What is QA
QA Core Purpose
- To monitor and maintain minimum standards of service, performance and quality across all elements of the screening programmes.
- To promote and lead the continual pursuit of excellence in screening.
Aims of Regional QA Service
1. Support both commissioners and service providers. Contribute to the specification, commissioning and delivery of screening programmes.
2. Act as a resource to provide specialist advice and expertise on screening.
3. Coordinate QA activities between and within professions.
4. Monitor and review the performance and effectiveness of the QA mechanisms in each individual screening service.
5. Devise and operate robust monitoring arrangements and check that screening services are delivered to the highest levels of quality, safety and efficiency.
6. Monitor and report whether screening services are delivered by appropriately trained and qualified staff e.g. encourage continuing professional education for individuals within the programme, facilitate close liaison between screening units and national training centres
7. Devise, implement and operate quality systems which e.g. maintain a multidisciplinary approach to QA, include collection and review of data, provide a programme of QA visits and their follow up, enable problems to be identified and responded to at an early stage - ensureing action is taken by the appropriate individual/organisation, support the achievement of necessary changes and be prepared to involve service commissioners and specialists in the government office as appropriate.
8. Contribute to the development of national policy by identifying and promoting key areas of development, which are evidence based. When approved ensure these initiatives are implemented and promoted in a timely and effective manner.
9. Develop and implement effective communication systems, ensure clear lines of communication through local, regional and national level. Ensure information is properly consulted upon and disseminated.
Essential Components of QA
A QA director who reports to and is accountable to Regional Director of Public Health (RDPH). - The operation of a regional QA reference centre. - Working in close partnership and collaboration with the national office of the NHS Cancer Screening Programmes. - A multidisciplinary QA team which undertakes QA visits at least once every screening round. - Coordination of professional activity within the QA team. - Overseeing and validation of Department of Health returns. - Being a key part of the team for handling screening incidents. - Overseeing equipment monitoring. - Monitoring of interval breast cancers. - Contribution to the development of health improvement programmes. Seeking to establish that screening services are properly reflected within service level agreements and financial arrangements - Participation in national audit and EQA activities e.g. BASO audit, EQA.
Manage and direct the quality assurance team. - Liaise with commissioners, providers of screening services and NHSCSP national office. - Produce an annual report on QA activities. - Report on performance of QA & provide copies of QA reports to RDPH and NHSCSP national office. - Ensure that action plans are developed to tackle problems identified by, or notified to the QA team and monitor progress. - Manage budgets of the QA service. - Lead the activities of the QA reference centre. - Participate in the National Coordination Group of QA Directors. - Communicate with media on QA issues. - Identify and develop best practice. - Identify core staffing including the appointment of a QA coordinator.
QA Reference Centre
Act as a focus for information, including data collection and validation of Department of Health returns. - Maintain close liaison with all key professionals, including clinical directors of screening units and supporting professionals. - Organise QA visits to screening units. - Liaise with national office, Department of Health, Government Office and Cancer Registries. - Organise and facilitate regional QA meetings.
QA Co-ordinator and QA Staff
Act as a pool of experience and resource to support and develop the QA function. - Conduct activities using a multidisciplinary approach. - Receive and consider QA reports and review actions. - Receive and consider reports from professional groups. - Review and report performance data against national objectives. - Authorise changes to procedures documented in regional QA manuals. - Ensure responsibility for monitoring the implementation of change is delegated to appropriate professional coordinator. - Consider progress of screening rounds and identify difficulties with local screening programmes. - Review satisfaction surveys. - Collection, monitoring and reporting of interval cancer data. - Disseminate performance information within agreed communications strategy.
QA Team - Lead Professionals
Lead professionals must be formally appointed and act as QA coordinators for their profession within the region. - Establish good liaison and communications with each screening unit. - Provide specialist advice to QA director and keep informed of any issues. - Provide specialist advice to other members of the team. - Ensure technical issues are considered by all appropriate disciplines. - Provide support for peers within the region and identify training needs. - Convene regular meetings of profession within the region. - Ensure professional guidelines are communicated and implementation monitored. - Participate in multidisciplinary QA visits and take the lead on own professional aspects of the visit. - Represent the profession at regional and national QA meetings. - Team membership to include (colposcopists, radiologists, radiographers, pathologists, surgeons, breast care nurses, a&clerical staff and medical physics). - Contribute to annual report of regional QA service.
Provide a formal mechanism to review the whole screening process in a unit on a multidisciplinary basis. - Audit the quality of screening. - Identify problems and share experience and best practice. - Have a clear protocol for reporting the outcomes of visits to all interested parties including chief executives, service commissioners, national office and RDPH. - Visits to take place at regular intervals and to include professional QA coordinators. - Visits to be conducted in accordance with national guidelines. - Use visits to identify training needs and assist in the development of responses to those needs Unscheduled visits may be requested by the national office of the NHS Cancer Screening Programmes or the RDPH to consider particular issues in a screening programme.
Maintain an overview of IT systems - Advise on developments required - Ensure IT systems operate to ensure patients are processed in a safe, efficient and effective manner - Monitor the arrangements for the provision of hardware support and organise if necessary - Monitor arrangements for the support and development of software applications and organise if necessary - Ensure IT systems operate to standard national definitions.
Role of Government Office
RDPH to take personal responsibility for the performance of QA within each region. - Manage the regional QA director to ensure that the QA function is working properly. - Ensure adverse QA reports are acted upon. - Ensure good and regular communication is maintained with QA Directors and the national office. - Take a strategic overview of the regional QA service. - Ensure that breast screening is nested with wider cancer services.
Role of National Office
To develop quality assurance through national coordinating groups. - To advise RDsPH as necessary on the effectiveness of quality assurance in their region. - To monitor the effectiveness of quality assurance systems nationally. - To liaise with professional bodies and Royal Colleges.