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Indicators produced to help transform community services

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A total of 76 proposed clinical indicators to measure the standard of care provided in the community are to be introduced as part of the Transforming Community Services programme, the latest stage of the Darzi Next Stage Review of the NHS.

The Indicators for Quality Improvement, published last week, will cover both general and specific areas of care, but the Department of Health insists they are not targets.

It says the indicators will ‘offer consistency and support comparison and benchmarking across services’, as the NHS shifts provision of care into the community. The DH said the indicators may be used by both commissioners and providers, and that they may be incorporated into service contracts.

They will be piloted in two waves this year, and more may be added later. NHS community service providers will be obliged to publish quality accounts from the next financial year, based on a set of nationally and locally agreed indicators.

The DH has also published six transformation guides detailing how to improve quality, productivity and outcomes across six areas of care, as services are devolved into the community.

The guides, which have been developed after consultation with nurses and allied health professionals, cover six areas: health, well-being and reducing inequalities; long-term conditions; children, young people and families; acute care in the community; rehabilitation; and end-of-life care.

They will be monitored by a panel of 60 nurses from the Queen’s Nursing Institute’s community nursing forum in partnership with the DH, who will assess how well the guides translate into practice, and suggest changes to them at a final meeting next year.

QNI director Rosemary Cook said: ‘We see these guides as a new tool for helping nurses to improve care, so we are happy to encourage nurses to take them into practice, and see how they can use them.’

Cheryl Adams, lead professional officer for Unite/CPHVA, said the consultation on developing the TCS guidance had been ‘very useful’, and a ‘genuinely bottom-up process’.

She also welcomed the publication of the quality indicators.

‘It should be extremely useful in supporting practitioners develop community services, and it is so useful to have something to benchmark against so that other organisations can work towards similar goals.’

Deputy chief nursing officer for England Viv Bennett said community nurses can use them to look at their own service, compare it with the best out there, identify where the gaps are, and then prioritise the work that needs to be done.’

‘What community nurses are telling us is that they have never had all this information in one place before’, she said. ‘

Ms Bennett said the publication of quality indicators was essential to develop high-quality community services.

‘My background is in community nursing and too often we have developed a model of acute services and then shoehorned community services into it,’ she said. ‘But with the quality agenda now so important, that is not going to work.

‘This document sets out what is quite a complex quality landscape and makes sense of it, and then sets out how it is going to apply. The information that will be collected will be useful for practitioners’ jobs as well as for benchmarking.’

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