Key achievements
Concordat signatories have been working to implement the concordat since June 2004. Some key achievements have been listed below. Further details of initiatives can be found by following this link:
Notable practice
Reducing the burden – minimising duplication and overlap.
Audit Commission
The Audit Commission’s new code of audit practice requires auditors to consider the cost of recommendations. It has developed a framework for costing recommendations, together with associated practical guidance for auditors.
Assessments from two elements of the Audit Commission’s local work programme (the auditor local evaluation – ALE and the use of resources score) will be fed directly into the Healthcare Commission’s annual healthcheck assessment framework, and provide the required conclusion on value for money arrangements - thus reducing potential duplication.
Commission for Social Care Inspection (CSCI)
Delivery and improvement statements have recently been reduced in size by some 40%.
Healthcare Commission
Following the Commission’s consultation on the criteria for core standards, the criteria and prompts were revised and reduced significantly.
The cross-checking process that forms part of the new annual health check methodology uses information from a wide range of sources, including concordat partners. This eliminates the need for the Commission to duplicate activity. The findings of work conducted by the Audit Commission and Monitor will also be used to inform some elements of the core standards assessment.
As part of a move to reduce the burden of inspection for independent healthcare providers and as part of wider changes within the healthcare sector, the Healthcare Commission moved from an assessment system which effectively audited every establishment against every national minimum standard to a risk based approach in April 2005. This process allows us to target healthcare organisations according to risk through a transparent process, which makes more use of pre-inspection information rather than using only our own previous findings. This has meant that we have reduced the inspection time spent in all categories of establishment from large acute hospitals to small beauty salons with lasers for hair removal, run by a single person.
Before April 2005, the average on site inspection time in a large acute hospital was three to four days by three to four inspectors. This time has now dropped to three to four inspectors over one and a half to two days. For beauty salons with lasers, time on site has been reduced from one day down to half a day.
We have also revised our methods and tools for inspection, from a one size fits all approach, to adopting different tools for different types of establishments. This makes the inspection process much more relevant for the smaller services (especially the non-clinical ones) and delivers a more targeted approach. Our reporting process is also much more concise, making it a much less time consuming experience for staff, but also giving a more accessible product to the public.
Following an inspection, the Healthcare Commission gathers feedback from independent healthcare providers. 73% of respondents surveyed between July and September 2005 felt that their inspection had been less burdensome than inspections carried out during 2004.
Mental Health Act Commission (MHAC)
MHAC changed its methodology in 2004 from pre-announced, team-based ’set-piece’ inspections to a system of Commissioners based in local teams who inspect singly at short notice or unannounced. This imposes a significantly reduced burden on inspected bodies.
National Audit Office (NAO)
The NAO recently carried out a follow up of its review of hospital acquired infections (2000). The NAO liaised extensively with the Healthcare Commission and others to avoid duplication, including sharing detailed findings and suggesting people who might help the Healthcare Commission with its work.
NHS Counter Fraud and Security Management Service (NHS CFSMS)
The NHS Security Management Service (part of NHS CFSMS) has published a statement of collaborative working together with the NHS Litigation Authority. You can download the statement here:
NHSLA and NHS SMS statement of joint working (pdf 120kb)
NHS Litigation Authority (NHSLA)
The NHSLA has published a statement of collaborative working together with the NHS Security Management Service (part of NHS CFSMS). You can download the statement from this page (see above under NHS Counter Fraud and Security Management Service).
Following discussion with the NHS Health and Social Care Information Centre, NHSLA has stopped collecting data annually to allow it to calculate member contributions. This will save an estimated 600 person days per year in the NHS, with some associated savings at the NHSLA.
