How we hold providers to account


Islington CCG regularly reviews and monitors our local NHS Trusts’ performance around patient experience through monthly Clinical Quality Review Group meetings. There are at least 2 patient representatives who sit on all of our Clinical Quality Review Groups ensuring that patient voice is heard when we assess the quality of the services we commission.

We use these meetings to monitor and assess patient experience by reviewing complaints, Friends and Family Test responses, comments on NHS Choices and national patient survey results. We also review any action plans that the Trusts have put in place to address areas of poor performance or poor experience.

Sometimes the CCG will conduct insight visits if we get an indication that a service is not performing to the standard that it should be. Patient representatives are invited to carry out these visits with us and are involved in making recommendations to providers on how services can improve.  Re-visits are usually undertaken around 12 months after the initial service visit to ensure recommendations have been embedded into routine practice. Insight visits can also be carried out by Healthwatch Islington. These visits are called Enter and View visits.

We review and respond to complaints received by the CCG, MP enquiries on behalf of Islington residents, and any quality alerts raised by GPs about other local providers, as part of the CCG’s Insight and Learning Programme.

Where trends or serious risks are identified as a result of a patient concern, additional meetings are held with the provider in order to flag the issues and request remedial actions.  Quarterly reports on complaints, GP Alerts and Insight Visits are regularly presented at the CCG’s Quality & Performance Committee which has a lay member and Healthwatch representative.

Our commissioners hold regular contract monitoring meetings with our providers to ensure they are fulfilling their contractual obligations of delivering high quality health services to local people. Some of these contract meetings, such as those that are part of our 'Out of Hours' GP service contract, can also include patient representatives.  

Quality accounts

One way we support our Trusts to address concerns raised through our work with local people (whether this is through patient experience, engagement or complaints) is through the development of their Quality Accounts. 

The Quality Accounts include priorities for the coming year which are our key areas for improvement. These are selected following the analysis of information from patient experience, engagement, complaints, any incidents which occurred during the year and consultations with patient representatives, shadow governors, GPs, the Trusts’ staff and the CCG. 

Please see the Whittington Health’s Quality Accounts.

Case Study: Improving Discharge Summaries for patients

Healthwatch Islington raised feedback they had received from local residents, at the CCG’s July 2018 Patient and Public Participation Committee, that the Discharge Summaries local people were receiving when they left hospital were confusing and difficult to understand. Therefore, they did not support effective self-management and after care.  The evidence was substantial and compelling. In partnership with Whittington Health, Healthwatch and the feedback of local patients, the CCG are developing a new template Discharge Summary which will be piloted with local patients from May 2019.  As a result of direct feedback from local patients the new discharge summary will address: 

  • What’s going to happen to me when I leave hospital?
  • What do I do if I start to feel ill again?
  • Who do I contact if the support arranged doesn’t materialise?’ 

The discharge summary is currently being worked on in partnership with Healthwatch Islington, Islington and Haringey CCGs, and Whittington Health. To see current progress please click on the link below, or you can click on the download link on the right of this page.

Discharge Summaries Draft