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Measuring single specialty services

Smaller single specialty departments often form part of a wider clinical group Measuring graphicwithin a hospital. Performance highs and lows can be lost within pooled data for divisions, directorates or the whole trust. It may not be until a problem develops that any indication of quality and safety issues surfaces.

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Smaller departments are not always seen to warrant individual assessment, or the specialty expertise is not available within the management team to decide what to measure. Clinical and service management leads for whom this data should be crucial can feel too busy keeping the service afloat to devote the time to measuring performance metrics.

However, not only is it important in a general sense for single specialties to be assessed but it is also crucial to have metrics, judged against standards for achievement (targets) where possible. These can be used to decide whether or not a service can continue as it is, whether changes should be made or a partnership with another specialty provider considered. It is also important for a unit or trust to be able to quantify the specialty performance of any potential partner.

When deciding how to evaluate a specialty, there are a number of generic measures which are collected by any trust and which simply need to be assessed for the specialty separately, for example the number of serious incidents or the compliance with annual mandatory training for the specialty staff.

Beyond that, there are specialty-specific measures but these generally fall within certain predictable categories of information, such as the complication rate for the main specialty procedure or adherence to specialty national guidelines.

Reliable sources for specialty-specific quality requirements and targets include guidance from NICE, royal college or national specialty body guidelines and recommendations, national audits, patient reported outcome measures and the CQC.

If a smaller service has not been appropriately measured, the potential specialty partner will need to undertake appropriate due diligence.

We have provided examples of broadly agreed generic metrics for colorectal, neurology, orthopaedics, ophthalmology, blank version for other specialties to use and a template for quality sharing. They are by CQC domain and metric group. These can be downloaded (below) and adapted.