Knowledge Matters V6 I6

Volume 6 Issue 6 February 2013 Welcome to Knowledge Matters Hello everyone and welcome to a VERY special edition of Knowledge Matters—my last edition as Editor!

The great news is that Knowledge Matters will continue though, and I have been promised ‘guest pages’ in future editions— so you haven’t seen the last of me yet! I am delighted to report that hosting arrangements for the team are now confirmed.

From April, the Quality Observatory will be hosted by Central Southern Commissioning Support Unit. John Wilderspin (previously Chief Executive of West Sussex PCT) is the Managing Director of Central Southern CSU and is very pleased to be hosting the team (more on this inside). The team will continue to be based in the Horley area (exact location yet to be confirmed), and will be available to help Knowledge Matters readers (wherever they are) with high quality analysis, training, dashboard design and interactive web based tools. Until new contact details are confirmed, I would recommend that people keep an eye on the Quality Observatory website which will provide up to date information on how to contact the team (nww.qualityobservatory.nhs.uk).

For those of you attending the Innovation Expo on 13th and 14th March at the Excel Centre in London, please do pop along to the Quality Observatory stand where the team will be showcasing a number of the excellent products developed over the past 2 years. This will include the web-based Friends and Family Test tool recently developed for use across the South of England (which I am particularly interested in as this is one of my responsibilities as the newly appointed Director of Insight for the NHS Commissioning Board).

I bid Knowledge Matters readers a fond farewell. I can’t quite believe that we have published Knowledge Matters every 2 months since May 2007 (when we started with 4 pages, not that many readers and I had a really bad haircut) - to date the December 2012 edition has had over 3,500 views via our issuu website (http://www.issuu.com/secqo).

For those of you interested in my reflections looking back on my time with the team, have a read of page 4 , and for those of you interested in my new role, you can read all about it on page 2.

Thanks for reading and I’ll see you on the inside pages next time!!

Inside This Issue : What does a director of insight do?

2

Goodbye to Sam

8

Ask an Analyst : Dependant drop downs

13

The Birth of the Quality Observatory

4

Analysis Ancient and Modern

9

News

14

The Future of the Quality Observatory

5

Skills Builder: What is an Infographic

10

Nice Technology Appraisals

6

Friends and Family Test – Online tool

12

twitter.com/SECSHAQO issuu.com/SECQO http://www.networks.nhs.uk/nhs-networks/sec-qo www.QualityObservatory.nhs.uk

2

'What does a Director of Insight do?'

Samantha Riley director Good question!!!!! Well, to be honest, although I clearly read the job description before I applied for the job, it is only over the past month or so that I have got to grips with my new responsibilities—which are both slightly scary and very exciting!!!!!

As Knowledge Matters readers will know, my passion is very much about presenting data in a way which is meaningful to front-line staff to support improvement—and this analysis of course needs to be updated on a regular basis to demonstrate whether changes made have resulted in an improvement. I think that the Quality Observatory has successfully provided this kind of support over recent years—utilising existing national data flows (such as SUS) and data sets to demonstrate where Trusts and teams are in terms of performance, how they perform compared to other organisations and how they perform over time. In my new job—Director of Insight for the Commissioning Board — the critical importance of utilising data to drive improvement will be key. As Director of Insight, my focus will be on understanding the experience of patients. In some instances there are existing flows of data that it will be possible to utilise more fully (such as the annual surveys carried out in a range of areas), but there will be the need for new and more frequent data flows if the NHS is going to be responsive to the needs of patients.

So, what will I be responsible for? I’m really pleased to be taking on responsibility for PROMs. This is, in my view, a really valuable data set. However, our experience in the Quality Observatory suggests that in general, people find it difficult to understand what the data is saying. The language is pretty complicated when it comes to PROMs, so I will be looking at how we can demystify this area, explain how the data can be used to best effect and presented in the most straight forward way. I believe that the next edition of Knowledge Matters will include an article on PROMs which will take readers through the PROMs dashboard which has recently been developed by Adam Cook.

I will also be responsible for the range of surveys which are undertaken annually within the NHS—these include the inpatient survey, GP survey and the staff survey. I’m in the process of gaining a handover from the team that oversees the survey programme in the Department of Health so soon hope to be a bit of an expert in this area. I’ll keep you updated on my thoughts around the future of the survey programme in a future edition of Knowledge Matters,

Last, but by no means least, I have responsibility for the Friends and Family Test (FFT). I have learnt very quickly that many people have strong opinions on FFT—whether these relate to the potential benefits of asking patients a single question, the calculation of the FFT score, the applicability of the Net Promoter System (NPS) approach to health— they are strongly held.

