Assurance is a vital aspect of governance within an NHS Organisation. Boards need to ensure that their organisations can deliver the financial sustainability and quality care that they declare within their annual governance statement, be this business as usual or mid crisis.

It is well known that it is vital to have effective assurance systems in place to ensure that reality is not distorted from ward to board. However with increasing pressures on the NHS, regular and continued organisational change and the need for constant innovation what does an effective assurance system look like in 2020?

With the increasing capabilities of hardware, constantly evolving software and your employees greater ability to consume and utilise information, it is clear that the demands of what an assurance system should have and do has also increased. As a minimum the following requirements should be considered as prerequisites:

• Online and Real-Time
• One System One Login
• Ability to self-assess against regulatory and compliance frameworks (national and local)
• Integrated Performance of Strategic Goals, Risks and Actions
• Interoperability
• Cost Effective
• Business Continuity Planning 
• Crisis Management

Online and Real-Time

It seems obvious to state but having an online, always available system is critical in a 24hr a day, 7 day a week, 365 day a year organisation. Whether its staff on the night shift or Directors on call needing up to date information, being able to access information on demand equals better decision making and quicker issue resolution.

Having information that is delivered immediately after collection enables a proactive management approach and improves collaboration between multi-disciplinary teams.

One System One Login

Good assurance comes from multiple sources; whether its comparative data and statistic, talking to staff and patients or completing structured visits or inspections. Multiple sources often leads to multiple systems. We have all heard the mutterings of a staff member in a training session “not another password for me to remember”.

Having all aspects of assurance managed in one system will improve system adoption, data accuracy and strengthen the “Golden Thread” of ward to board information. This also means that when it comes to a crisis, teams know and are familiar with the software. 

Self-Assess Against Regulatory and Compliance Frameworks

CQC, NICE, NHSi the list goes on. The modern NHS Organisation has a wide range of regulatory bodies and compliance frameworks it must comply with.

Organisations need to be able to assess, evidence and report on compliance so having an assurance system that can enable and support that process is important. It is often a time consuming and resource heavy process to ensure compliance with each entity. This however can be combatted with an integrated assurance system.

Having requirements pre-populated and automatically updated ensures consistency and reduces the manual workload often included in disseminating information throughout the organisation.

Evidence, assessment data and subjective commentary can be added and shared against multiple sources, for example the need to comply with a NICE guidance could link to the completion of a clinical audit which in turn could be used as a piece of evidence to prove compliance with a CQC Key Line of Enquiry.

Having a transparent and easy to access system will also enable and encourage the sharing of best practice throughout the organisation ensuring time isn’t wasted trying to re-invent the wheel! By having compliance linked to day to day activity and real time data the focus changes from “passing an inspection” to continuous quality improvement.

Integrated Performance of Strategic Goals, Risks and Actions

Strategic Goals, Risk, Actions, Compliance with Frameworks, Policies, Clinical Audit, Inspections……they are all connected ( and even more so in a crisis!)

The performance of one relates to another, a clinical audit could produce a recommendation that once complete could mitigate a risk, which once mitigated could increase a service performance, which in turn could generate additional income increasing financial sustainability and ultimately improving patient outcomes.

It does not make sense to view the organisational strategic plan, risk register and action plans in separate systems or without a view of cause and effect.

Interoperability

Interoperability is not just the latest buzz word in the digital landscape but a key factor in the future a technology within the NHS. Simply put interoperability is the ability of computer systems or software to exchange and make use of information from multiple sources.

How many times have you heard “we can't get that data it's in another system” or “yes, we collect that data but we use a different system to generate reports”. Having an assurance system than can link to multiple data sources and output data in multiple formats ensures not only a single source of input for employees but more importantly an “single version of the truth” at all times from ward to board.

Cost Effective

Year on year there is increasing pressure on the NHS to streamline resources and become more cost efficient, with this in mind there is a need for the NHS to work closely with hardware and software providers to ensure public money is spent efficiently and ethically.

The need to buy multiple systems from multiple suppliers to provide different solutions that should be connected but won't be, can make the procurement processes lengthy, complicated and often expensive with the result often being a systems that “almost” do what you want them to do.

The responsibility of assurance and in turn good governance belongs to all employees. Next time you are writing a report, analysing data or gathering data for a CQC inspections ask yourself the following questions about your assurance system;

• Can each stakeholder access relevant information in one place allowing them to focus on what is important to them?
• Is your assurance system compatible with current technology?
• Is it easy to spot gaps in assurance and compliance across multiple frameworks at once?
• Does it help staff understand link between assurance on Organisational performance?
• Is the assurance system a crucial part of the quality management process?

If any of the answers to the above questions is No then it might be time to review your system.

Paul Clinton

Chief Solutions Officer

Paul has vast expertise in healthcare, NHS, independent providers and social care, from practical experience and implementations of dozens of healthcare systems over the past decade. Leading the design and integration of solutions today using the InPhase suite with unparalleled knowledge.