Applicable national standards e g. NICE The Provider is expected to deliver in care in accordance with the following core standards and guidelines:- Core standards Assessment for transplantation Patients with progressive deterioration in renal function medically suitable for transplantation will be offered the option of being placed on the national transplant list within six months of their anticipated dialysis start date to optimize their chance of a pre- emptive deceased donor transplant and/or be worked up for a pre-emptive living donor kidney transplant. Patients will be given written and verbal information about the benefits and potential risks associated with transplantation prior to listing. Transplantation Transplant centres will have the necessary infrastructure to enable transplantation of organs from DBD and DCD donors and living donors (including the national kidney sharing schemes), ensuring optimal cold ischaemia times and with outcomes which are not significantly inferior to the national average. When live donors are antibody incompatible the option of entry into the Paired Exchange scheme, local management or onward referral for direct transplantation must be discussed and offered where appropriate. Transplant follow-up Transplant centres and referring renal units will i) prescribe and monitor immunosuppressive therapy; ii) ensure all transplant recipients have regular follow up and holistic care as per national guidelines; iii) ensure the data return to NHSBT and Renal Registry is timely and complete and iv) have a robust clinical governance structure including clinical audit. The National Standards for Organ Retrieval From Deceased Donors state that, following withdrawal of treatment in DCD donors, organ retrieval teams will wait for at least three hours for the onset of functional warm ischaemia. Transplant Centres will consider accepting each individual organ offered, based on the suitability of the organ for their recipient. Guidelines NICE Quality Standards: Chronic Kidney Disease Quality Standards (2011) NICE Quality Standards: Patient Experience in Adult NHS services (2012) The National Service Framework for Renal Services. Part One: Dialysis and Transplantation (2004) Human Tissue Authority (HTA) Guidance for Transplant Teams and Independent Assessors NHS England – Reimbursement of expenses for living kidney donors (2012) National Standards for Organ Retrieval From Deceased Donors 2010 4.2 Applicable standards set out in Guidance and/or issued by a competent body...
Applicable national standards e g. NICE, Royal College Providers will carry out a mandatory patient note and consent audits in accordance with the trust audit requirements. All audits and the patient satisfaction survey must be registered with the trusts audit department. Providers must comply with the trusts requirements for safe haven status when transferring patient information between NHS organisations. Also see NHS England service standards for PCD. Continual service improvement plan The PCD service is required to demonstrate continual improvement in patient care and service delivery. This process will be informed by clinical and service audit, patient and public engagement and awareness of national and international clinical and policy developments that could inform service development. The service will agree a service development improvement plan with commissioners and demonstrate progress at joint service review meetings. Areas of service improvement may be stimulated through the following areas: • Complaints • Monitoring information • Learning from other services (if appropriate) • Service user feedback / patient involvement; • Research • Policy / guidance on best practice e.g. NHS Institute for Innovation and Improvement • Other communication with stakeholders. 4. Key Service Outcomes Percentage of patients tested positive. 5. Location of Provider Premises The service is delivered in three locations: Royal Brompton & Harefield NHS Foundation Trust University Hospitals of Leicester NHS Trust Southampton University Hospital NHS Foundation Trust Sub-contractors None
Applicable national standards e g. NICE, Royal College The service will be provided from a child facility with equipment to national standards and co-location with other paediatric specialties. DH Report 2008 “Commissioning a Safe and Sustainable Specialised Paediatric Services: A Framework of Critical Inter- Dependencies.” A specialist team would consist as a minimum of: • Consultant trained in paediatric respiratory medicine • Specialist respiratory nurse • Specialist respiratory physiotherapist • Lung function technicial • Sleep technician/physiologist With access to a specialist dietician, clinical psychologist, speech & language therapist, occupational therapist, and social worker. Standards of Care Available from the British Thoracic Society (BTS) - xxx.xxxx-xxxxxxxx.xxx.xx • BTS asthma guidelines 2011 • BTS assessment and management of cough in children guidelines 2008 • BTS community acquired pneumonia in children guidelines 2011 • BTS air travel guidelines 2011 • BTS pleural infection in children guidelines 2005 • BTS spontaneous acquired pneumothorax guidelines • BTS neuromuscular disease guidelines 2012 • BTS Guideline for non-CF bronchiectasis. 2010.
