BOARD MEETING
18 MAY 2011
Maintaining and Improving quality and safety in the transition;
safety, effectiveness and experience (Part One – 2011-2012)
ISSUE
1. To share with the Board the recent National Quality Board (NQB) report
Maintaining and Improving quality and safety in the transition; safety,
effectiveness and experience (Part One – 2011-2012)and to provide the Board
with an opportunity to discuss in line with the recommendation of the report.
RECOMMENDATION
2. That the Board note the contents of the report and comment on implications for
CQC.
BACKGROUND
3. The National Quality Board was established in 2009 to bring about greater
alignment for quality between the national bodies responsible for the overall
health system. Through bringing together the Department of Health, the Care
Quality Commission (CQC), Monitor, the National Institute for Health and Clinical
Excellence (NICE) and the National Patient Safety Agency (NPSA) the Board is
uniquely placed to look at the risks and opportunities for quality and safety across
the whole system, both during the transition and once the new system
architecture is fully operational.
4. The NHS has begun to make the complex transition to the new architecture set
out in the Government’s White Paper Equity and excellence: Liberating the NHS.
There are few parts of the current system that remain untouched and past
lessons have shown that any period of transition or structural change can put the
quality and safety of care at risk. CQC, as the regulator of quality by ensuring
providers comply with Essential standards, is one of the few constants in the
system.
5. The Board has recently published its report Maintaining and Improving quality
and safety in the transition; safety, effectiveness and experience (Part One –
2011-2012).The report is the first of a two-phase review about maintaining and
improving quality during the transition and beyond. It builds on the NQB’s 2010
Review of Early Warning Systems in the NHS and emphasises how quality must
remain the guiding principle as organisations move to implement NHS
modernisation.
6. CQC has influenced the contents of the report and it is useful reading for our
frontline staff. It describes the key roles and responsibilities for maintaining and
taking action to improve quality; suggests practical steps to safeguard quality
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during the transition; and emphasises the importance of the effective handover of
knowledge and intelligence on quality between old and new organisations. It also
specifically confirms the role of SHAs and PCTs during the 2011/12 year of
transition.
7. Alongside the above report, the NQB also published The Quality Governance
Guide – a guide for provider boards as a supporting tool. It provides trust boards
with further advice on how best to govern for quality.
KEY ISSUES
8. One of the report’s recommendations for CQC (and similarly for all other
organisations covered by the scope of the report) is to;
'Read, understand and hold a board level discussion about this report (and the
NQB's previous report). Following board discussion, ensure key messages from
both reports are disseminated throughout the organisation.'
9. The report is appended for consideration by the Board and attention is drawn in
particular to chapter 3 which discusses enhancing resilience for quality during
2011-12. (Chapter 4 of the previous Early Warnings report, which deals with the
performance and regulatory framework for safeguarding quality is also
appended).
10. The report provides a helpful summary of how transitional risks to safety and
quality should be mitigated. CQC is actively engaged in the development of the
second part of the report which will describe the quality and safety framework
once the current round of reforms to the NHS are in place. CQC is also
considering as part of its future of Care programme what its relationship needs to
be at national and local level with other parts of the system and putting measures
in place to ensure that these relationships provide adequate public assurance
and realistically reflect the contribution CQC can make.
11. The Board are asked to comment on the implications of the report for CQC and
the wider system and in particular;
 Given that the attention of other players will be focussed elsewhere during the
transition period, what are the particular areas of risk for CQC and how
should we mitigate against these?
 What are the key messages about the report CQC will wish to transmit to
staff?
 How would the Board like to be sighted on this important work going forward?
12. Following the Board’s discussion, information about the report will be shared with
CQC staff including through the Team Brief system.
LINK TO STRATEGIC OBJECTIVES & BUSINESS PLAN
13. Further contribution to the development of this work is a deliverable of the Future
of Care Programme and included in the business plan.
RESOURCE & RISK IMPLICATIONS
14. As noted above, development of CQC’s contribution to this work is included in
planned work. The risks for CQC of not contributing to and influencing this work
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are that the further system will not reflect CQC’s role and will provide inadequate
assurance to the public about the quality and safety of healthcare..
RECOMMENDATION
15. That the Board note the contents of the report and comment on implications for
CQC.
NEXT STEPS
16. Following the Board’s discussion, information about the report will be shared with
CQC staff including through the Team Brief system.
Annexes
Annex 1 Maintaining and Improving quality and safety in the transition; safety,
effectiveness and experience (Part One – 2011-2012
Annex 2 The Performance and regulatory framework for safeguarding Quality –
extract from the NQB February 2010 Review of Early Warning Systems in the NHS
Amanda Hutchinson
Acting Director of Regulatory Development
5 May 2011
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