Advancing Quality NHS Advancing Quality Alliance

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The Advancing Quality Alliance’s (AQuA) flagship reliability of care programme, Advancing Quality (AQ), has recently published 2015/16 clinical intervention measure results for its NHS member organisations across the North West.

The AQ programme, which was founded in 2008, supports partners to improve the consistency and quality of clinical care across a number of Clinical Focus Areas (CFAs) such as; Acute Kidney Injury, Hip and Knee Replacement, Sepsis and Early Intervention Psychosis.

For each of these areas, a set of core quality measures are identified and agreed by local clinical experts across the region, aligned to national standard guidelines. Working to ensure every eligible patient receives the standard care every time, according to each measure has proven to positively impact outcomes; not only helping to save lives but reduce re-admissions, complications and length of hospital stay. 

Nadine Boczkowski, Director for the AQ Programme said:

“We know that people’s health in the North West is generally worse than the England average. In part this is due to the high levels of deprivation seen across the region compared to other areas of England. The AQ programme provides an approach to measure and evidence base the delivery of consistent quality practices in prevalent conditions across the North West. 

“Although there has been decline in results in some areas, impacted by changes to measure definitions and thresholds, it is encouraging to see such positive and increasing results in critical areas such as sepsis, AMI and Diabetes . The ongoing commitment of member organisations and their staff to continuously improve and sustain the quality of clinical care is unfounded. 2015/16 continued to identify and spread the scope and scale of best practice by coming together as a collaborative community, sharing knowledge and learning to drive innovation and improvement.’’

The results, which are featured in full on www.advancingqualitynw.nhs.uk can be viewed by hospital or locality. Hospitals included in the published results are commissioned to participate in the programme as part of their local contracts. Some participating organisation’s data may not be published if they do not meet the data quality / completeness threshold for public reporting. 

The Clinical Focus Areas included in the 2015/16 results are:

The Trusts with 2015/16 results being published today are:Acute Trusts

  • Aintree University Hospital NHS Foundation Trust
  • Countess of Chester Hospital NHS Foundation Trust
  • East Cheshire NHS Trust
  • East Lancashire Hospitals NHS Trust
  • Lancashire Teaching Hospitals NHS Foundation Trust
  • Liverpool Heart and Chest Hospital NHS Foundation Trust
  • Mid Cheshire Hospitals NHS Foundation Trust
  • Pennine Acute Hospitals NHS Trust
  • Royal Liverpool and Broadgreen University Hospitals NHS Trust
  • Salford Royal NHS Foundation Trust
  • Southport and Ormskirk Hospital NHS Trust
  • St Helen’s and Knowsley Teaching Hospital NHS Trust
  • Stockport NHS Foundation Trust
  • Tameside Hospital NHS Foundation Trust
  • University Hospitals of Morecambe Bay NHS Foundation Trust
  • Warrington and Halton Hospitals NHS Foundation Trust
  • Wirral University Teaching Hospital NHS Foundation Trust

Mental Health and Care Trusts

  • 5 Boroughs Partnership NHS Foundation Trust
  • Cheshire and Wirral Partnership NHS Foundation Trust
  • Greater Manchester West Mental Health NHS Foundation Trust
  • Lancashire Care NHS Foundation Trust
  • Mersey Care NHS Foundation Trust
  • Pennine Care NHS Foundation Trust

Independent sector providers

  • BMI Healthcare – The Alexandra Hospital
  • Ramsay Healthcare UK – Euxton Hall Hospital
  • Ramsay Healthcare UK – Fulwood Hall Hospital
  • Ramsay Healthcare UK – Renacres Hospital

Over the next three months we want your views on our flagship reliability of care programme, Advancing Quality (AQ).

We’re asking all our members, including those not currently participating in AQ, to share their thoughts and help us shape our 2017/18 plans for the programme. You can do this through our short online survey, or by taking part in 1-1 meetings and telephone interviews.

For more information, please download the flyer. To take part in the survey please click here, or contact nadine.boczkowski@srft.nhs.uk to arrange a meeting or phone call.

The Advancing Quality team will be presenting the successes of the trusts in the North West at the International Forum on Quality and Safety in Healthcare which is to be held in London.

This is the twentieth Quality and Safety in Healthcare event and it will see over 3000 health care specialists connect to share best practice and learning to improve patient safety and innovation. Advancing Quality will be able to promote the dedication and hard work hospitals engaged with the programme have achieved in delivering patient safety improvement at this international event.

Lesley Kitchen, AQ Programme Director, said: ”This is an amazing opportunity to really demonstrate the successes in the North West in improving the quality of care our patients are receiving. AQ will be able to exhibit the new focus areas and the dedication of the programme in continually pushing the quality agenda.’

