"Quality Standards to Quality Assured Indicators: The End-to-End Process", presentation delivered by John Varlow (Director of Information Services - HSCIC) and Nick Baillie (Associate Director, Indicators, Health and Social Care Quality Team, NICE), at the Healthcare Efficiency Through Technology Expo 2013.

1. Quality Standards to Quality Assured
Indicators
The End-to-End Process
Healthcare Efficiency Through Technology Expo 2013

2. Overview
• Introducing
– NICE and HSCIC
• Background
– To NICE quality standards
– To the national library of quality assured
indicators
• The journey from quality standards to a
national library of quality assured indicators

3. Introducing NICE
The National Institute for Health and Care Excellence
(NICE) is a Non Departmental Public Body - funded by the
Department of Health
• Responsible for developing:
– Evidence-based guidance & support tools on the most effective
ways to diagnose, treat, prevent disease and ill health and care
for people receiving social care
– A library of quality standards (and menus of associated
indicators)
– NICE Evidence.

4. Introducing HSCIC
HSCIC is an Executive Non-Departmental Public Body (ENDPB)
which came into being on 1st April 2013
• Responsible for:
– The collection, linkage and secure storage and publication
of the core data resources for health and social care,
bringing together into a single place all indicators, the data
and details of their methodologies
– IT systems delivery; providing the expertise necessary to
support the continuation of existing national systems and
services as well as the delivery of new systems and critical
services such as information standards
“The Information Centre must establish procedures for the assessment of a
quality indicator; and arrange for each quality indicator published in the library
to be periodically reviewed.” The Health and Social Care Act Statutory
Instruments 2013 No.259

5. What are NICE quality standards?
A comprehensive set of recommendations for a particular
disease or condition, particular need or service
Evidence Guidance
Quality
Standards
A NICE quality standard is a concise set of statements
designed to drive and measure priority quality
improvements within a particular area of care. Around 6-8
statements per standard – up to 15 in exceptional
circumstances.

6. How can quality standards be used?
• NICE may be directed to prepare statements of
standards in relation to the provision of
– NHS service
– public health services or
– social care in England
• In discharging its duty, the
NHSCB/Secretary of State must
have regard to the quality standards
prepared by NICE
• Organisations improving the quality of health
services must have regard to the quality
standards prepared by NICE

7. Quality standards – three interfaces
Social
care
Public
health
NHS

8. The development approach - EPiC
• Evidence based
• Partnership work making best use of
expertise across HSCIC and NICE
• informed by Collaboration with key
stakeholders

9. Key stages in the process
NHS E refers topics to NICE for health-related areas
Development of quality standard
Publish quality standard
Development of NICE menu of indicators
HSCIC Indicator Assurance Service
NHS E approval for use in CCG OIS

10. NHS E refers topics to NICE for health-related areas
0 5 10 15 20
Blood disorders
Hearing
Public Health
Eyes / vision
Skin
Infectious disease
Respiratory
Musculoskeletal
Trauma
Metabolic
Genitourinary
Service delivery
Neurological
Gastrointestinal
Cancer
Maternity
Mental health
Cardiovascular
Other/cross-cutting
Children
Number of referrals
Category

11. Development of the quality standard
Topic referred to NICE
Development of the quality standard
Published quality standard
Development of NICE menu of indicators
HSCIC IAS
NHS E approval for use in CCG OIS
Overview development
Identification of quality areas
Prioritisation of quality areas
Draft development
Consultation
Final development

12. HSCIC inputs to the quality standard development process
Topic engagement
Quality Standard Advisory Committee (QSAC)
Meeting 1
Draft quality standard
Consultation
QSAC Meeting 2
Publishing
HSCIC Comments on draft NICE topic overview paper
for meeting of Quality Standards Advisory Committee
HSCIC Comments on draft NICE quality
standard pre-consultation
HSCIC Comments on draft NICE quality
standard pre-publication

13. Measure development
• Measures
– Structure, process and outcome measures
– based on existing NHS indicators or use sources of
routinely collected data, where possible
• High level quality measures
– Use at local level as audit criteria
– Inform subsequent national indicator development
• Also highlight related national quality assured
indicators
– Including those developed by the Health and Social
Care Information Centre
Indicators for Quality Improvement Programme

14. Development of NICE menu of indicators
NHS E refers topics to NICE for health-related areas
Development of quality standard
Published quality standard
Development of NICE menu of indicators
HSCIC IAS
NHS E approval for use in CCG OIS
Identifying indicators for rating
HSCIC Feasibility assessment Horizon scan
Advisory Committee rating
Advisory Committee for prioritisation
Evaluation
HSCIC testing Consultation
Advisory Committee for recommendations
NICE Menu of indicators

15. HSCIC Indicator Assurance Service: towards a national library
of quality assured indicators
Peer Reviewers feeding into
Methodology Review Group initial
assurance
Final Assurance by Indicator
Governance Board
Publishing to indicator library
NHS E refers topics to NICE for health-related areas
Development of quality standard
Published quality standard
Development of NICE menu of indicators
HSCIC IAS
NHS E approval for use in CCG OIS
The Information Centre must establish, maintain and publish a database of quality indicators in relation to the provision of health
services and adult social care in England… The Information Centre must establish procedures for the assessment of a quality
indicator; and arrange for each quality indicator published in the library to be periodically reviewed.” (Health and Social Care Act:
Statutory Instruments)

16. HSCIC Indicator Assurance Service: towards a national library
of quality assured indicators

17. Putting the indicators into practice
• Quality Strategic
Framework Group –
CCG OIS responsibility
• Published indicators
NHS E refers topics to NICE for health-related areas
Development of quality standard
Published quality standard
Development of NICE menu of indicators
available on HSCIC
HSCIC IAS
Portal and NHS iView NHS E approval for use in CCG OIS
“Information is a source of learning. But unless it is organized,
processed, and available to the right people in a format for decision
making, it is a burden, not a benefit.” William Pollard

18. NHS iView
4.1 Patient experience of GP out of hours services, in which a higher
value shows greater satisfaction with the service

19. What next?
Can only demonstrate improvements if we have clear standards, transparent
methodologies etc.
Problems of snapshot indicators – need for comparison over time
Context needed to understand some indicators eg SHMI
"Not everything that counts can be counted, and not everything that
can be counted counts." - Albert Einstein

20. How can you get involved?
• Public consultation on quality standards
and indicators
• Committee members recruited via NICE
website
• HSCIC Indicator Assurance Service
• Assurance process is only as good as the
people who input into it
• MRG peer reviewers
• Organisational representation on IGB

21. To Find Out More About the HSCIC
Follow us:
Call us on: 0845 300 6016
Email us at enquiries@hscic.gov.uk
@hscic
@hscicmedia
@hscicOpenData
@HSCIC_LSP
@EPSnhs
@NHSSCR
@NHSPathways
@NHSereferral
http://www.flickr.com/photos/hscic/
https://www.linkedin.com/company/health-and-social-care-information-
centre
http://www.slideshare.net/HSCIC
https://www.youtube.com/user/HSCIC1