National Service Frameworks: Production

Transcription

1 National Service Frameworks: Production 1. Background This paper was commissioned by the NSF sub group to contribute to the discussion on the development of a generic pathway or process for NSFs. DEVELOPMENT 2. Communications Strategy There should be a communications strategy for the development and implementation of all NSFs. This will need to use a range of media to ensure that all stakeholders are targeted and engaged in the process and should form an explicit part of the NSF process. It should be agreed at the outset and reviewed at intervals. A key part of the strategy will be ensuring that appropriate announcements are made in Wales should other UK countries announce NSFs. It is important that professionals and the public receive clear messages about the Welsh position. 3. Definitions For the purposes of clarity a strategy is defined as a long term high level vision for a topic or client group. A National Service Framework is the vehicle to deliver the strategy, which will set standards and timescales to support the delivery of improved clinical care for patients. It will be transparent about the evidence base and will have an implementation plan. DEVELOPING A WALES ONLY NSF 4. Wales only Fig. 1. NAW Wales Only External Reference (s) Prioritisation Criteria Wales Only Production/Implementation Team E.g. CHD (Health Evidence Bulletins) Sub s Sub s Evidence HR Performance IM&T (baseline) Finance The evidence, minimum standards and broad scope of the NSF will be decided by the Assembly drawing on advice from an Internal Reference, External, existing evidence in the context of existing Assembly priorities, strategies and policies. 1

2 5. External (EAG) There will be an EAG for each NSF. Every group would need a wide ranging constitution to allow for debate, and a smaller executive committee to take decisions and take forward actions. Where there is clearly a read across between NSFs, for example diabetes and CHD, membership should reflect that. The remit of the EAG is to advise the Health and Well Being Partnership Council through the Policy Lead, on the [scope] development and implementation of the NSF. The NSF will set national standards for the prevention, identification, rehabilitation and management of the condition or client group. It will put in place strategies to support implementation and establish performance measures against which progress will be measured within an agreed timescale. The EAG will put forward recommendations which should: Be based on robust evidence Be value for money and explicit about cost, quality effectiveness and evidence timescales for delivery Be set within the context of other Assembly policy initiatives and NSFs Give consideration to how they can be monitored and reviewed joined up focused within the NHS but linking to partners eg local authority, voluntary sector They will be supported by an Internal Reference and a Secretariat in delivering the recommendations. 6. Membership of EAG The membership of EAG should be fit for purpose and consist of individuals selected for their experience, knowledge, expertise and perspective in the NSF area. The All Wales Professional s, Joint Professional Forum [Health and Well Being] should be used as a source to help identify appropriate professional membership; voluntary sector representation membership should be identified via Community Health Councils, Welsh Council for Voluntary Action, and other relevant groups. Advice will need to be sought from specific groups to ensure the issues affecting disadvantaged groups are fully considered. The EAG needs to have a large constitution that allows for a lot of comment and debate; and a smaller executive arm that takes the decisions and actions forward. The EAG should be constituted so as to have an appropriate range of skills, experience and perspectives. The skills should cover, for example, planning, commissioning, HR, IT, Finance, performance management, etc as appropriate for purpose, and be made up from the internal reference group. These individuals would cover more than one NSF and would support the EAG by providing factual information on their subject and to take the work forward. The representation can be customised to the topic area and they should decide how to recruit members. 2

3 Users and carers, voluntary and private sector and the wider public with the appropriate perspectives will need to form part an integral part of the EAG. Membership will vary according to topic or client group area. Members of the group will be expected to use into their own networks, disseminating information and feeding views back into the EAG as part of an overarching communications strategy. 7. Internal Reference There will be an internal reference group for each NSF, tasked to deal with executive functions, for example ensuring that the resource needs identified during the development of the NSF are addressed in the Budget Planning Round and in Workforce Planning. Policy leads will identify key players from the Assembly who will be of Head of Division/Head of Branch seniority for an Internal Reference which will work closely with the External to ensure that each aspect of work is cross referenced. The members of the Internal will be expected to liaise with relevant external stakeholders, e.g. Directors of Finance as part of an overarching communications strategy. This internal group will vary depending on the topic or client group but will require expertise/background in all or some of the following areas; : HR Planning Commissioning Finance Health promotion Public health IM&T Health professionals Social work professionals R&D Performance management Statistics Communications Public Involvement 8. Chair of External (EAG) It is suggested that to bring together National Assembly for Wales and external stakeholder interests the group will be co-chaired by the policy lead and an expert selected by Ministers. This may not be appropriate in every case but can be particularly helpful in areas, which for example, follow a clearly medical model. Where the NSF is wider ranging it may be more appropriate to have one chair with the relevant skills and expertise to deliver advice on the NSF. 3

