leading thinkers, practitioners and researchers, who share a vision for a world where all people experience as good death as an integral part of their individual life, supported by the very best personalised care.

Dr Rosie Bronnert, (bottom right, blue top), Dr Mary Miller (bottom right, red cardigan) and Jess Moss (bottom right, white top) representing the NHS Benchmarking Network

Day 1:

Jess’s poster was accepted for presentation: ‘Learning from loved ones’ involvement in the re-design of the National Audit of Care at the End of Life (NACEL)’.

Dr Marisa Martín Roselló and Mr Yusuf Hamied welcomed the group to the summer school 2024. Professor John Ellershaw outlined the programme for the school and outlined the work of the international collaborative. Dr Agnes Van der Heide led the plenary, discussing key findings of the EU Horizon iLIVE project.

The NHS Benchmarking team participated in the ‘Benchmarking in the Care of the Dying’ workshops, one of four workshop streams that ran throughout the day. The team were invited to present on each of the three themes:

• Different models of benchmarking for care of the dying across the world: Dr Mary Miller

• Quality improvement in the context of national benchmarking: Dr Rosie Bronnert

• Perceptions of staff and relatives on care of the dying person from use of questionnaires: Jess Moss

The NHS Benchmarking team were privileged to showcase NACEL as one of the two major global success stories.

Day 2:

Dr Marisa Martín Roselló welcomed the delegates back for a second day. We heard about palliative care in intensive care departments in low resource settings in the plenary before moving on to invited oral presentations. Dr Mary Miller spoke about the ED results from the NHS Benchmarking pilot of the redesigned case note review (2023). Three other presenters discussed work from Ireland, the United Kingdom and Germany.

The NHS Benchmarking team participated in workshops looking at global research on benchmarking. Dr Claudia Fisher presented a very interesting systematic review looking at the impact of benchmarking on improving care.

Dr Mary Miller presented the current research outputs of NACEL and a vision for the future. Delegates worked in collaboration to pull together an outline proposal for EU funding – a call for applications is awaited with eagerness! The school drew to an end with reflections and learning led by Professor John Ellershaw.

 As well as providing an opportunity to showcase the work of NACEL and NHS Benchmarking, the team met colleagues seeking to introduce benchmarking (Malta, Iceland and South America), learned about international practice (Sweden and Australia) and learned about the vision to improve care at the end of life by measuring practice and using knowledge to undertake quality improvement. The summer school was a fabulous networking and learning experience – now to decode and capture my notes and reflections.    

NACEL launch Data and Improvement Tool (DIT)

The NACEL team are pleased to announce the launch of the NACEL Data and Improvement Tool (DIT) and the reporting of the Quality Survey findings.

All organisations participating in NACEL 2024 can access the Data and Improvement Tool to review their initial Quality Survey findings. To date, NACEL has received 1,076 Quality Surveys from the bereaved.  

The tool will display the Quality Survey findings for participating providers, showcasing each organisation’s position against the national and regional peer group. The Data and Improvement Tool has launched as a beta product, with an expectation that developments will be made between now and July 2024.

As more Quality Survey data is submitted, the Data and Improvement Tool will update to enable real-time reporting of the findings.

Find out how to access the Data and Improvement Tool by following this link https://www.nacel.nhs.uk/how-to-access-the-Data and Improvement Tool

NACEL Quality Improvement Webinars

Need help understanding the Data and Improvement Tool and how to translate data into quality improvement?

Mark your calendar for the first NACEL Quality Improvement webinar taking place on Thursday 9th May, 1pm – 2pm, via MS Teams.

The webinar will focus on how to use the NACEL data for quality improvement, including how to navigate the Data and Improvement Tool. We are delighted to have Dr Sarah Mitchell, NHS England's National Clinical Director for End of Life Care, as a guest speaker.

Register for the webinar here: https://www.nacel.nhs.uk/events/nacel-quality-improvement-webinar

Watch this space or keep an eye on our website for lunch time drop-in sessions happening on the 14th and 16th May to answer any questions and support the use of the Data and Improvement Tool.

For more information about NACEL please visit our website https://www.nacel.nhs.uk/ 

National Audit of Care at the End of Life (NACEL) 2024 – What next?

Firstly, we’d like to thank everybody who attended our warm up event a few weeks ago. We’re thrilled to have welcomed nearly 300 attendees on the call. We hope you found the session worthwhile in helping you prepare for NACEL 2024. If you’d like to rewatch any of the session, you can access the recording and slides through the warm up event page via the NACEL portal.

At the moment, NACEL registration is in full swing. Data collection for NACEL will be opening on 1st of January 2024. If you haven’t yet registered, now is the time to do so!

Before participating, it’s key to understand some of the key changes that will incorporate NACEL 2024, such as a new reporting tool to easily identify improvement with benchmarking at differing system levels and quality improvement support for audit participants.

We are also delighted to confirm that we’ve increased the accessibility of the Quality Survey. The survey of the bereaved person’s feedback is now available in the 10 main languages spoken in England and Wales, as well as English and Welsh. The translated versions of the Quality Survey can be printed and handed to people to complete. The translated surveys are available here.

You can do a number of things to prepare for NACEL 2024:

• Review the NACEL guidance notes and questionnaires, available to download from the audit guidance page of the website

• We recommend that you suspend local bereavement surveys whilst participating in the  NACEL Quality Survey.

• Consider whether you will implement the NACEL Quality Survey from the 1st of January, and how and when is best to communicate this information e.g., during the collection of the death certificate, via an electronic messaging system, posters, etc. Example Quality Survey promotional resources are available: poster, leaflet and letter.

• If your organisation has a bereavement office, we recommend contacting the team for help and advice.

• Decide whether you will distribute an online Quality Survey link/QR code, or distribute the paper version.

• Explore whether your organisation complies with the national data opt-out and where this information is stored. The national data opt-out is a service that allows patients to opt out of their confidential patient information being used for research and planning. It is the organisation’s responsibility to ensure that the appropriate patient data is submitted to the NACEL 2024 Case Note Review.

Keep an eye out for further communications to be released by the NACEL team. You can find out all the latest information by accessing our new portal here: https://www.nacel.nhs.uk

If you have any questions, please contact the NACEL team here: nhsbn.nacelsupport@nhs.net