Advancing Quality will be presenting the improvement in appropriate care score North West trusts have achieved in the following clinical focus areas; Heart Attack, Heart Bypass Surgery, Heart Failure, Hip and Knee Replacement Surgery, Pneumonia, Stroke, Dementia and First Episode Psychosis.

The new clinical focus areas are; Alcohol Related Liver Disease, Chronic Obstructive Pulmonary Disease, Diabetes, Hip Fracture, Kidney Injury and sepsis.

Clinical representatives from hospitals across the North West gathered at the Mercure Bolton Georgian House Hotel yesterday for the second Advancing Quality Awards.

The Awards, launched in 2013, were held to recognise the achievements of the acute and mental health trusts across the North West of England who participate in Advancing Quality and reflect on the impact the programme has had over the last year. This year hospitals were rewarded based on their work in the specific clinical focus areas.

The winners were:

St Helens and Knowsley; Joint Winner: Best Performing Trust for Acute Myocardial Infarction. Winners: Best Performing Trust for Hip and Knee Replacement Surgery and Best Performing Trust for Pneumonia.

St Helens & Knowsley AMI, HK, PN Winners

Pictured: Craig Downs and Joanne Booth collecting the trophies on behalf of St Helens and Knowsley

 

Greater Manchester West Mental Health NHS Foundation Trust; Winners: Best Performing Trust for Dementia and Best Performing Trust for First Episode Psychosis.

GM West DEM & FEP Winners

Pictured Alison Chapman collecting the trophies on behalf of GMW

Wrightington, Wigan and Leigh; Best Performing Trust for Heart Failure

WWL HF Winners

Pictured: Alison Unsworth and David Byrne collecting the trophy on behalf of WWL.

Liverpool Heart and Chest: Winners Best Performing Trust for Coronary Heart Bypass Graft Surgery

 

Pictured: Paul Arnold collecting the trophy on behalf of Liverpool Heart and Chest

Mid-Cheshire; Joint Winner: Best Performing Trust for Acute Myocardial Infarction

Mid Cheshire AMI Winners

Pictured: Liz Huntbach collecting the award on behalf of Mid-Cheshire

Royal Liverpool and Broadgreen University Hospitals Trust; Joint Winner: Best Performing Trust for Acute Myocardial Infarction

Royal Liverpool AMI Winners

Pictured: Will Maitland collecting the trophy on behalf of Royal Liverpool and Broadgreen.

Salford Royal Foundation Trust; Winners: Best Performing Trust for Stroke

Salford Stroke Winners

Pictured: Mark Lammas collecting the trophy on behalf of Salford Royal

Andrew Binnie, Quality and Performance Manager, Eastern Cheshire Clinical Commissioning Group said; “AQ addresses the systems of care and engagement that are critical to driving change and while targets and goals are still very important, shifting the focus to seeking continuous improvement is the motivating mind-set.”

Runners up for the Best Performing Trusts were;

Stephen Nixon, Assurance Manager, Grant Thornton said; “data quality remains at a high standard no hospitals fell below the 80% CQUIN threshold and several scored 100%.”

Advancing Quality will almost double the conditions monitored in the North West as part of the quality improvement programme.  AQ and North West Trusts are working together to launch six new clinical focus areas.

The focus areas are highly prevalent clinical conditions affecting patients in the North West. Hospitals that are taking part in the new focus areas have begun work to develop robust means of recording specific data that will allow AQ to monitor the quality of care a patient receives.

Liz Kanwar, AQ Programme Manager, said: “This is the largest expansion ever in the Advancing Quality programme, we are launching more clinical focus areas now than we did when the programme started. The addition of these new areas means that AQ will now cover roughly 10% of admissions to hospitals in the North West.”

The focus areas  will be monitored using measures based on best practice and input from specialist clinicians. The new areas are:

The number of clinical focus in Advancing Quality will increase to 14, and the majority of the new areas will be live in hospitals from April 2015.

Over 150 healthcare professionals gathered at the Mercure Manchester Piccadilly Hotel yesterday for the first Advancing Quality Awards 2013.

The Awards were held to recognise the achievements to date of the acute and mental health trusts across the North West of England who participate in Advancing Quality and reflect on the impact the programme has had over the last five years.

The winners were:

Advancing Quality Team of the Year

AQ Team of the year

Winner: University Hospitals of Morecambe Bay

Runners up: Manchester Mental Health and Social Care Trust and Wirral University Teaching  Hospitals

Liz Kanwar, AQ Programme Manager:

“The judges liked the fact AQ has brought together teams  from a multi-site hospital achieving uniformity, cohesive team working, improving cultural  differences and better patient care and was really impressed by the way they have embraced AQ.”


Most Improved Trust (Y1-Y5)

Most Improved Trust

3rd place: Royal Liverpool and Broadgreen University Hospitals NHS Trust

2nd place: Wrightington, Wigan and Leigh NHS Foundation Trust

1st place: Countess of Chester NHS Foundation Trust

Liz Kanwar, AQ Programme Manager:

“Countess of Chester has very much embraced Advancing  Quality from the onset, striving to improve from a grass roots level. They have shown consistent  improvement over the years with the AQ measures truly embedded within the organisation.


