4.11 In most strategic health authorities, monitoring of the QIPP challenge is evolving. Much of the QIPP monitoring is carried out by existing performance management teams within the strategic health authorities and has been built into the general monthly reporting (core returns) of performance to date.
4.12 Monitoring information tends to focus on activity data, workforce data and financial data, including the information on indicators set out in the NHS Operating Framework for 2011-12. Some of the activities underway will not generate outcomes for a few years. For these activities, strategic health authorities and the Department will monitor progress against key milestones. Financial monitoring is carried out on a quarterly basis using the Financial Information Management Systems (FIMS), which is the system through which trusts report their results to the Department and strategic health authorities. Activity and workforce data comes from a wide range of sources.
4.13 Different approaches have been taken in different strategic health authorities:
● some have established project management offices in primary care trusts/clusters to assist with the monitoring of progress;
● some have set up their monitoring arrangements to mirror their reporting to the Department using the report card format;
● some areas performed their own 'deep dives' similar to those undertaken by the Department; and
● one strategic health authority is developing an integrated dashboard for all primary care trusts to help them interpret progress against targets.
4.14 At a primary care trust level, monitoring is managed via numerous tools and processes including dashboard style reporting, board level monitoring and clinical level monitoring. Some have commissioned tools to support their monitoring activity.
4.15 Strategic health authorities highlighted a number of issues relating to monitoring including:
● the time lag between action and saving accrual for some workstreams;
● the lack of real-time data in some areas and poor/different data definitions are a hindrance to accurate reporting;
● a loss of informatics staff is limiting the monitoring ability of some organisations;
● foundation trusts do not have to provide data for monitoring purposes;
● double counting is an issue across workstreams, but most strategic health authorities have mitigated this risk by only allowing one workstream to count a saving; and
● data validation remains a challenge especially in the community and mental health settings.