# Peer review



## fencesitter (May 15, 2014)

I thought you'd be interested to hear that I'm taking part in a peer review exercise on Saturday, which is a training day I think. It's an NHS thing asking parents to help improve paediatric services by contributing their experiences. I don't have a lot of detail at the moment but after three years of learning alongside my son I am ready to offload! Once signed up and trained we'll be doing things called 'peer review visits'. No idea what they are yet. Anyway I'll report back and if I get the chance I'll put in a good word for this forum which is the source of so much great info and support


----------



## trophywench (May 16, 2014)

Probably visiting other hospitals in the same area, visiting their diabetes clinic and asking the right questions to find out what services are on offer and how they deliver them

You won't be alone so don't worry!  There will be eg a D consultant and maybe a Paediatric DSN, or another Dr, or all of them from different places who will be doing the same as you, but from their own professional POV.

You will get paperwork upfront basically telling you what they are sposed to have in an ideal world.  Then from the hosp you are visiting you will get a another ream of paper as a PDF (it's presented in a table which I had to expand to 200% to read cos they are A3 and nobody's computer screen is) - outlining what they do and how they do it, you will have queries on it - there will be gaps, things missing you don't think there ought to be - eg no psychologist or something - so you write them down and keep your notes with you.

You meet in a room provided on the day, don your ID and gather in your team and introduce yourselves then discuss briefly what you want to see - and then sally forth to meet the staff.  They do a little informal presentation to you of their services, and show you round and you can cross examine any of them or pounce on anything new to you and just generally get to know EVERYTHING LOL

Then you go back into a huddle and do your report.  There's a format and all the major points are listed, you plod through and can just tick boxes Yes they have this, no they don't - and add comments as appropriate.

Then whoever is in charge from the auditing body goes through your form and asks questions if they need to - they have to put it in the format they need for the full report on the hospital.  Cos it isn't just childrens D services that will be being reviewed that day, it will be more than one department, all by different teams.

It's quite a hectic day actually, but it opens your eyes to the other side, as a User.  Very enjoyable I found it, but did feel I'd like to do another one soon as I now thought I knew what I was supposed to be doing!  No opportunities came up except one too far away from me.  It can be a little 'in at the deep end' so I asked the others on my team to explain stuff, the Consultant was a bit of an arse because he was young ,supercilious and talked down to me! (and I wanted to smack him) but the others treated me with respect and DID explain it.  Main man said What shall we put here? and then wrote what he wanted, so I argued and said No - they didn't say that at all, they said whatever and you aren't going to leave it like that are you?  The others agreed with me so he had no option tee hee hee.

Don't be afraid to put your oar in, we were all supposed to be equal and sometimes you have to insist on it.  

Eventually you get a copy of the actual report and you proof read your bit and see if you agree what it says is what you actually found, if it doesn't, or you don't understand something, query it.  They have to respond to the queries and explain, you discuss it and hopefully eventually you are happy with it and say so.

Any remedial actions required are put into Action Points.

You finally get a letter telling you what happened when they presented the thing to whoevers running the hospital so it isn't finished when you go home that evening.

You will actually enjoy it believe it or not, but it IS definitely WORK.


----------



## Northerner (May 16, 2014)

I hope everything goes well, I will look forward to hearing about your experiences


----------



## Pumper_Sue (May 16, 2014)

Willsmum said:


> I thought you'd be interested to hear that I'm taking part in a peer review exercise on Saturday, which is a training day I think. It's an NHS thing asking parents to help improve paediatric services by contributing their experiences. I don't have a lot of detail at the moment but after three years of learning alongside my son I am ready to offload! Once signed up and trained we'll be doing things called 'peer review visits'. No idea what they are yet. Anyway I'll report back and if I get the chance I'll put in a good word for this forum which is the source of so much great info and support



How fantastic and very good luck. I'm sure you will have plenty of practical input.


----------



## fencesitter (May 16, 2014)

Thanks all, and thanks especially to TrophyWench for the brilliant summary of what goes on! I am looking forward to it but quite awed by the responsibility  Still, tomorrow is just the training bit so I don't need to get nervous just yet


----------



## trophywench (May 17, 2014)

Yep - it ain't just the peer reviewers being trained - you'll meet ALL SORTS of people - I met a D Consultant I'd actually met before, he works at another hospital in the vicinity and had been on the stage at one of the local DUK meetings I'd been too and I know I cross examined him about something - so he remembered me too.  I hoped he'd be on my inspection, but sadly I drew the short straw there LOL

Anyway, nurses, Drs and Consultants, all sorts of peer reviewers - it interesting!  Amongst other things you'll do a practice review, so you get to see examples of what will be required.

It's good LOL


----------



## fencesitter (May 18, 2014)

It was a good day, parents and T1s at the training although the review teams will include clinicians too. Trophy's description of peer review is exactly what we'll be doing. It does sound like hard work, but think it will be v.worthwhile because apparently the same exercise with cancer services helped to improve them significantly. Asks 'how is your service meeting x objective, what's the evidence and how are you documenting it' about a whole lot of criteria that all paediatric diabetes services must fulfil. Then if they are not you categorise any issues according to whether they're an immediate risk or a cause for concern or whatever, and the hospital has to take action. Patient reps are there to fly the flag for service users. Wasn't a lot of time for chat but I did mention this forum in glowing terms! Other people were using different ones like the CWD lists (I don't like the email format so tend not to use them myself) and something called TuDiabetes (the T1s at the meeting were very keen on this one). General agreement that forums can be v.empowering and are often a more effective source of help than HCPs


----------



## Northerner (May 18, 2014)

Sounds really good, good for you for taking part


----------



## trophywench (May 18, 2014)

Have they warned you about the homework you get upfront, and the fact if there are any additions you probably won't get them upfront so you'll need to speed read them in between meeting the team and embarking on the inspection ?

Be Warned !!

Hospitals tend to have Intranets, so all the things they are sposed to do and how they actually do them, they just say airily - It's on the Intranet! - forgetting that NONE of the reviewers, nor the Review Body - have access to it - so that means they have to print it off and this seems to cause them probs, they don't like doing it.

Which is when you get stuff that's a mile wide onscreen, condensed down to A4 sheets ......

In theory it should be simple but unfortunately when you put human beings and hospital bureaucrats into the mix ........


----------



## fencesitter (Jul 10, 2014)

Did my first peer review last week, it was a very exhausting and interesting day! Trophy you were right about all the vast amounts of paper to get to grips with in no time at all. But I thought that the team leader was very impressive and understood her job really well, so we were steered efficiently through the whole thing. I won't go in to detail about the particular visit, but just to say that I think it's great that all paediatric diabetes services are going through this process. A bit of constructive/objective criticism and helpful scrutiny has to be a good thing, although it's hard for the service in much the same way as ofsted is hard for schools, lots of preparation and evidence gathering has to be done. I did find it quite stressful and boggling at times because there was so much to understand and get through in just a few hours, but hopefully next time (September) I will be more familiar with the process and make a more active contribution


----------



## Northerner (Jul 10, 2014)

Good for you Willsmum


----------



## trophywench (Jul 10, 2014)

I felt that, Willsmum.  Until you have done one, you don't actually know what you are looking that, even though it's written down and you've been in such a clinic loads of times before, which leads you to the erroneous assumption that you know how these things work.

But you don't - on the review you are treated as a member of staff almost - you definitely see things from the other side.


----------



## trophywench (Jul 10, 2014)

PS  My feet hurt for two days after I did mine !


----------