For me, the great value of the Friends and Family Test is the opportunity of receiving feedback from patients in near real time which can be acted upon. In addition to an FFT score being calculated, patients will be given the opportunity to provide text comments which explain why they have scored their experience as they have. This will provide frontline staff with a really rich source of data to understand how well they are doing (experience to date suggests that many comments are positive about the care that they have received), and make changes in areas that could be improved.

As data will be collected continually, it will be possible for wards, departments and Trusts to monitor whether the changes that they are implementing are improving their FFT scores.

So, let’s run through the basics…….. What’s the question? “How likely are you to recommend our ward/A&E Depart-

Quality.Observatory@southeastcoast.nhs.uk

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3 ment to friends and family if they needed similar care or treatment?” Patients will be able to choose from the following response scale and provide a text comment to explain why they have responded as they have.

Extremely likely

|

Likely

|

Neither likely nor unlikely

|

Unlikely

|

Extremely unlikely

|

Don’t know

FFT will initially apply to adult acute inpatients (this will apply to independent providers where care is funded by the NHS) and adult patients who have attended A&E. From 1st April 2013, every patient in these categories needs to be surveyed at or within 48 hours of discharge. Trusts can choose the mechanism by which the question is asked—online feedback systems, text messaging and postcards are some of the mechanisms that Trusts will be using. I was interested to learn that the old fashioned method of a postcard appears to receive a high level of responses, but online feedback mechanisms not faring so well.

Data on response rates and scores will be transparently published with Trusts being required to publish data locally and national reporting commencing in July 2013. I am really pleased that the Quality Observatory has already developed a web-based tool which will be used by Trusts across the South of England to enter their data, create their Unify return and of course provide graphical, immediate feedback on the data entered. More on this on page 12.

There is a requirement for FFT to be applied to maternity services from October 2013 with a plan of further roll out to other service areas currently in development.

A key focus for me over the next few weeks will be working up an effective communications and engagement plan to support the NHS to really understand the benefits of the Friends and Family Test approach, understand what is working successfully in different parts of the country and of course to ensure that we explain to patients and the public what this means for them.

Here are some links which maybe useful: Implementation guidance

http://bit.ly/dh-fft-implementation-guide

Publication guidance http://bit.ly/dh-fft-guide Detailed technical guidance for UNIFY2 http://bit.ly/fft-unify

And I would really encourage you to have a look at this short film about how FFT results are being used by wards at Heart of England Foundation Trust http://bit.ly/fft-film-heartofengland

The final element of my new role is to look outside the NHS to other sectors and industries to understand the different systematic approaches to gaining insight from customers which is then acted upon. The next phase of work will be to consider how these approaches could be applied, adapted and tested within the NHS. This provides a great opportunity to help the NHS to become a truly customer focussed service…… SERVICE of course is the S in NHS—we need to remember that.

www.QualityObservatory.nhs.uk

Quality.Observatory@southeastcoast.nhs.uk

4

The birth of the Quality Observatory

By Samantha Riley, Director of Information for Service Improvement So, what were the beginnings of the Quality Observatory??

Sam’s photo from the first Knowledge Matters!

Was it the publication of High Quality Care for All in June 2008 which outlined the requirement for each region to establish a team to support front line clinicians in the development of metrics, tools and benchmarking information to improve the care provided to patients? The answer to that is no—the beginnings of the Quality Observatory started long before that—as a result of my frustration at having taken up post as Deputy Director of Service Improvement for Surrey and Sussex SHA in January 2005.

I’ve had a lot of roles over the years in the NHS—all with a focus on improvement. Having taken a role at the SHA, a lot of my time was taken meeting with Trusts to learn about the improvement work that they had undertaken—I attended very many Service Improvement Steering Boards which outlined detailed improvement plans and described impressive improvements, but to be honest there was never any data to prove the changes made…… Now, I don’t want to appear cynical, but without clearly defined indicators, a baseline and on-going measurement how can you know that the change that you made was an improvement? In previous roles, I had learnt the importance (and power) of measurement. So after a year in post I decided to appoint an analyst—the lucky person was Simon Berry (a frequent contributor to Knowledge Matters) - who at my request provided some analysis on the 10 High Impact Changes. Although Trusts in Surrey and Sussex had reported that all of the recommended changes had been implemented, the analysis indicated that wide variation still existed. For some Trusts, I think this came as a surprise.

