Heart disease service improvement
Care for people in Scotland with heart disease
requires continuous improvement. The national improvement programme
launched in 2007, provides evidence, implementation support and
measurement to ensure this improvement is effectiveness.
Our heart disease service improvement focuses on:
In 2011, we published Take Heart, a national review of heart
disease services in Scotland. Targeting resources locally and
nationally to streamline data collection and analysis, we moved
away from a 'measure everyone against everything' approach.
The data, intelligence and knowledge produced as a result of
this work has been used to develop a national heart failure care
bundle by the Scottish Patient Safety Programme.
We work collaboratively with the managed clinical networks in
NHS boards plan and support improvement in heart disease
services.
Measuring heart disease services in Scotland
The 2010 Heart Disease Clinical Standards were piloted in NHS
Ayrshire & Arran and NHS Western Isles. All NHS boards then had
two rounds of measurement or audit to complete. The first round
helped NHS boards test local systems and provided us with feedback
on how best to measure performance against the standards. Second
round measurement data was analysed and used for submission as part
of the formal performance assessment exercise.
Collecting improvement evidence
NHS boards were asked to evidence that they were meeting the
standards or developing systems of improvement that would lead to
the standards being met. Every NHS board completed a self
evaluation and gave supporting evidence.
Supporting evidence included:
- details of current local services and improvement plans
- local protocols, pathways, care plans and patient information
documents
- data from national and local audits
- data provided by ISD
- data from the Quality and Outcomes Framework (QOF)
- data provided by the Scottish Ambulance Service.
Evaluated by professional, patient and public
representatives
Evaluation panels were used to review each NHS board’s overall
performance against each standard. The panels consistent of public
partners, medical and nursing staff, managers, and representatives
from voluntary sector organisations.
Panel members met over a 2-day period in January 2011 and issued
a score for each NHS board using this four-point assessment
scale:
- Level 1: The NHS board is developing its policies, strategies,
systems and processes to deliver heart disease services in line
with national evidence, standards and guidance.
- Level 2: The NHS board is implementing its policies,
strategies, systems and processes to deliver care in line with
national evidence, standards and guidance.
- Level 3: The NHS board is monitoring the effectiveness of its
policies, strategies, systems and processes to deliver care in line
with national evidence, standards and guidance.
- Level 4: The NHS board is reviewing and continuously improving
its policies, strategies, systems and processes to deliver care in
line with national evidence, standards and guidance.
This scale reflects the infrastructure in place to provide
person-centred, safe and effective care for people with heart
disease. Our National Overview report and local review
summaries provide full details on each boards performance.