Most Improved Trust (Y4-Y5)

Most Improved Trust MH

3rd place: Mersey Care NHS Trust

2nd place: Manchester Mental Health and Social Care Trust

1st place: Greater Manchester West Mental Health NHS Foundation Trust

Liz Kanwar, AQ Programme Manager:

“WWL have been high achievers across all clinical focus areas, implementing many service improvement initiatives to ensure that all patients receive excellent care. They have regularly contributed to the many AQ collaboratives sharing their best practice case studies with hospitals across the North West.”


Best Performing Trust (Y4-Y5, Acute)

Best Performing Trust

3rd place: Mersey Care NHS Trust

2nd place: Royal Liverpool and Broadgreen University Hospitals NHS Trust

1st place: Wrightington, Wigan and Leigh NHS Foundation Trust

Liz Kanwar, AQ Programme Manager:

“WWL have been high achievers across all clinical focus areas, implementing many service improvement initiatives to ensure that all patients receive excellent care. They have regularly contributed to the many AQ collaboratives sharing their best practice case studies with hospitals across the North West.”


Best Performing Trust (Y4-Y5, participating in only one focus area)

3rd place: Manchester Mental Health and Social Care Trust

2nd place: Rotherham, Doncaster and South Humber NHS Foundation Trust

1st place: Oaklands Hospital (part of Ramsay Healthcare)

Liz Kanwar, AQ Programme Manager:

“Oaklands Hospital joined AQ less than two years ago and their results have reflected the outstanding treatment their patients consistently receive.”


Best Performing Trust (Y4-Y5, Specialist Cardiac Centre)

Best Performing Trust Cardiac

3rd place: University Hospital of South Manchester NHS Foundation Trust

2nd place: Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust

1st place: Liverpool Heart and Chest Hospital NHS Foundation Trust

Liz Kanwar, AQ Programme Manager:

“Liverpool Heart and Chest has consistently achieved outstanding results, in particular for heart bypass surgery. They have embraced new measures and assisted in the development of the AQ metric pathway making this Best Performing Trust award very much well deserved.”


Best Performing Trust (Y4-Y5, Mental Health)

Best Performing Trust MH

3rd place: Greater Manchester West Mental Health NHS Foundation Trust

2nd place: Lancashire Care NHS Foundation Trust

1st place: 5 Boroughs Partnership NHS Foundation Trust

Liz Kanwar, AQ Programme Manager:

“5 Boroughs Partnership has been consistent high performers throughout the mental health focus areas from inception. They have been able to maintain this improvement throughout the years of the programme and, in true AQ style, have been able to improve year on year.”

The quality of care in North West hospitals is continuing to improve, according to new figures released today.

The Advancing Quality Alliance (AQuA), the North West’s health care quality organisation, has published the annual results from its Advancing Quality programme which show the region’s NHS trusts achieved improvements of more than 30 per cent in key quality measures designed to drive up standards.

This equates to an estimated 17,000 lives and 76,000 bed days saved over the last five years across the region.

The table below shows the scores for each clinical focus area from year 1 to year 5 of the programme. These figures represent the North West region as a whole. The trusts are scored by how consistently they deliver the quality of care measures. The percentage increase is the overall improvement in the North West from year 1 to year 5.

AMI* CABG** Heart failure Hip and knee Pneumonia Stroke Dementia FEP***
Year 1 92.52% 96.78% 62.12% 89.55%  76.32%  N/A N/A N/A
Year 2 97.49% 96.94% 69.95% 92.82%  81.54%  N/A N/A N/A
Year 3 97.76% 98.22% 75.46% 94.58%  85.97%  N/A N/A N/A
Year 4 98.29% 97.88% 80.64% 95.91%  85.01% 87.03% 77.09% 89.30%
Year 5 98.50% 96.59% 82.06% 96.75%  87.92% 90.83% 84.95% 94.52%
Actual increase between Y1-Y5 scores +5.98 -0.19 +19.94 +7.2  +11.6 +3.8 +7.86 +5.22
% increase from Y1-Y5 +6.47% -0.20% +32.08% +8.04%  +15.21% +4.37% +10.19% +5.84%

The aim of Advancing Quality is to improve quality of care in hospitals by reducing complications, length of hospital stay, mortality and re-admission rates for patients in regularly performed surgery and treatments for heart attacks, hip and knee replacement surgery, pneumonia, heart failure and heart bypass surgery.

Following early success of the programme, it expanded into the care of stroke patients and patients suffering from dementia and first episode psychosis (FEP).

Medical Director for NHS England, Greater Manchester, Dr Raj Patel, said: “We all welcome these new figures which clearly show how quality improvement programmes can make a big impact. It’s not an academic exercise, AQuA saves lives.”