A younger Simon!

How did we present the data? Well, I am sure that Knowledge Matters readers can guess……. We DID NOT apply red, amber and green ratings and we DID NOT show the data as a snapshot. And MOST IMPORTANTLY we DID NOT apply judgement to the data that we were presenting. We presented the data in a transparent, simple format, showing progress over time—along with a range of indicative benchmarks. All data was shared for all Trusts in a graphical format. Nothing fancy—just straight forward ‘plot the dots’ graphs—but graphs that were easily understandable.

Over the years the team expanded, I aligned different members of the team to different clinical areas and I directed the team to be more outward focussed to the NHS. With hindsight, this was without any doubt the best decision that I made Now we had expert analysts working alongside passionate clinicians—the benefits of which have been very many. We could look at the hip replacement programme (one of the examples included within the NICE Evidence Library—this would not have been included without the analysis provided by Simon), or the Normalising Birth Programme (the first of its kind in the world supported by Kate) or the work more recently undertaken with regards to respiratory care (thanks to Nikki). There are very many more examples of what the team has achieved, but the common theme is the focus on clear presentation designed with front line staff to support improvements in care.

I am very sad to be leaving the Quality Observatory, but am very proud of the legacy that I leave to the NHS. A team which is the most passionate, committed, professional, able, personable and fun team that I have ever encountered. I have no doubt that the team will add a huge amount of value to the NHS in the future. I am forever grateful to John Wilderspin for agreeing to host the team in future and really look forward to seeing how the Quality Observatory grows under his watch!

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5

The future of the Quality Observatory

By John Wilderspin, Managing Director ,Central Southern Commissioning Support Unit Central Southern Commissioning Support Unit are delighted to be hosting The Quality Observatory from the 1st April, and are already looking forward to working with them.

I was fortunate to work with the team when I was a PCT Chief Executive in South East Coast, and I therefore know what a professional team they are, and the excellence of their products .

Since then they have gone from strength to strength and established a thoroughly deserved national reputation.

We are very confident that the new hosting arrangement will enable them to maintain and build that reputation, with benefits for the team, and for their clients, but also for the clients that we serve.

Central Southern is a large CSU which currently supports 14 CCGs serving a population of 3.5 million people.

Using and analysing information to support improvement in health and care is at the heart of what we do, so our work and the work of the Quality Observatory is very aligned.

But we also provide support for a range of other activities such as service re-design, planning, conNew Safety Thermometer website tracting, and medicines optimisation, which are equally complementary to the work of the Observatory.

In particular, we will focus on support to our clients to help them improve quality in all its aspects; clinical outcomes, safety, and patient experience.

This is where the Observatory have gained their high reputation, and by working together, we believe that we can further enhance the standard of our collective work.

Over the next few weeks we will be discussing with the Quality Observatory team and our own staff how best to make the partnership work. For example, I know that readers of “Knowledge Matters� apThe Quality Observatory website preciate the opportunity it gives to share best practice in a very readable format. We will be looking at how we can continue that process of knowledge sharing and dialogue under the new arrangements.

I look forward to working with the team, but also with their clients and readers of Knowledge Matters, in the future.

www.QualityObservatory.nhs.uk

Quality.Observatory@southeastcoast.nhs.uk

6

NICE to see you, to see you NICE (NICE Technology Appraisals)

by Adam C. Cook, Specialist Information Analyst Recently the IC have published data from The National Institute for Health and Clinical Excellence (NICE).

This data is a technology appraisal, which shows assessments of both clinical effectiveness and cost effectiveness for a variety of medicines and treatments, some new and some pre-existing.

The data in the IC publication is at an experimental stage only but is available to download with a tool to interrogate the data. To compliment this we have built a dashboard which benchmarks this data at a geographical area.

There are five tabs in the dashboard which relates to how the data is split. There are three tabs coloured blue for CCG/SHA level data and two coloured yellow for trust based information.

The first chart shows data from three different sources. Medicines shown as a ratio of defined daily dose (DDD) to NICE estimated dose, medicines as DDD per 100,000 population and medical technologies per 100,00 population. From the drop-down menu at the top old SHA area can be selected, as well as the chosen medicine or technology. This will display all CCGs in that area along with an all England comparator.

