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Neurology: Outpatient Services in Belfast Trust (focusing on Neurology & High Volume Specialties)

This review has been completed and the report is undergoing final checking before publication.


What we were asked to do:

1. To describe and assess the governance systems and processes in place in the outpatients service in the Belfast HSC Trust, with a particular focus on neurology and other high volume specialties*, which assure quality of care with regard to:

  • Leadership
  • Safety
  • Effectiveness
  • Compassion

2. To assess the effectiveness of the arrangements for monitoring the quality of care and patient outcomes in the outpatients service in the Belfast HSC Trust, with a particular focus on neurology and other high volume specialties*.

3. To assess the effectiveness of the arrangements for identifying and managing risk in the outpatients service in the Belfast HSC Trust, with a particular focus on neurology and other high volume specialties*.

4. To gather the views and experiences of service users (patients, families, carers and general practitioners) of the outpatients services for neurology and other high volume specialties* in the Belfast HSC Trust.

5. To report on the findings, identify areas of good practice and, where appropriate, make recommendations for improvement.

*Definition of High Volume Specialties: to cover identified specialties in relation to high volume of attendances, both new and review appointments and identified specialties in relation to high risk/complex conditions.

How we carried out the review:

We utilised a mix of methodologies to gather information to inform the review, including:

  • A review of relevant literature to identify key themes and the areas likely to require focus;
  • A review of the Care Quality Commission’s (CQC’s) Inspection Framework for NHS Acute Hospitals for Core Service of Outpatients, which was used to develop a framework to support our work;
  • Completion of a structured questionnaire by the Belfast Trust, to capture information relating to outpatient services as delivered by the Trust;
  • Analysis of information and development of key lines of enquiry relating to key aspects of outpatients services delivered by the Trust, such as design and delivery of outpatient services, maintaining a well-led service, and ensuring safe and effective care is delivered;
  • Meetings with a range of staff from across Belfast Trust.  We met with in excess of 100 staff including the Chief Executive, the Chairman and Members of the Board, the Executive Team, Directors, Co-Directors, Clinical Directors, Service Managers, Specialist Neurology Nurses, Consultant Neurologists, Governance Managers and Information Managers;
  • Meetings with the HSC Board and Public Health Agency which have responsibility for commissioning, public health expertise to service development and integrated care (pharmacy services);
  • Unannounced multi-disciplinary inspections of the Trust’s five main hospital sites that deliver outpatient services, Belfast City Hospital, the Mater Infirmorum Hospital, Musgrave Park Hospital, the Royal Victoria Hospital and the Royal Belfast Hospital for Sick Children.  We visited approximately 60 specialist services which delivered care and/or treatment in the outpatients areas inspected;
  • A survey to capture the experiences of, and feedback from, patients, relatives and carers;
  • Focus groups with neurology patients and their relatives and carers;
  • A survey to capture the experiences of, and feedback from, General Practitioners working in Northern Ireland and interfacing with the Trust in the context of services provided to/for their patients;
  • Meetings with the General Medical Council and with Tier Two Responsible Officers in Northern Ireland to discuss matters relating to medical appraisal and revalidation.

The Review Team

You can find more information on the review team here