Advancing Quality launched in 2008 and is live in all NHS acute and mental health provider trusts across the North West of England. The programme is based on a set of quality standards which clinicians agree define and measure good clinical practice and should be delivered to every patient to ensure they receive the highest standard of care. Hospitals collect and submit data on these quality standards, which range from recording that the right antibiotics are given at the right time through to patients receiving written discharge instructions on how to prevent relapses.

Each trust has an Advancing Quality team who work locally to drive improvements. AQuA hosts Advancing Quality shared learning events throughout the year to give the teams the opportunity to come together to share examples of best practice and learn about the latest developments in the programme and the focus areas.

The results are publicly reported once a year on the Advancing Quality website, www.advancingqualitynw.nhs.uk so patients can see how well their local trust is performing. The results published today [28.11.13] are from the fifth year of the programme, April 2012 to March 2013.

A team of economists and health experts led by the University of Manchester have been independently evaluating the programme associating a “significant” fall in mortality rates since the introduction of Advancing Quality.

The researchers investigated figures for in-hospital deaths within 30 days of admission for patients with pneumonia, AMI and heart failure 18 months before and after the introduction of Advancing Quality. They conclude that avoidable mortality rates fell by 6% in the North West, the equivalent of 890 deaths with additional research associating AQ with 23,000 fewer bed days, equating to savings of £4.4 million. Using the same calculation method, AQuA has been able to extrapolate those figures to estimate the impact over the last five years.

David Fillingham, Chief Executive of AQuA, said:

“To see the Advancing Quality results improve year-on-year is really encouraging and is testament to the dedication and commitment of clinical teams and NHS staff across the region. There is still work to do, nothing is a ‘quick fix’ but the fact that we are now able to see the impact AQ is having on mortality rates, length of stay and financial savings far exceeds even the most ambitious expectations we held for the programme and further demonstrates AQ’s value as a method for commissioning for outcomes.”

We are absolutely delighted the Advancing Quality programme has won a Guardian Public Services Award!

guardian-awardThe programme scooped the title for the Measuring Excellence category, which awards initiatives where excellence is recognised using data and grounded on a solid bed of evidence.

Judges, including Jessica Crowe, Chief Executive of the Office for Public Scrutiny who presented the award, said the programme had a strong ethos of transparency and shared learning and proved that using and measuring data isn’t just a chore, but a means of really understanding what people need. It was added the judges felt Advancing Quality should win because of our aims to tackle variations in care, cut readmissions and save lives so that thousands of patients receive the right care at the right time and in the right place.

Read more about the Guardian Public Services Awards 2013

 

Lesley Kitchen, Advancing Quality Programme Director, said:

“This is a fantastic achievement for Advancing Quality and we are delighted the acute and mental health provider trusts, along with commissioners from across all North West CCGs, are getting national recognition for their commitment to implement the programme. It is a wonderful and well deserved accolade for the region!”

 

PleasecreditthephototoAnnaGordonandtheGuardianPublicServices

Picture: Members of AQuA’s Advancing Quality team including Lesley Kitchen (centre) are presented with their Guardian Public Services Award from Jane Dudman, editor of the Guardian Public Leaders Network (left) and Jessica Crowe (second from right)

Researchers evaluating the impact of Advancing Quality on health care in the North West have had a second paper published online in Health Economics.

The paper, The cost-effectiveness of using financial incentives to improve provider quality: a framework and application (Health Econ. (2013)DOI: 10.1002/hec), follows on from the publication in the New England Journal of Medicine last year which estimated Advancing Quality to have reduced the number of deaths by 890. Read more here

Researchers led by a team at the University of Manchester looked at the number of patients who had a heart attack, heart failure or pneumonia in the North West of England during the first 18 months of Advancing Quality (Oct 2008 – Mar 2010). They reviewed how many died within 30 days of hospital admission, how many had an emergency readmission within 30 days and how long they stayed in hospital. They then compared these figures to 18 months before Advancing Quality was introduced and also compared them to patients admitted with the same conditions but treated at hospitals outside the North West.

They concluded, in the first 18 months, Advancing Quality:

This in turn represents a greater than eight-fold return on investment.

Lesley Kitchen, Advancing Quality Programme Director, said:

“This is another fantastic piece of news for every North West England NHS trust who participate in and commission Advancing Quality. We are now five years into the programme and it continues to go from strength-to-strength. One of our key motivations is the fact that is is independently evaluated proving to patients, families and the wider health economy that healthcare in the North West is continuing to improve year-on-year.”

Advancing Quality has been shortlisted for its second national award of the year.

The programme, which is live across the North West, is one of three entries to be shortlisted for the Measuring Excellence category in the Guardian Public Services Award 2013.

Now in their 10th year, the Public Services Awards reward innovation and impact in all public services and have been recognised as a gold standard of achievement for people working in public service teams.

