Responsibility for regulating and monitoring compliance

Accepted.
The Academy of Royal Medical Colleges and Faculties are committed to delivering consistent and high quality patient experiences and outcomes and will continue to support the design, implementation and review of clinical standards and the processes for assuring their use. The Academy will do this in a patient-focused way and in conjunction with key partners. The Academy of Royal Medical Colleges and Faculties have always taken an active leadership role in setting clinical service delivery standards. In addition, with individual Royal College and Faculty activity such as accreditation schemes and invited reviews and the Academy’s membership of the National Institute for Health and Care Excellence’s Implementation Collaborative, involvement in assuring compliance with clinical standards is continuing to strengthen.
In response to the Inquiry, the Academy and the National Institute for Health and Care Excellence are also working to agree and implement how medical and other Colleges will contribute to the development of outcomes measures. For example, on staff suitability and competence; evidence based tools for establishing what each service is likely to require as a minimum in terms of staff numbers and skill mix; and measures of standards compliance.
The Care Quality Commission will look at the implementation of the National Institute for Health and Care Excellence clinical and other guidelines as part of their inspection process and there is a move to greater transparency of clinical outcomes – NHS England has for the first time published clinical outcomes by consultant for ten medical specialties and has also begun to publish data on the friends and family test.

See response to Recommendation 23 about the National Consultant Information Programme (NCIP).

The NCIP portal is a free data platform that allows consultants to review their own data: improving clinical quality, patient safety and supporting career development. It provides consultants with data covering their NHS practice wherever it is performed with high-quality, specialty-specific dashboards at patient level.

Nearly all NHS Trusts and NHS Foundation Trusts in England have been enrolled in NCIP (99%) and over 9,000 consultants now have access to the portal following universal access given across 7 surgical specialties.

NCIP is on track to give access to every consultant in 14 surgical specialties by 1 April 2025 with the intention of expanding into non-surgical specialties subsequently. Access to the portal has also been given to Medical Directors, Responsible Officers (who have governance responsibilities) and Trust Specialty Clinical Leads.

NCIP is now established as the visualisation platform for individual consultant outcome data but for very cogent reasons is not in the public domain. However, once a single repository is established and there is confidence in the accuracy of the data, discussions will take place with the profession as to what information is appropriate for publication.

Independent sector

The NCIP portal contains outcome data on NHS procedures no matter where they are performed i.e. both in NHS Trusts, NHS Foundation Trusts and the Independent Sector (IS) but excludes those procedures performed on private patients carried out in the Independent Sector. It was always intended that these data would come into NCIP via the Acute Data Alignment Programme (ADAPt), as supplied by the Private Healthcare Information Network.

ADAPt has now been subsumed into the Outcome and Registry Programme (ORP). A single repository can only be established when the private data flows into NCIP

Please also see response to recommendation 23 (Clinical outcomes).

The medical Royal Colleges and Faculties continue to develop standards within their specialist areas and provide direct input to the development of the National Institute for Care and Health Excellence’s guidance with the aim of driving improvement in health and patient care.

The Colleges are working with the Care Quality Commission on their contribution to the regulator’s standards and inspection processes. This work will be continuing during 2015.

The relevant Colleges have been actively involved with NHS England in the publication of consultant treatment outcomes data for specific specialties.

Work is also being taken forward to develop the scope and remit of Colleges’ supported service accreditation schemes and, particularly to ensure consistency of approach, including a common framework and set of standards for accreditation across services and specialties

This recommendation was accepted by the Government.

In the January 2014 Hard Truths report, the Government said that the Academy of Royal Medical Colleges and Faculties and the National Institute of Health and Care Excellence were working together to agree and implement how medical and other colleges would contribute to the development of outcome measures.

In the January 2014 Hard Truths report, the Government referred to the Royal Colleges working with the Care Quality Commission on their contribution to the regulator’s standards and inspection processes; the Colleges being involved with NHS England in the publication of consultant treatment outcomes data for specific specialities; and development of the Colleges’ supported service accreditation schemes.