There is a further page of CCG based charts where the CCG can be selected and all of the medicines and technologies are displayed for that single organisation.

Again this shows the rate for the CCG with an all England benchmark.

This process is replicated for provider organisations with there being one benchmarking chart for individual medicines/technologies selectable by former SHA area, and another showing all medicines/technologies for a single provider.

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7

The dashboard can be found on the catalogue on the Quality Observatory site: http://nww.qualityobservatory.nhs.uk/ and the original data is available from the IC at: www.ic.nhs.uk

The network team—Casebook 2 The Network (www.the-network.org.uk ) recognises that all over the country junior doctors are engaged in work that leads to improvements in patient care, or teaches them something about creating change in the NHS.

The network is all about sharing experiences, and creating connections between junior doctors interested in improving the way we practice. The Network Casebook is a compilation of innovative projects from all over the country, with the emphasis not on results (although that is nice) but on sharing lessons learned.

The network has been collecting improvement projects and audits for a new casebook. The Network Casebook will be launched on NHS Change Day at the Healthcare Innovation Expo in ExCel London, with poster and platform presentations of the most exciting projects. There will be the opportunity to network, share ideas and quiz our esteemed panel.

Places are limited and are for Network members only, so if you haven't already registered visit www.the-network.org.uk to become part of our growing community for free.

For further information contact The Network Team on: thenetwork.org.uk@gmail.com

www.QualityObservatory.nhs.uk

Quality.Observatory@southeastcoast.nhs.uk

8

A goodbye to Sam...

Here at QO HQ we are very sad to be saying goodbye to Sam at the end of March. Sam has created a fun and dynamic working environment for us all and we are sure she will do well in her next role. We would like to take this opportunity to thank Sam for all the hard work she has put into creating the team and wish her well for the future!

Sam (To the tune of Ben by Michael Jackson…)

By Adam C Cook Sam, you took a bunch of nerds and geeks And took us up to uncharted peaks

We are sad to say Goodbye

You built up quite a team

But our friendship will not die

Regarded with such esteem

(We are sad to say Goodbye)

Let's make it understood

(But our friendship will not die)

It's down to you we're good Sam, now you'll bring new light

(It's down to you we're good)

Unto the world of insight Sam, you're always running here and there

The friends and family test

(Here and there)

Says, as a boss, you're best

The epitome of style and flair

I know that we're all glad

(style and flair)

That we have a friend like Sam

You are our Quality muse

(A friend)

In bright flamboyant shoes

Like Sam

You've kept us on our course

(Like Sam)

An indomitable force

Like Sam

(An indomitable force) “One of the best decisions the SHA ever made was to develop the Quality Observatory. Under Sam’s leadership it has flourished and she still found the time and energy to spearhead the fabulous SHA staff ‘Entrepreneurs’. We’re all proud of Sam; I’ll miss our chats.”

Candy Morris CBE, Shadow Chair at Health and Social Care Information Centre

“I had heard about Sam before I got the new merged director post at the SHA but had never met her.

When we did eventually meet, I realised that everything that people had told me was true.

Sam was a bright spark, oozing with enthusiasm and passionate about Service Improvement. What they didn’t tell me was that she was a “Shoe Diva” like me!! Well obviously, we were going to get on and indeed we did.

In my time at the SHA, I saw the birth and growth of the Quality Observatory (as is now) and watched Sam grow both in confidence and watched with pleasure, as her team management style flourished and a fantastic service was being delivered.

Sam played a great part in the team turnaround of the Surrey and Sussex SHA and I am not surprised that she is moving up and on.

Well done Sam, it is well deserved and good luck for the future.”

Marianne Griffiths, Chief Executive Western Sussex Hospitals NHS Trust

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9

Analysis Ancient and Modern – ancient numbers!

By Katherine Cheema, Specialist Information Analyst One of my children recently asked me why, when we count everything else in hundreds, tens and units, do we not apply this to the way we tell the time. Why, the outraged four year old asked, do we not have 100 minutes in an hour (heaven knows how they might have coped with pre-1970’s currency!). At least in this instance I was able to provide them with an answer.

