The sharing of local intelligence between professional and system regulators in an appropriate and timely way is key to ensuring that risks to service users are identified and acted upon as needed. The Government’s response to the Caldicott Review states that, ‘Health and social care professionals should have the confidence to share information in the best interests of their patients within the framework set out by [the Caldicott principles]. They should be supported by the policies of their employers, regulators and professional bodies.’ The response to recommendation 252 outlines further how data can be shared through appropriate anonymised routes.
At a local level, in April 2013 a network of local and regional quality surveillance groups was established that brings together commissioners, regulators, local Healthwatch representatives and other bodies on a regular basis to share information and intelligence about quality across the system, including the views of patients and the public.
Quality surveillance groups help to proactively spot potential problems early on and coordinate any action that is needed to respond where risks to patients are identified. Where potential concerns arise of a serious failure, members of the quality surveillance groups will be able to act quickly by triggering a risk summit. All quality surveillance group members relevant to the provider in question attend these summits so that they can, together, give specific, focused consideration to the concerns raised and develop a joined-up response.
The National Quality Board is currently conducting a review of how the quality surveillance group network is operating, and what support it needs to be as effective as possible. It will publish revised guidance and support materials by the end of the 2013 to support all quality surveillance groups to reach their full potential.
At a national level, professional and system regulators have agreements and memoranda of understanding supported, as appropriate, by statutory requirements to ensure information is shared. It is the responsibility of all organisations to review what information can, appropriately, be shared openly with its partners and the public to support transparency and improvement.
As part of this agenda, the Care Quality Commission:
- uses a range of information from regulators and partners to supports its surveillance process and collects that data routinely to support its processes. For example, when any reports to prevent future deaths are produced by a coroner they are shared with the CQC to support their understanding of risk (see recommendation 282)
- contacts professional regulators, and others, to request relevant intelligence to inform them of the inspections that it is undertaking as part of its new regime and to request appropriate intelligence. The Care Quality Commission also collects information from the Nursing and Midwifery Council and the General Medical Council routinely to support its surveillance model and intelligence used within its data packs
- has a detailed memorandum of understanding with Monitor regarding the sharing of intelligence and the working practices that support this. The Care Quality Commission and Monitor will continue to review this document and update it in the light of the Care Quality Commission’s A New Start
will, as part of the single failure regime, send any notices regarding performance to Monitor and the NHS Trust Development Authority
Revised guidance for Quality Surveillance Groups How to make your Quality Surveillance Group Effective was published in March 2014
Despite NHS England restructuring its field force, there will continue to be 27 Quality Surveillance Groups on their current footprint, and 4 regional Quality Surveillance Groups. Central information is not collected on the performance of Quality Surveillance Groups, however anecdotal information suggests they have bedded in further and got into their stride in many parts of the country – with commissioners and regulators seeing them as a vital part of the quality infrastructure
Information sharing between regulators:
The General Medical Council has been working closely with the Care Quality Commission to build on its Memorandum of Understanding. A joint operating protocol was signed with the General Medical Council in December 2014. This supplements the Memorandum of Understanding and formalises the existing practice that relevant information will be shared between the two organisations. Information given by General Medical Council will support the Care Quality Commission in preparing for inspections of hospitals and general practices. The Care Quality Commission provide non-routine alerts to General Medical Council such as information about a potentially serious emerging or urgent concern.
The Care Quality Commission and the Nursing and Midwifery Council signed an updated memorandum of understanding in December 2013. The Memorandum of Understanding outlines the areas of cooperation between the two organisations, and was supplemented in July 2014 by a joint operating protocol, the protocol sets out in detail when and how the Care Quality Commission and the Nursing and Midwifery Council will share and record information, and covers five key areas; emerging and urgent concerns, routine information sharing, coordination of ongoing activities, risk-related activity, and strategic collaboration.
Updated Memorandum of Understandings are being developed with the NHS Trust Development Authority and, with Monitor. It is expected that these agreements will be signed later in 2015.