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Making a difference - Reducing burdens in healthcare inspection and monitoring

‘ Making a difference: Reducing Burdens in Healthcare Inspection and Monitoring,’ published 23rd July 2003, is the fourth joint project between Cabinet Office (CO) Public Sector Team (PST) and the Department of Health (DH).

Purpose of the project

The purpose of the project is to deliver practical changes (actions) that reduce or remove unnecessary or bureaucratic burdens in the NHS caused by inspection, accreditation or audit. A total of 55 actions have been agreed with DH and other stakeholders to reduce burdens and free up front-line staff to focus on healthcare standards and patient care.

Scope of the project

A multitude of organisations undertake some form of inspection, accreditation or audit in the NHS. Approximately 200 interviews with front-line staff from 25 Primary Care, Acute and Mental Health and Social Care Trusts were undertaken in October and November 2002.

Front-line staff and management acknowledged the value added by inspection in driving up standards in healthcare, enhancing public accountability and ensuring patient safety. However, several recurring themes arose during the course of these interviews that were seen by staff to hamper the effective delivery of healthcare. They were:

• Multiplicity, overlap and lack of co-ordination between reviewing organisations and their functions
• Duplication and inconsistency in requests for data and information
• Proportionality and transparency of reviews
• Burdens of preparation for reviews
• Benefits of review outputs and quality of review reports and action plans
• Quality of review teams

As with other PST Making a Difference (MAD) projects, an Advisory Panel of stakeholders and experts was established to provide specialist advice for the duration of the project.

Key achievements of the project

Actions include:

Fewer inspections – a number of organisations are piloting joint inspections (CHI and SSI, NHSLA CNST and RPST).

Less requests for data and information - including workforce data, estates and facilities data and staff and patient surveys.

Staff in local NHS organisations will be more empowered to address bureaucracy - local bureaucracy Gateways and champions will empower the NHS to address local created bureaucracy and to spread best practice around local bureaucracy reduction.

Fewer new burdens and sharing of good practice between inspectorates – an Inspection Concordat will bring key stakeholders together to agree and consolidate practices of good inspection.

Less demands on the NHS before an inspection – inspectorates will clarify data demands and expectation and communicate effectively with NHS organisations.

Implementing agreed actions

Responsibility for delivery rest with the stakeholders. The PST will continue to work with them to ensure that the actions agreed are delivered accordingly.

Progress on implementing the outcomes delivered by the previous joint PST/DH report, Making a Difference: Reducing Burdens in Hospitals can be obtained by clicking here.

Further work to reduce bureaucracy

DH has set up two Implementation Monitoring Taskforces to oversee implementation the previous three Making a Difference health reports.

DH has also set up a Reducing Bureaucracy Team to co-ordinate all bureaucracy reduction activities the Department is undertaking. Further details can be found on their website:

http://www.doh.gov.uk/bureaucracy/

The NHS Reviews Co-ordination Group has published its Survey and action plans (see Action 47). This will Streamline Risk Management Reviews.

Further details can be found at: www.chi.nhs.uk/nhsrcg

Participants

The project team wishes to thank all participants who gave up their time to talk to us. The issues they raised and the solutions they suggested informed the development of the project. For a list of participants click here.