A guide to commissioning cardiac surgical services - NHS ...

A guide to commissioning cardiac surgical services
Good planning can inspire change that leads to improvements
Leadership and
engagement
Knowledge and
skills – the basics
Planning the
improvement
workstream
• Identify the key people to be involved early on in the workstream.
• Who are the key stakeholders?
• Clinical and managerial leadership is critical to success.
• Have you included data and informatics and finance,
primary care and social care?
• Establish the steering/working group.
• Has the group got the people with the knowledge and skills?
Can they make the decisions?
• Do they have service improvements skills?
• Knowledge of heath and social care processes?
• Is there service user Involvement?
• Is their agreed local accountability and responsibility for delivery?
• Knowledge of commissioning?
• Information gathered from all perspectives (service users, staff,
commissioners, partnerships etc).
• Identify, understand and define the ‘real’ problem not the
solution.
• Review data to understand demand, activity and variation in
performance.
• How are your improvements going to be measured and
monitored? Have you included qualitative and quantitative
performance indicators?
• Match the collection of baseline data with the scope of the
problem identified.
• Remember that no data will be perfect and beware of analysis
paralysis (collecting everything that tells you nothing).
• Break the data down into sections of information to help
you identify what needs to be collected and analysed.
• Look for the 80/20 rule (Pareto principle) this happens to 80%
of our users; focus on the 80% first, look for trends in
retrospective data.
• Keep clinicians, leaders and key people involved.
• Identify (visioning) and design the ideas to tested.
Engagement with
public and service
users
Test out your ideas
Evaluation
Implementation -
spread and sustain
• Seek and build continuous and meaningful engagement with
the public and service users, involve them in shaping services.
• Have an understanding of different user engagement options,
including the opportunities, strengths, weaknesses and risks.
• Routinely invite service users and the public to respond to and
comment on issues.
• Ensure that users and the public understand how their views will
be used, which decisions they will be involved in, when decisions
will be made, and how they can influence improvement.
• Communicate widely about ideas being tested.
• Test the idea (maybe more than one testing cycle).
• Capture results, benefits and measure the impact. Match across
to your performance indicators.
• Capture the learning (the things that work and those that
didn’t documenting reasons why).
• Communicate regularly with the whole team and partnerships -
keep the message short and snappy.
• Ensure identified ownership of action points.
• Analyse the results and quantify the impact of actual and potential.
• Identify benefits- e.g. quality, cost, outcomes.
• Identify risks.
• Evaluate the alternatives.
• Make recommendations.
• Build your business case on evidence.
• Recommendations for implementation
(provide the evidence that supports your testing).
• Commissioners want to see the evidence.
• Celebrate your achievements.
• Share the learning - publicise your work.
• Prepare your spread/adoption strategy.
• Include how you will measure sustainability.
www.improvement.nhs.uk/heart
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