4 9. NSF leads An Assembly Policy lead will be the project commissioner. Their role is to lead the NSF from its inception to delivery of the implementation plan to the service. Once delivered the NSF will require monitoring and review and this responsibility will be for the relevant performance management team. A project management approach should be used for the development of NSFs. Project Leads will have the support of NHS Quality in mapping out and delivering the project. 10. Process pathway Fig. 2. Wales Only NSF Decision on NSF (Use epidemiological info? E.g. GP morbidity database) Internal Scope NSF External Baseline assessment (service appraisals GP morbidity database) Implementation Internal Develop standards identification of actions flowing from standards (key stakeholders) External Consultation Access for capacity, deliverability (wider NHS?) Identify costs, issues, timescales. Internal External Draft NSF to Ministers Issue NSF Consultation and Communications will be ongoing throughout the life of the NSF development and implementation. 4

5 The EAG will put forward a scope which will be sent to Ministers for approval by officials. When approved or amended, there will be wide ranging consultation with key stakeholders at a scoping event or events. Once scoped, a literature review and baseline assessment should be undertaken to ensure that a robust view of the current position is available. This should identify the resources required to produce and deliver the NSF. DEVELOPING AN ENGLAND AND WALES NSF 11. England and Wales Fig. 3. England and Wales NAW England Programme Criteria Met External Reference & Internal Steering (NHS; Patient Rep; etc.) (Officials) Prioritisation Criteria E & W E.g. Diabetes Production Framework Wales Programme Implementation Plan Where an English NSF meets the Wales criteria and the Minister has approved the NSF for Wales, the following process should apply:- Assembly policy lead make contact with DoH and seek membership of the DoH Internal Reference to ensure involvement from the scoping stage. They will identify external experts from Wales in the relevant areas and seek to have them on the DoH External Reference Policy lead will identify key players for an Internal Reference which will work in parallel with the External. 5

6 12. Wales External Membership Fig.4. England and Wales NSF Process Pathway Broad Scope of English NSF identified Input from National Assembly for Wales Establish Welsh representation on Internal and External Reference for England (officials and experts in condition) Scope refined Set up Welsh Internal and External Implementation Implementation Baseline Assessment Identification of actions flowing from standards (key stakeholders) Assess for capacity, delivery, etc. Consultation Assess for capacity, deliverability (wider NHS), identify costs, issues and timescales Internal Reference External Reference Draft Implementation plan to Ministers Issue implementation plan for NSF It is suggested that the group developing the Welsh response to the English NSF should be set up along the same guidelines as for the Welsh NSF development. 6

7 The External to be co-chaired by the relevant policy lead and a service lead approved by Ministers. Timescales shall be agreed. Policy lead to keep in regular contact with England s NSF lead. It is recommended that where the NSF is a joint England and Wales NSF there should be a partnership between the Assembly and DoH. This would mean that information on the emerging NSF would be shared equally between England and Wales. This will be taken forward with Ministers, together with proposals for the development of a programme of NSFs. 13. Baseline assessment A baseline assessment or service review will be needed when developing a Wales only or an England and Wales NSF. NSFs must have a baseline assessment and that assessment must include detailed work on good practice this can then be developed and disseminated as a matter of routine. The baseline assessment must be undertaken as the NSF is being developed. Available information such as, GP morbidity database, service appraisals are a source of information for the assessment. 14. Developing standards and actions It is proposed that the External will discuss standards and their applicability to Wales and agree actions flowing from those standards. To do this must measure the baseline to the greatest extent possible and be able to establish what is needed in terms of resources to achieve those standards. Must consider: Capacity IM&T Training Education R&D Financial issues Human resources Performance standards The development of standards and actions will be a process which will involve key stakeholders in a consultative process. Once the process, which may consist of focus groups, workshops, conferences, has taken place, the responses will be analysed and fed back to the Expert. 7

8 15. Resourcing the NSF Resourcing the development of the NSF and resourcing the costs of the NSF itself are issues which must be addressed at the outset. As part of the project management approach, the cost of resourcing the development of the NSF will be identified at the outset. In some cases, the cost of resourcing the NSF implementation may be apparent from the outset and should be identified by the baseline assessment/service review. A key function of the reference groups will be to take issues such as finance, HR, IM&T etc into account as the process develops, using the NSF template at agreed key points along the process pathway. The resources required for the NSF process will include engaging and consulting with stakeholders in the development and implementation. Special attention should be paid to the needs of users and carers in engagement and in ensuring that this is properly resourced. NSFs, their planning and resource implications must be reflected in the Health Improvement programme. 8