National Licensing in a Time of Austerity A Unique Opportunity for Innovation

John SweeneyDirector, HCI

Building Control Authority Environmental Protection Agency Radiological Protection Institute of Ireland Health & Safety Authority of Ireland Food Safety Authority of Ireland (EHO's)Pharmaceutical Society of Ireland Health Services Executive CORU - Health and Social Care Professionals HIQA - Infection Control Mental Health Commission National Disability Authority Clinical Indemnity Scheme Irish Medical Council An Bord Altranais Opticians Board Dental Council Irish Medicines Board Irish Blood Transfusion Service Royal College of Physicians in Ireland Faculty of Occupational Medicine Faculty of Paediatrics Faculty of Public Health Medicine Institute of Obstetricians & Gynaecologists Royal College of Surgeons in Ireland Faculty of Dentistry Faculty of Radiologists Irish College of Anaesthetists Irish College of General Practitioners in Ireland Irish College of Psychiatrists Irish College of Ophthalmologists Irish Society of Chartered Physiotherapists National Treatment Private Health Insurance Purchase Fund Joint Assessment Group (GI )HIQA Pre-Hospital Emergency Care Council Fire Officers Excellence Ireland National Standards Authority of Ireland Joint Commission International CHKS Accreditation Centre for the Development of Nursing Policy and Practice, University of Leeds Irish National Accreditation Board Clinical Pathology Accreditation (UK) Academy of Medical Laboratory Science National Council for the Professional Development of Nursing and Midwifery NERA - National Employment Rights Authority

Overlap?

2006 – 64%

Quality Manager (or similar)Departmental Quality Manager (e.g. Labs) (or similar) Accreditation Manager (or similar)Risk Manager (or similar)Health and Safety Officer (or similar)Infection Control Officer (or similar) Clinical Audit Manager (or similar) Governance Manager (or similar)Best Practice Development Officer (or similar)Standards Development (or similar)Quality Co-ordinator (or similar)Risk Administrator Health Promotion Officer (or similar)Audit Administrator Quality Administrator

Gaps?

2006 – 75%

Framework

EnforcementEnforcement EducationEducation Research & Research & DevelopmentDevelopment

Enforcement

• Implementation – Hospital Prioritisation• Regulatory Co-ordination (PSC)• Incident Investigation• Incorporates HIQA• Costs

2012

Enforcement

• Prioritisation - Hospitals • Private - Public• Standards Comparable – ISQua - WHO

Implementation

• Leadership, Governance and Management

• Person-Centered Care • Promoting Better Health • Effective Care • Use of Information • Safe Care • Use of Resources • Workforce

• Governance, Leadership, and Direction• Access to Care and Continuity of Care• Patient Rights & Education• Assessment and Care• Quality Improvement and Patient Safety• Communication and Information• Prevention and Control of Infections• Facility Management and Safety• Staff Qualifications and Education

Enforcement

• Prioritisation - Hospitals • Private - Public• Standards Comparable – ISQua - WHO• Other Risk Areas - Immediate• Options?

Implementation

Enforcement

• USA - Centers for Medicare & Medicaid Services (CMS)

– CoP – Joint Commission - Random validation surveys

• New Zealand - Health and Disability Services (Safety) Act 2001 - Designated Auditing Agency – ISO / ISQua

• VHI – Hospitals – Imaging - VHI

Outsourcing

Enforcement

• Rapid Implementation• Best Practice Standards – ISQua / WHO • International Expertise• PSA Control – Resource Utilisation• Cost

Potential Benefits

Enforcement

• Primary Regulator• Regulatory Integration• Specific Requirements re SBC• Demonstrable need for additional• Reduced Workload - Cost

Regulatory Burden

Quality and Risk• Framework for Provision of Care• Responsibility Lies…• Co-ordination/ Management• Integration (Committees) and Localisation • Reduction in Overlap• Staff Gap - Best Use of Resources

Outcomes• Quality and Risk Integration. • Rapid Implementation.• Regulatory Co-ordination.• Reduced Cost – (Regulation and Quality).• PSA – Changing Culture.• Innovation. • Improved Care.

Let’s make things better.

Philips

Necessity, who is the mother of invention. Plato