Advancing Quality has also been shortlisted for Enhancing Care by Sharing Data and Information in the Health Service Journal (HSJ) Awards 2013.

David Fillingham, AQuA Chief Executive, said:

“It is an honour to have AQuA’s flagship programme shortlisted for two national awards this year. Whether we win or not, it is still a testament to all AQ teams across the North West who are committed to ensuring their patients get the possible care by implementing the AQ approach.”

The winners will be announced at an awards ceremony in London on 12 November 2013.

We are absolutely delighted to announce Advancing Quality has been shortlisted for a national award in recognition of its impact on enhancing patient care.

The programme, which is ‘live’ in all NHS acute and mental health provider trusts across the North West of England, has been shortlisted in the Enhancing Care by Sharing Data and Information category in the Health Service Journal (HSJ) Awards 2013.

The HSJ Awards are the most prestigious and coveted awards in UK health. More than 1,000 entries were submitted across the 22 categories championing best practice and innovation to overcome the challenges which face the health sector today.

Alastair McLellan, Editor-in-Chief, HSJ, said:

“Being shortlisted means the organisation/programme has been specifically chosen as a leader in innovation and best practice. We received a record number of entries for this, our 32nd year of the awards – a reflection of the pride health services and organisations have in their vital work.”

David Fillingham, Chief Executive, AQuA, said:

“We are absolutely delighted Advancing Quality has been shortlisted for a HSJ Award. The success of Advancing Quality is attributed to the commitment from all the clinical and administrative teams across the North West to implement a collaborative approach to sharing data and best practice, so this is very much a well-deserved accolade for the entire region, not just AQuA.”

The HSJ Awards will be presented at Grosvenor House in London on 19 November 2013.

Advancing Quality is now in its sixth year and, in the last 12 months, the 32 participating acute and mental health trusts have gained international recognition via the New England Journal of Medicine (ref: N Engl J Med 2012; 367:1821-8) for implementing a region-wide quality improvement programme which promotes truly patient-centred care.

We want to acknowledge this dedication by introducing annual AQ awards which will celebrate the success stories and spread best practice across the region.

Enter the awards today

The Advancing Quality Awards will be held on Wednesday 4 December 2013, 1.30pm-5pm (approx), at the Mercure Manchester Piccadilly Hotel. Awards will be presented on the day such as:

Why should we enter?

Awards for the top performing and most improved Trusts will be presented based on Y5 results.

For Advancing Quality Team of the Year, this is the award to give Trusts the opportunity to shine by submitting examples of how they have implemented the AQ approach and demonstrate best practice, which can be shared with their peers.

The winners will be announced at the Advancing Quality Awards in front of an audience of healthcare professionals from across the North West and will position your team as one of the front runners in quality improvement.

How do we enter?

It’s easy and free to enter your team. Just go to www.advancingqualitynw.nhs.uk/awards. Along with the entry form, there is also additional information on the shortlist criteria, timelines and judging process.

Book your place at the Advancing Quality Awards

We look forward to receiving your entries.

Research into the impact of AQuA’s Advancing Quality programme took centre stage at the sixth Health Services Research Network (HSRN) annual symposium.

The HSRN symposium brings together researchers, practitioners, senior managers and policy makers to learn more about the latest research results and methods on a number of themes, including informatics; patient safety; and using evidence.

AQuA Chief Executive, David Fillingham, joined Professor Matt Sutton from the University of Manchester to give the keynote plenary on landmark evidence discussing the results of the independent evaluation which estimated hundreds of lives had been saved since the introduction of Advancing Quality (AQ).

Advancing Quality, AQuA’s flagship programme, is ‘live’ in every NHS acute and mental health trust across the North West and is based on achieving a set of quality standards which define and measure good clinical practice in a number of common clinical conditions for the region.

Professor Sutton and a team of researchers led by the Universities of Nottingham and Manchester investigated figures for in-hospital deaths within 30 days of admission for patients with pneumonia, AMI and heart failure 18 months before and after the introduction of AQ. They concluded that avoidable mortality rates fell by 6% in the North West, the equivalent of 890 deaths, and the results were published in the New England Journal of Medicine (ref: N Engl J Med 2012; 367:1821-8).

David said:

“I was delighted to be asked to give the keynote plenary at the HSRN symposium on Advancing Quality. The evaluation into AQ led by Professor Sutton and colleagues has gained national and international recognition for the programme and helped us to cement its reputation as an improvement initiative which is making a real impact across the North West so, to be able to give AQuA’s perspective on this, was a fantastic opportunity.”

For more details on the HSRN, go to www.hsrlive.org

GPs and commissioners are invited to attend one of several locality meetings being held in January to discuss the role of CCGs in Advancing Quality.