The basis for our sexagesimal (base 60) approach to time keeping is thought by many to lie in the Mesopotamian number system, a base-60 place value system which evolved around 2000BC. We know quite a lot about their approach to numbers because they wrote things down on clay tablets which have survived the centuries well. Even better, they clearly assigned homework as there are lots of ‘problem’ tablets and plenty of evidence of rough workings out.

Here’s how a sexagesimal place-value system works: each place has a value of sixty times the next. It employed two written symbols, a thorn like symbol (Y ) for 1 and left pointing arrow-type symbol (<) for 10. Remember, it’s a place value system, so you move up a power of 60 for each place to the left. For example,

•

the decimal number 32 is represented by the symbols <<<YY,

the decimal number 144 is represented

by YY <<YYYY, because 144 = 120 + 24 = (2 × 60) + 24,

•

and the decimal number 8492 is represented

by YY <<Y <<<YY, because 8492 = 7200 + 1260 + 32 = (2 × 602) + (21 × 60) + 32.

•

Bit more complex, at least to our decimalised minds, and not half as pretty as the Egyptians, but by developing the ability to calculate with such large numbers, the Mesopotamians were able to chart the cycles of the Moon, and thereby develop a reliable calendar.

Over your tea, have a go at the following problem using the Mesopotamian number system:

The Royal Sumerian hospital has had YY <YY <<YYYY emergency admissions in the past 6 months This has resulted in YYY <<<YYYYYYY <Y bed days What is Royal Sumerian’s average length of stay for this period?

Answers on a postcard to the usual address!

References: The Story of Maths, Open University, 2009.

www.QualityObservatory.nhs.uk

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10

Data Visualisation, Information design and Infographics In recent years there has been a rise in the use of the terms like “Infographics”, “data visualisation” and “Information Design”, but what do these terms really mean?

Well according to Wikipedia: Data Visualisation is the “study of the visual representation of data... including attributes or variables for the units of measurements” - hmmm this sounds like drawing graphs & tables...?

while Information Design is “the practice of presenting information effectively, rather than just attractively or for artistic expression.”

-hmmm this sounds like drawing graphs and making tables that mean something?

So what about “Infographics”? these are described as “graphic visual representations of information, data or knowledge intended to present complex information quickly and clearly” - So “Info Graphics” are graphs then?

Well it’s more like graphs are a type of infographic! Maps, road signs and transport maps are all examples of info graphic all designed to convey important information quickly.

-So what is your point then?

Well all infographics have one thing in common … they are trying to turn data into useful information, which is what we as analysts are trying to do every day, and maybe there are some tips and pointers we can take from Information Design to improve the way we convey knowledge.

The first step in analysis is to start with the “how, what and why” questions to figure what information you want to convey.

The next step is to really understand your data, keep it to the point, slice it and dice it until you know what it is telling you!

And as we have mentioned before in previous articles “KEEP IT SIMPLE” Now normally at this point the difference between an information designer and the traditional “analyst” kicks in.

In a high pressure environment it can be all to easy to just quickly knock out a graph or a table, however to “design information” you need to take a step back and think about

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11 what you are trying to show and how you might do it in a way that really engages people… and yes you might still end up with a graph!

But sometimes the results are STUNNING! My favourite infographic at the moment is an interactive visualisation tool created by periscopic at http://guns.periscopic.com/

http://www.slideshare.net/GeneralAssembly_SF/data-visualization-16265937

This is about US gun murders in 2010, in fact I think there are quite a lot of people who really like it!

It starts with a simple concept; how do you highlight the tragic wasted chances for each life lost to gun murders?

The simplicity of the graphic hides the complexity of the topic it is dealing with.

Firstly you need to calculate the potential lost years/ typical life span for each life lost which is no mean feat!

Next the information designer has used a simple line graph to connect birth, death and potential lifespan… with the lifespan in vibrant orange and the potential in grey.

The lines are then layered on top of each other to create a stunning visual representation of the lost potential.

- Wow that looks great! But when am I ever going to get any time to do that!

Well it doesn’t have to be uber-complicated. One method that you can use is to represent numbers as images!

Finally here are some links to good infographic sites. Pay them a visit, have a look around and maybe you will get inspired!

Dailyinfographic.com

Infogr.am The QO team have even been known to represent Mashable.com/category/infographics numbers of patients in terms of Routemaster Pinterest.com/mashable/infographics buses!