Applicable national standards e g. NICE, Royal College Improving Outcomes Guidance for Children and Young People with Cancer. NICE (2005) PTC Staffing The PTC needs to have the specified staffing arrangements in place including, consultant oncology staffing, middle grade medical cover, nursing staff and social worker, allied health professional, appropriate psychological support and a youth worker/ activity co-ordinator. The PTC should ensure training for PTC inpatient beds nurses and day case facility nurses. The TYA multidisciplinary team The TYA PTC will have a weekly TYA multidisciplinary team. The TYA multidisciplinary team should have the specified operational policy core and extended membership and cover arrangements in place. Its function is different to that of the purely cancer site specific multidisciplinary teams in the adult cancer measures and the diagnostic and treatment multidisciplinary team in the children's measures. The TYA multidisciplinary teams function is to add value through supporting finalisation of diagnosis and joint planning with the cancer site specific multidisciplinary teams, consideration of the best place of care and psychosocial aspects. This is different to that of the purely site specific multidisciplinary teams in the adult cancer measures and the diagnostic and treatment multidisciplinary team in the children's measures. Age appropriate care The concept of age appropriate care is broader than the provision of physical facilities for young people. Age appropriate care encompasses the requirement for PTCs to ensure an environment, treatment philosophy and training of staff to meet the particular needs of patients in this age group, combined with expertise in cancer in young people and effective interface with cancer site specific expertise. Services outside the PTC also need to support this aim, through the TYA leads identified within each service. The IOG gives clear guidance that: • All care for children and young people under 19 years old must be provided in age-appropriate facilities • Young People of 19 years and older should also have unhindered access to age-appropriate facilities and support when needed at the PTC. • The TYA peer review measures recognise that some parts of care may be provided within adult services and or through a shared care arrangement. Facilities for patients receiving shared care should be consistent with policy for the age range of the patients being treated and the designation for that service setting. TYA in-patient ...
Applicable national standards e g. NICE, Royal College The nationally designated ex-vivo partial nephrectomy service will be fully integrated into the trust’s corporate and clinical governance arrangements. The commissioners and service will conduct a formal Joint Service Review at least every six months. 4. Key Service Outcomes Quality Performance Indicator Threshold Method of measurement Consequence of breach Report Due 30 day post- operative survival 80% Regular outpatient follow up Inform NHS CB 6 monthly Overall survival (1 year) 75% Regular outpatient follow up Inform NHS CB Annually Recurrence free survival (1 year) 65% Regular outpatient follow up Inform NHS CB Annually Dialysis free rate in surviving patients (1 year) 70% Regular outpatient follow up Inform NHS CB Annually 5. Location of Provider Premises Oxford University Hospitals NHS Trust
Applicable national standards e g. NICE, Royal College Trans anal endoscopic surgery services, (when performed for cancer) are required to meet Cancer Waiting Time standards. These are: • Maximum two week wait for suspected cancers • 31 day maximum wait from diagnosis to first definitive treatment • 31 day maximum wait for subsequent treatment • 62 day maximum wait from urgent GP referral or screening referral or consultant upgrade to first definitive treatment. This is a very new treatment and there are no national standards yet. Most of these treatments are provided as part of clinical trials. The Association of Coloproctologists of Great Britain and Ireland (2007) have suggested that only T1 tumours less than 3 cm be treated by endo anal excision. This is the reason for the recommendation that the patient is discussed at the local colorectal MDT as well as the specialised early rectal cancer MDT before treatment. The participating ERC MDTs should contribute to the National Bowel Cancer Audit (NBOCAP) as well as maintaining a detailed database of outcomes including local and systemic recurrence and need for salvage radical resections and their outcomes.