Advancing Quality is a clinically-led quality improvement programme designed to drive up standards in healthcare, reduce variation and reduce avoidable mortality. Historically funded by all North West PCTs, Advancing Quality (AQ) is a well-established programme ‘live’ in every NHS acute and mental health provider trust in the region since 2008.

Operating in specific clinical areas, the AQ quality indicators aim to ensure every patient receives the same high standard of care in every hospital, as required by the NHS Mandate. The indicators form part of the CQUIN framework and provide a benchmark for commissioners to measure quality and understand variation across the region.

And it works. In a paper published in the New England Journal of Medicine, a team of independent health experts and economists led by the University of Manchester concluded AQ was associated with 890 fewer deaths in just the first 18 months alone.

Additional research from the same team has also shown that, for every £1 invested in funding AQ, an estimated £10 is generated in health gains.

As the new health landscape continues to take shape, GPs and commissioners play a vital role in deciding the future direction of AQ including governance arrangements, future funding and deciding which clinical areas the programme should expand into.

We are inviting the following people to attend a meeting arranged within each of the North West clusters:

The meetings take place as follows:

The quality of care in North West hospitals is continuing to improve, according to new figures released by Advancing Quality today.

The fourth annual results from the programme show the region’s NHS trusts achieved improvements of more than 30 per cent in key quality measures designed to drive up standards.

The table below shows the scores for each clinical focus area from year one to year four of the programme. These figures represent the North West region as a whole. The trusts are scored by how consistently they deliver the quality of care measures. The percentage increase is the overall improvement in the North West from year one to year four.

AIM* CABG** Heart failure Hip and knee Pneumonia Stroke Dementia FEP***
Year 1 92.52% 96.78% 62.12% 89.54%  76.31%  N/A N/A N/A
Year 2 97.49% 96.94% 69.95% 92.82%  81.54%  N/A N/A N/A
Year 3 97.76% 98.22% 75.45% 94.58%  85.97%  N/A N/A N/A
Year 4 98.26% 98.02% 81.23% 95.56%  84.33% 86.87% 74.55% 87.85%
Actual increase between Y1-Y5 scores +5.74 +1.24 +19.11 +6.02 +8.02 N/A N/A N/A
% increase from Y1-Y5 +6.20% +1.27% +30.76% +6.71% +10.50% N/A N/A N/A

*AMI: Acute Myocardial Infarction i.e. heart attacks **CABG: Coronary Artery Bypass Graft i.e. heart bypass surgery ***FEP: First Episode Psychosis

The figures follow last week’s publication in the New England Journal of Medicine of an independent evaluation by a team of economists and health experts from the Universities of Manchester, Nottingham, Birmingham and Cambridge who found there has been a “significant” fall in mortality rates since the introduction of Advancing Quality.

The researchers investigated figures for in-hospital deaths within 30 days of admission for patients with pneumonia, AMI and heart failure 18 months before and after the introduction of Advancing Quality. They conclude that avoidable mortality rates fell by six per cent in the North West, the equivalent of 890 deaths.

The aim of the Advancing Quality programme is to improve clinical quality and outcomes for patients by reducing complications, length of hospital stay, mortality and re-admission rates for patients in regularly performed surgery and treatments for heart attackship and knee replacementspneumoniaheart failure and heart bypass surgery.

Following early success of the programme, it was expanded into the care of stroke patients and patients suffering from dementia and first episode psychosis. The first set of these results have also been published today.

Mark Woodhead, Advancing Quality clinical lead for pneumonia, said:

“For adults with pneumonia, we have seen a clear improvement in the standards of care across the North West over four years of Advancing Quality and I look forward to continue working with all the pneumonia teams across the North West to share best practice and build on these excellent achievements.”

Scot Garg, Advancing Quality clinical lead for AMI, added:

“Advancing Quality is a success thanks to the dedication and commitment of all the teams who work together to share examples of best practice across the region. The results for AMI have improved year-on-year with 98% of our patients receiving the Advancing Quality measures, so we can be proud that the care we provide to patients is of the highest standards.”

~ ENDS ~

Notes to editors:

  1. For further information on Advancing Quality, see www.advancingqualitynw.nhs.uk or contact Lindsay Kirby on 0161 206 8438 or Lindsay.kirby@srft.nhs.uk
  2. Advancing Quality is the flagship programme of AQuA, an NHS membership body dedicated to helping NHS organisations in the North West provide high quality health care services and improved health. For more information, visit the AQuA website.
  3. The results which have seen the smallest improvements, such as CABG and AMI, can be attributed to the first year of Advancing Quality setting a higher baseline so there has not been as much room for improvement as in focus areas such as heart failure and pneumonia.
  4. Advancing Quality has clinical leads in each focus area to act as sounding boards for their area of expertise and work with colleagues across the region to drive compliance to the measures.

