At Aqua, our work falls into a number of different themes. To make it easier to find the right solutions for you, we have separated the work we do into 10 different areas of expertise.
At Aqua, our work falls into a number of different themes. To make it easier to find the right solutions for you, we have separated the work we do into 10 different areas of expertise.
We have expert advisors covering each of these topics that are here to support your improvement efforts.
Analytics and Evaluation
Our Analytics and Evaluation work consists of designing and delivering research and evaluation to generate insight, build learning, and understand the impact of improvements. The team supports programmes across Aqua and are also able to support your Analytics and Evaluation needs directly.
Aqua is a trusted partner to health and social care organisations in delivering Analytics and Evaluation support, project measurement and research.
Our Measuring for Improvement programme is designed to give you practical techniques to bring your data alive, allowing you to better use data to support your improvement activities. The Quarterly Mortality Report is provided to Medical Directors, Clinical Coders and Service Leads in member organisations, and collates data from the Summary Hospital-level Mortality Indicator (SHMI), which reports on mortality at trust level across the NHS in England.
We also offer tailor-made Analytics and Evaluation support, whereby we will work with you closely to determine your needs and how best we can help.
Aqua has a proven track record of successful delivery with our Analytics and Evaluation work, which recently includes: analysis and interpretation of programme analytics and survey data for NHS Horizons for a large-scale national training programme aimed at health and social care staff; and engagement across over 50 Aqua member organisation and partners on quality improvement initiatives.
Lived Experience
Our Lived Experience Panel is vital in supporting the development and improvement of our services by bringing experience of using health and care services. At Aqua, we can support you to implement your own Lived Experience Panel, to strengthen your quality improvement work.
Implemented in 2014, our Lived Experience Panel is a group of five individuals who bring their experience of using health and care services to ensure that the voice of patients, service users, carers and the wider public is reflected in all the work that we do.
Aqua also provides bespoke work for both members and customers via consultancy by supporting you to build your own lived experience panel, to support your quality improvement work and actively engage in your improvement activity. This has been implemented in a number of both providers and commissioners across the region.
We know from experience that having someone with lived experience as part of quality improvement conversations can shift the direction of the work that is happening, and so we advocate for the involvement of lived experience in all areas of improvement work.
Mental Health
Our Mental Health work supports our customers that provide or commission mental health services. We work closely with these organisations over a structured programme to determine their improvement needs and how best to tackle them.
The Mental Health work that we do is based around a particular theme, with our most recent work being done around the theme of suicide prevention and trauma. This theme is determined each year as a result of the Senior Executive Quality Leads meeting, which is a space for executives in mental health providers to discuss their strategic objectives for the year.
Our Quality Improvement Operational Leads Network Meetings also support those leading quality improvement work within mental health providers by bringing them together as a regional network.
Alongside this, Aqua also provides bespoke work for members, consisting of tailor-made quality improvement training for mental health providers.
We are proud to be a part of the continued and growing emphasis around quality improvement within mental health providers regionally. We are seeing quality improvement teams embedded within organisations and networks being developed across organisations.
Organisational Development
Our Organisational Development work at Aqua involves supporting customers to develop their organisations to be as fit for purpose as possible. We encourage investment in complex relationships across organisations, and collective movements towards positive change.
All of our Organisational Development work is informed by both quantitative and qualitative data, putting a range of recognised organisational development, quality improvement, team and leadership theories and tools into practice.
Great Organisational Development is understanding an organisation’s context and culture, working with communities and across systems, and enabling staff to curate and deliver excellent services.
We strongly believe in having lived experience embedded in all Organisational Development work.
Personalised Care
Personalised Care gives people choice and control over their mental and physical health, recognising that a one-size-fits-all health and care system cannot meet the complex needs of the population. We work with organisations to help them implement this way of working.
Aqua is one of the largest providers of Personalised Care training in the UK, working with organisations including NHS Trusts, CCGs, local authorities, care associations and housing providers. We offer project-by-project services to customers, providing organisations with the skills to deliver safe, high-quality personalised care in any setting.
Our training gives you the tools to understand what personalised care is, and how to develop and implement this practice in a sustainable way in your organisation. We are very experienced in this work, with over 70 clinical teams having received training as part of our collaborative programmes.
Just one of our successful programmes was the National NHS RightCare Shared Decision Making (SDM) Programme. As one of three National Delivery Partners, we successfully led a programme looking at the culture for building and embedding shared decision making with 33 musculoskeletal, maternity and renal teams.