Applicable national standards e g. NICE, Royal College Please refer to section 1.1, paragraph 3 4. Key Service Outcomes Clinical outcomes: • Mortality: In and out of hospital mortality (including cause of death). Comparison with published survival data. • Post operative morbidity: vocal cord palsy & hypocalcaemia after thyroidectomy, cure rates for hyperparathyroidism, open versus laparoscopic procedures for adrenal disease. • Remission and relapse rates: Using recognised disease specific measures of disease activity. • Disease related damage: Using recognised disease-specific damage indices. • Quality of life. • Participation in clinical trials. • Number (and outcome) of adrenal surgical procedure. • Number (and outcome) of pituitary operations. • Number (and outcome) of total thyroidectomy (cancer and non- cancer). • Mortality from Neuro-endocrine tumours. • Disease cure for patients with eg Phaeos, Cushings Disease. • Disease remission for patients with eg Acromegaly. • Post-surgical morbidity. • Quality of life in patients with Specialist Endocrine disease. Process outcomes: • Waiting times: Time to operation, time from referral to operation from hospital data systems. • Post operative morbidity length of stay, reoperation rates, readmission rates. • Patient / carer satisfaction: Questionnaire survey. • Access to support groups and education: Questionnaire survey plus patient/ carer participation. • Maintenance of Disease Registry: Rare Bone Disease registry (in development). • Evidence of programme of joint working with non-specialist centres: Shared care protocols, outreach clinics. • Contribution to surgical data registry (eg British Association of Endocrine & Thyroid Surgeons). • Collection of standardized and coded activity and outcome data. • Activity data should be collected in cases of i) Use of off-label drugs, and ii) Management of rare diseases. 5.
Applicable national standards e g. NICE, Royal College The provider shall ensure that the service participates in IQAS Allergy Accreditation or future Paediatric equivalent, initially by registering and working towards full accreditation. Accreditation shall eventually be mandatory for Specialist Centres. The scheme is called Improving Quality in Allergy Services (IQAS) (xxxx://xxx.xxxxxxxxx.xx.xx/resources/improving-quality-allergy-services-iqas- registration-scheme) The provider shall ensure that Centres shall be active members and participants of a UK Accreditation Scheme (IQAS or future Paediatric equivalent) as evidenced by: • Full registration of the Centre within a specified timeframe informed by a gap analysis and action plan. • If accreditation has not yet been achieved, Centres should be actively working toward accreditation. • Patient information should be standardised nationally or within each network • Where HAE care is provided the centre will register to accredit the service to UKPIN (UK Primary Immunodeficiency Network, xxxx://xxx.xxxxx.xxx.xx/home/accreditation-standards.html) standards as defined in the Immunology Specialist Service specification. The provider shall ensure that allergic disorders are managed according to best practice guidelines and position statements as defined by: • RCPCH (Royal College of Paediatrics and Child Health) patient pathways, BSACI, RCP (Royal College of Physicians), NICE guidelines and others. • IQAS standards for allergy services or future paediatric equivalent (when developed). • Collaborate with other expert centres at national and international levels. • Where appropriate, all clinic letters should be copied to patients. The provider shall provide a means of collating workload data on inpatient and home therapy workload linked to ICD10 coding including population of a national or local specialist workload monitoring tool (for example, a web-based database). The provider shall provide data for the national/network dashboard for recording outcomes, process or proxy measures. The provider shall act as ambassadors for the service and support patient and professional organisations improving support and care for conditions under their remit. The provider shall develop regional care pathways or comply with national care pathways and referral criteria. The provider shall ensure that specialist centre staff support peer accreditation processes by acting as inspectors. The provider shall have active participation in training and development of ...
Applicable national standards e g. NICE, Royal College Care delivered by the urological cancer service providers must be of a nature and quality to meet the CQC care standards and the IOG for urological cancers. It is the Trust’s responsibility to notify the commissioner on an exceptional basis should there be any breaches of the care standards. Where there are breaches any consequences will be deemed as being the Trust’s responsibility. Urology cancer services are required to achieve the two week wait for all patients where urological cancer is suspected. In addition the services are required to meet the following standards for all urology cancer patients, • 31 day wait from diagnosis to first treatment, • 31 day wait to subsequent treatment, • 62 day wait from urgent GP referral or screening referral or consultant upgrade to first treatment. Teams should as a minimum aim to achieve the median value for compliance with the Cancer Peer Review measures, and if a team has immediate risks or serious
Applicable national standards e g. NICE, Royal College Providers meet normal NHS governance requirements. Details are set out in the service standards. 4.