Professor Mark Woodhead is a consultant and honorary senior lecturer in respiratory and general medicine at Central Manchester University Hospitals NHS Foundation Trust.
Dr Scot Garg is a consultant cardiologist at East Lancashire Hospitals NHS Trust.

Researchers evaluating the impact of the Advancing Quality programme in the North West have estimated hundreds of lives were saved within the first 18 months.

In a paper published in the New England Journal of Medicine, a team of economists and health experts from the Universities of Manchester, Nottingham, Birmingham and Cambridge found there has been a significant fall in mortality rates since the introduction of Advancing Quality.

The researchers investigated figures for in-hospital deaths within 30 days of admission for patients with pneumonia, AMI and heart failure 18 months before and after the introduction of Advancing Quality. They conclude that avoidable mortality rates fell by 6% in the North West, the equivalent of 890 deaths.

Lead author Matt Sutton, Professor of Health Economics in The University of Manchester’s Institute for Population Health, said:

“We examined a unique initiative in which a bonus system from the US was adopted only in North West of England. We found that while research has shown the US scheme had no effect on patient health, the same scheme in the NHS did and resulted in 890 lives being saved during the 18 month scheme.”


Julia Hickling, AQuA Director, said:

“This is really encouraging news and is testament to the dedication and commitment of clinical teams and NHS staff across the region. The fact that AQ is associated with 890 fewer deaths in just the first 18 months far exceeds even the most ambitious expectations we held for the programme and further demonstrates AQ’s value as a method for commissioning for outcomes.”

Advancing Quality was introduced in all North West hospitals providing emergency care in 2008 to improve standards and reduce variation. It is based on the Healthcare Quality Incentive Demonstrator project which was operated by Premier Incorporated in the United States. In late 2010, Clarity Informatics was contracted by AQ to continue the operation of data and other support services. Along with pneumonia, heart failure and AMI, it is also live in coronary artery bypass graft surgery, hip and knee replacement surgery, stroke, dementia and first episode psychosis.The programme is based on a set of quality standards which clinicians agree define and measure good clinical practice and should be delivered to every patient to ensure they receive the highest standard of care. Hospitals collect and submit data on these quality standards, which range from recording that the right antibiotics are given at the right time through to patients receiving written discharge instructions on how to prevent relapses.

Each NHS trust has an AQ team who work locally to drive improvements. AQuA hosts Advancing Quality collaborative and shared learning events throughout the year to give the teams the opportunity to come together to share examples of best practice and learn about the latest developments in the programme and the focus areas.

The results are publicly reported once a year via the Advancing Quality website and the latest results for Year 4 of the programme (April 2011 to March 2012) will be published Wednesday 14th November 2012.

The full New England Journal of Medicine article is available to subscribers via www.nejm.org

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Notes to editors:

  1. For further information on Advancing Quality, see www.advancingqualitynw.nhs.uk or contact Lindsay Kirby on 0161 206 8438 or Lindsay.kirby@srft.nhs.uk
  2. Advancing Quality is the flagship programme of AQuA, an NHS membership body dedicated to helping NHS organisations in the North West provide high quality health care services and improved health. See the AQuA website for more information.
  3. Clarity Informatics is an internationally-renowned centre of excellence in the application of evidence-based health informatics. For further information, please contact Rebecca Brown of Clarity Informatics on 0845 113 1000 or Suzie Creighton of Castlegate on 0772 999 3721 or suzie@castlegatecommunications.co.uk

The Y4 results of the Advancing Quality programme are scheduled to be publicly reported for the first time this November.

The results, which will be uploaded to the Advancing Quality website, will also include the results for the new measures introduced in stroke, dementia and first episode psychosis care pathways over the last 18 months.

The original ethos of AQ programme, which was introduced in all hospitals across North West England in 2008, includes a commitment to transparency so members of the public can see how their local NHS acute or mental health trust is performing across some of the most common clinical conditions which affect the region’s population.

If you would like to be notified when the Y4 results are live on the Advancing Quality website, please email us.

An updated version of the AQuA Work Programme, which sets out it’s priorities over the next 12 months, has been published for the summer.

The programme, which can be accessed via the AQuA website, outlines how the AQuA (Advancing Quality Alliance) approach relates to the five domains of the NHS Outcomes Framework: Preventing premature deaths; Enhancing quality of life; Episodes of ill health or injury; A positive experience; Safe and harm free.

Advancing Quality is the flagship programme of AQuA, an NHS membership health improvement body which aims to promote best quality care across the North West.

Thank you to everyone who visited the Advancing Quality exhibition stand at this year’s NHS Confederation in Manchester. It was a fantastic opportunity to meet so many people who wanted to find out more about Advancing Quality and the impact it is having on health services in the North West of England.