Periscopic.com Visualisingdata.com Visual.ly Flowingdata.com

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12

Friends and Family Test—Online Tool

By Charlene Atcherley-Steers, Performance Analyst Here at the Quality Observatory we were asked to create an online tool that would allow local trusts to upload their Friends and Family Test results at ward level and give some analysis on the results at ward level. So we got to work and this is what we have so far: Administration Each Trust has their own administrator, who can add and remove users. Only those registered against that trust can view the data and access can be given to users to add data. It is planned to add a ‘publish data’ option, so those trusts wishing to make their data publicly available can do so.

Collecting the data Users who are registered as Author or Administrators can add wards, then add data for those wards on a monthly basis. The response rate and Friends and Family score (worked out using the DH publicised formula) are worked out automatically when data is added and appear in the ward table.

Analyse Trusts that submit data will be able to compare wards’ Friends and Family score and Response rate to that of their trust using a small dashboard created. This again will update in real time when new data is submitted.

Unify View To avoid Trusts having to input data on both the site and the Unify template we have designed a Unify view, that allows you to download an Excel spreadsheet in the format of the Unify view, which can then be pasted into the appropriate places in the Unify template.

If this is a tool that you would be interested in using for your Local Area or trust, then please get in touch with us to discuss your requirements: quality.observatorty@southeastcoast.nhs.uk

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13

Dependent drop downs Application: Excel Dear Quality Observatory, I want to create a dropdown list that depends on another drop down list in Excel. Is this possible, if so how do I do this?

An Excel User, A Trust

Solution: Complexity 3/5 — Uses VLookups

Hi Excel User, the good news is this is possible, so let’s run through an example.

Let’s try to create two dropdown lists – one for Types of food (e.g. Fruits and Protein) and the second to show specific food items based on the type of food selected (e.g. Orange or Fish) We need a list of items and also a cell to link the dropdown box to. (I have typed the following into cells A1: F4).

The first dropdown (Food type) is the simpler of the two – Click View ->Toolbars ->Forms and select the ComboBox. This should give you a blank dropdown list.

Right click on this and select Format Control and then select the Control tab. In the input range (this is the list you’re selecting from) highlight your list of food types. Also select your cell to link it into - in this case I have chosen cell A9 The next step is how to make the 2nd list change depending on what has been selected in the first.

Create another list but using a combination of vlookup and if formulae to determine the list (basically, if food type is 1, lookup from Fruits else lookup from protein).

It is this combined list that will be used to drive the 2nd dropdown list. As you can see in cell H4, we get an error message because Protein only has 2 food items. This will come to play in the next steps.

Before we create the 2nd dropdown list, let’s create a defined named range that we will use in the 2nd dropdown list.

Click on Insert ->Name ->Define: Add a new named range called ‘lookup’ and using a combination of offset and countif, we can define the area of the name range based on the combined column but not including any cell containing an error message (#N/A).

Now lets create a second dropdown list but this time instead of selecting from a list of items, let’s use the name range we just created: And that’s it – because of the clever use of countif, vlookups and named ranges, we now have the second dropdown with content dynamically created based on the selection from the first.

www.QualityObservatory.nhs.uk

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14

NEWS NICE Clinical Commissioning Group Outcome Indicator Set (CCG OIS) Consultation As part of the process to develop the Clinical Commissioning Group Outcome Indicator Set (CCG OIS) stakeholders have the opportunity to comment on potential new indicators.

The indicators have been mapped against the five domains of the NHS Outcomes Framework, encompassing the three dimensions of quality (effectiveness, patient experience and safety).

The consultation for these potential new indicators for the 2014/15 CCG OIS will begin at 9.00am on Friday 1 February 2013 and will run for a four week period until 5.00pm on Friday 1st March 2013.

Comments received during the consultation will be considered by the CCG OIS Advisory Committee in May 2013. The Committee will then recommend a set of indicators for consideration by the NHS Commissioning Board and publication on the NICE website.

How to submit your comments: There will be a proforma available on the NICE website : http://www.nice.org.uk/aboutnice/cof/cof.jsp.

If you would like to comment on any of the indicators out for consultation please use the comments proforma.

Please forward your response to Liane Marsh at ccgois@nice.org.uk.

