4.5 The process: Quality assurance

Quality assuring directories

"If the information to be used in the information prescription is not current, it's useless." — health professional

An IP needs to contain information which is reliable and trusted by users, carers and professionals.

How can you ensure that the information you are prescribing is as good as it ought to be? A few of the pilot sites developed their own quality assurance processes for their directories, or used voluntary sector partners or user panels to quality-assure all content. Others, feeling that there was no need to 'reinvent the wheel', chose only to use resources which they had reason to believe were reliable, such as those produced by reputable organisations, and that had already been subject to local or national quality assurance.

In Durham there is a strong focus on ensuring that users, providers and volunteers played a part in quality-assuring the information in the directories. This has helped to make sure information is accessible, relevant and helpful to those who receive it.
In Evelina, NHS Direct took responsibility for accreditation.
South Staffordshire adapted a number of accreditation approaches and developed a system for assessing content in which data was scored against a number of criteria, and discarded if it fell short.
Some sites used existing resources that had been developed for another project, but this ran the risk of information gaps not being filled, for example if there was non-condition-related information that would be useful for the IP but that had not been addressed previously, it might not be identified.
Some sites relied entirely on the assumption that appropriate quality assurance processes would have been adopted by the information provider of the directory content, whether a voluntary organisation, government website or local council and, therefore, that the content would be regularly updated.

Project leads will need to be able to assure professionals, patients and carers that the information being given is accurate, up to date and the best available. Pilot experience has shown that local organisations will want to quality assure the local directories they are developing. In some pilots the website tool 'EQIP' was used and the online resource pack provides further details of quality assurance processes already available nationally.

The DH information accreditation scheme is currently being developed to accredit national organisations and support groups that already provide help, support and advice to patients and carers about a range of health conditions. Once this scheme is operational, all links within NHS Direct and NHS Choices will be part of this national accreditation process.

Quality assuring other elements of information prescribing

Other elements of the information prescribing process also need to be quality assured. In particular, the IP template and any accompanying material to be provided to patients and carers needs to be checked periodically for accessibility and content. Involving users in this is very important: most of the pilot sites undertook a process of template review with both users and professionals.

A number of sites reflected that it would be very useful to have a national databank of accredited information resources which could be adopted and tailored by each site. Some also had questions about data protection and copyright issues, and wanted national guidance to help them navigate such legal complexities.

Follow up

To monitor the effectiveness of information prescribing, it is vital to record not only whether an IP has been issued, but also whether it has been taken up and acted upon. This is particularly so where IPs direct people to websites. You might consider telephoning IP recipients some weeks after issuing an IP to check if the information has been followed up, is useful and is, indeed, what they need.

The prescribing and dispensing processes themselves also need to be checked for their ability to meet everyone's needs – professionals as well as users and carers. Once again, asking people, and involving users as well as professionals in the process of reviewing the process is most important.

Pilot sites usually asked the people to whom IPs were issued if they would be happy to be contacted and asked whether the IP was effective and whether they wished to comment on the prescription or the process. Examples here are of an evaluation letter (Mid-Trent) [PDF untagged 43KB] and of how Heart of England NHS Trust invited patients and carers to be involved [PDF untagged 43KB] in their pilot and/or comment on its progress.

on the next page: templates