The NHS Confederation hosts an annual exhibition and conference to bring together delegates with leaders from across the healthcare system so we were especially proud to be asked to present Advancing Quality as one of the strand sessions entitled Innovation and Incentives: the road to commissioning for quality and improving hospital care.
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AQTeamMembersLesleyKitchenJaneHarperLindsayKirbycompressed

Picture: (From left) Advancing Quality’s Programme Director Lesley Kitchen, Project Manager Jane Harper and Communications Officer Lindsay Kirby at the NHS Confederation 2012.

Notes to Editors:

Advancing Quality was launched in 2008 in all North West hospitals and focuses on heart failure, heart bypass surgery, heart attack, hip and knee replacement surgery, pneumonia, stroke, first episode psychosis and dementia.

Advancing Quality is the flagship programme of AQuA, an NHS membership body dedicated to helping NHS organisations in the North West provide high quality health care services and improved health. For more information on AQuA, visit the AQuA website.

For more information regarding this press release, please contact Lindsay Kirby, Advancing Quality Communications Officer, on 0161 206 8438 or email lindsay.kirby@srft.nhs.uk.

Advancing Quality Alliance (AQuA) has published its work programme for 2012-13 setting out its main priorities over the next 12 months.

The programme, which can be accessed via the AQuA website, outlines how the AQuA approach relates to the five domains of the NHS Outcomes Framework: Preventing premature deaths; Enhancing quality of life; Episodes of ill health or injury; A positive experience; Safe and harm free.

Advancing Quality is the flagship programme of AQuA, an NHS membership health improvement body which aims to promote best quality care across the North West.

AQuA Chief Executive, David Fillingham, said:

“We strongly believe that only be everyone pulling together can we achieve out aim of improving the quality of care delivered to patients and improving the health of local people.”

Patients suffering from five of the North West’s most common conditions are benefiting from improved standards of hospital care, according to the latest results published by Advancing Quality.

Results from the third year of the programme show that the region’s NHS trusts achieved improvements of more than 21 per cent in key quality measures designed to drive up standards.

The aim of Advancing Quality is to improve clinical quality and outcomes for patients by reducing complications, length of hospital stay, mortality and re-admission rates for patients in regularly performed surgery and treatments for heart attackship and knee replacement surgerypneumoniaheart failure and heart bypass surgery.

The table below shows the scores for each clinical focus area in years one to three of the programme. These figures represent the North West region as a whole. The trusts are scored by how consistently they deliver the quality of care measures. The percentage increase is the overall improvement in the North West from year one to year three.

AIM* CABG** Heart failure Hip and knee Pneumonia
Year 1 92.52% 96.78% 62.12% 89.54%  76.32%
Year 2 97.49% 96.94% 69.95% 92.82%  81.54%
Year 3 97.76% 98.22% 75.45% 94.58%  85.97%
Actual increase between Y1-Y3 +5.66% +1.48% +21.45% +5.62%  +13.15%

*AMI: Acute Mycocardial Infarction (i.e. heart attack)
*CABG: Coronary Artery Bypass Graph (i.e. heart bypass surgery)

Advancing Quality is the flagship programme of the Advancing Quality Alliance (AQuA), the North West’s health improvement organisation.

AQuA chief executive, David Fillingham, said: “I am delighted to see that in year three of the Advancing Quality programme the entire region has continued to improve the quality of care delivered to patients. These results pay tribute to the excellent work that is being done by NHS staff. This plays a key role in AQuA’s mission to support improvements in health and the quality of health services in the North West of England.”

The Advancing Quality programme was launched in 2008 and is now live in 32 North West NHS provider trusts. Clinicians have agreed a set of standards for the conditions above which define and measure good clinical practice. Consistent delivery of these interventions is associated with better outcomes for patients. Each measure should be delivered in every patient to ensure they receive the highest standard of care and drive improvements in healthcare across the regiong.

Each trust has an Advancing Quality team who work locally to drive improvements. AQuA hosts Advancing Quality collaborative and shared learning events throughout the year to give the teams the opportunity to come together to share examples of best practice and learn about the latest developments in the programme and the focus area.

Advancing Quality clinical lead for heart failure, Dr Jeff Ball, said: “Advancing Quality is a programme which is driven by clinicians and has been effective with demonstrable improvements in patient care across the North West within a very short time. The programme is about ensuring diagnosis, investigation, treatment and advice are given at the right time, every time for every patient. Published data shows that is is working and we are expecting patient care to continue to improve as the programme progresses.”

The results are publicly reported once a year on the Advancing Quality website so patients can see how well their local trust is performing.

The programme also measures care of stroke patients and patients suffering from dementia and first episode psychosis. Results from these measures will be published later in the year.

A new-look Advancing Quality website has been launched to co-incide with the publication of the programme’s Year Three results.

The website now enables visitors to select their local North West hospital from the ‘Results’ tab where they will then be directed to a page dedicated to the NHS trust which is in charge of that hospital and a summary of its performance over the last three years.

The Year Three results, covering April 2010 to March 2011, will be published online on Wednesday 1st February 2012.

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