CQUIN 2013/14 Guidance Published The Commissioning for Quality and Innovation (CQUIN) 2013/14 guidance has been published. It provides an overview of the financial framework for 2013/14, detailed guidance on the national pre-qualification criteria and national goals for 2013/14, as well as advice for those developing local CQUIN goals. It can be found here:

http://www.commissioningboard.nhs.uk/files/2013/02/ cquin-guidance.pdf

Quality Observatory Birthdays

In January we celebrated three birthdays here at the QO HQ. Adam, Kate and David all turned another year older and another year wiser.

David received a new light for his bike. Kate got a case for her new iPhone. Adam received some beers and a voucher to use with his new Kindle Fire.

Make a contribution to the newsletter

If you have an article you would like to submit or a topic you would like to write about or a news item you would like featured, please get in contact with us: quality.obersvatory@southeastcoast.nhs.uk.

Trolley Dolly Update

Friends and Family Test Guidance Published The Friends and Family Test guidance has been published by the Department of Health. It details how the data will be published and how the Friends and Family Test score is worked out. It can be found here:

We have as always been keeping the trolley stocked with treats to help keep us going and working hard. Custard creams have been a particular favourite since the last edition. We also had a lovely cinnamon cake provided by Adam (cooked by his wife) to celebrate his birthday. As well as oranges to help boost our vitamin C levels!

https://www.wp.dh.gov.uk/publications/files/2013/02/NHS -FFT-publication-guidance.pdf

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15

NEWS Our latest twitter feed……

Christmas Quiz Question Answers Answers to the Know It All crossword: Across: 1. Redhill 4. Unify 5. Nazir 8. Hundred 10. Prevalence 12. Winnie The Pooh 14. Formulary 16. Barnie Down 2. Health Visitor 3. Incidence 6. Olympics 7. Paul Levy 9. Discharge 11. Thousand 13.Ward 14. Five 15. Frog Solution: Polar Bear Quick Christmas Quiz answers: 1. Turkey 2. Australia 3. Bert and Ernie 4. Ten 5. Comet and Cupid 6. Slade 7. Westminster Abbey 8. Turkey

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Cook’s “Elegy in a Horley Office Block”

Farewell to Naz

By Adam C. Cook This month we said goodbye to Naz after 11 months of working here at the Quality Observatory.

All that's left is not years, nor months, nor weeks but days, The sands of time have reached the last few grains, Now is the hour of the dissolution of the SHAs, Slowly slowly fading 'til naught but a shadow remains.

Naz has gone to work as an Analyst at for the NHS in London.

It was, but eleven years ago, that HA's became strategic,

As a farewell Naz and the team enjoyed a curry together. Naz received a pair of noise cancelling headphones to help on his commute into London.

Thanks for all the hard work Naz and good luck!

Merging and renaming 'til twenty-eight were formed, Now they're gone, leaving us with feelings most nostalgic, Memories are all that’s left to keep our hearts feel warmed.

Then four years on those twenty-eight merged into ten, More merging in the last few years has brought it down to four.

Fascinating Fact

A salute to all who worked there both now and then, Great things you strived, constantly, none could ask for more.

Did you know that “Eleven Plus Two” is an anagram of “Twelve Plus One”?

A conduit 'twixt the department and the NHS, Guiding, implementing policy, trying to get things right, Not trying to be popular, never trying to impress, Doing what was necessary in a manner bold, forthright.

It's true they were demanding on matters of finance, And keeping up performance was something most vexatious, But these things must never falter or be left to chance, But oft' in times of need they could be kind and gracious.

Many times they were champions of inspired innovation, And helped pushed through improvement via needed changes, Supporting trusts on the rocky road to Foundation, Using sometimes kind words, and other times harsh exchanges.

Now the Health and Social Care act has finally drawn a veil, Over Strategic Health Authorities all across the land, Let's say goodbye with a toast and raise a glass of ale, "Good health to all of you, long may your legacy stand."

Simon says…….

In very high pressure steam systems, like steam ships, leaks can be so high pressure that the steam jet is invisible and could take a limb off.

These leaks are detected by waving a broom handle around the area. Hopefully the broom handle gets chopped rather than an arm or worse!

Knowledge matters is the newsletter of NHS South East Coast’s Quality Observatory, to discuss any items raised in this publication, for further information or to be added to our distribution list, please contact: NHS South East Coast York House 18-20 Massetts Road Horley,Surrey, RH6 7DE Phone:

01293 778899

E-mail: Quality.Observatory@southeastcoast.nhs.uk To contact a team member: firstname.surname@southeastcoast.nhs.uk