Quality Improvement
For us at Aqua, Quality is care which is safe, effective, timely, efficient, equitable and person-centred. We offer support aimed at solving the problems in your organisation, putting theories and tools into practice to improve quality and build capability.
At Aqua, we want to empower staff members to identify the Quality Improvement needs within their teams and support them to find the best solutions.
We do this by offering a number of programmes centered around improvement, engagement, appreciative inquiry, lean thinking and improvement practice. We also offer tailor-made programmes for organisations looking to tackle a specific issue around Quality Improvement and capability building.
We believe that data is vital in determining what changes need to be made in your organisation, and whether those changes were successful.
Safety
At Aqua, we look at what Safety means from different perspectives across health and care, supporting teams, organisations and whole systems through educational development. We introduce the fundamentals of safety science and work with staff to understand how these can be used practically.
Aqua offers a number of programmes to support organisations with improving Safety. Our programmes focus on Human Factors, Appreciative Inquiry, Safety Culture Surveys, Psychological Safety and Incident Investigation. We also offer tailor-made programmes for organisations looking to tackle a specific issue around safety.
We also host a number of networks, such as the Patient Safety Specialists network which brings together those leading on safety at organisations across the region, as well as supporting Integrated Care Boards and Integrated Care Systems across the North West to implement the requirements of the Patient Incidence Response Framework.
At Aqua, we always make sure that we are adding value to the existing work that organisations are doing around improving Safety.
System Transformation
Our System Transformation work is about supporting people, wherever they work, to collaborate in different ways. Aqua has a long history of bringing people and their organisations together, but this work is now as important as ever due to the new Duty to Collaborate from the Health and Social Care Act 2022.
Aqua’s System Transformation work is all about improving relationships and processes in order to improve outcomes. We bring people and their organisations together in order to collaborate in different ways. This work is highly relevant in the current environment, with the introduction of the Health and Social Care Act 2022 and the creation of Integrated Care Boards.
As part of our System Transformation work, we host masterclasses as well as running our own Leading Integrated Teams (LIT) programme, which is a substantial leadership programme aimed at supporting effective integration in systems and places.
However, it’s vital for us at Aqua that you receive the specific support that you need. This is why we work together with organisations and systems to design unique programmes that will be most beneficial for you.
Unwarranted Clinical Variation
Unwarranted Clinical Variation refers to patient care that differs in ways that are not in keeping with national policy and clinical best practice, or reflect the needs and choices of patients. At Aqua, we are committed to reducing Unwarranted Clinical Variation by improving the reliability, quality and experience of health and care for people in the North West and beyond.
Unwarranted Clinical Variation refers to patient care that differs in ways that are not in keeping with national policy and clinical best practice, or reflect the needs and choices of patients. At Aqua, we are committed to reducing Unwarranted Clinical Variation by improving the reliability, quality and experience of health and care for people in the North West and beyond. We aim to do this by using validated clinical datasets, quality improvement approaches along with building governance, clinical leadership and data literacy within organisations.
The Advancing Quality (AQ) programme is our flagship Unwarranted Clinical Variation programme, and is the longest running improvement programme in the NHS, established in 2008. Data is at the heart of what we do with our AQ programme, and plays a key part in helping us identify the opportunities to improve care quality.
We currently support organisations improve the reliability of care and reduce unwarranted clinical variation across six clinical focus areas: Acute Kidney Injury, Decompensated Liver Disease, Community Acquired Pneumonia, Hospital Acquired Pneumonia, Elective Hip and Knee Replacement and Sepsis.
Well Led
Is your service Well-Led? This question is a key part of the Care Quality Commission’s criteria when assessing health and care providers. With more than three decades of experience co-designing and delivering governance, leadership and quality improvement; Aqua can help you meet the Well-Led framework.
Aqua is here to support organisations to meet the standards of the Care Quality Commission’s Well-Led framework, utilising our breadth of experience built since the introduction of Well-Led.
Our expert team will perform an in-depth review of your organisation to determine if:
At Aqua we have in depth knowledge of the healthcare sector, being an NHS organisation working with over 80 NHS providers, commissioners and regulatory bodies. We are also able to draw knowledge and expertise from our accountants, governance experts, clinicians, improvement experts and analysts to ensure that the review we perform is of a high standard.
AQ: Elective Hip and Knee Replacement – Behind the Numbers
Demand for elective care has risen over the recent years and this has been exacerbated by the pandemic. This report includes insights from analysis of Advancing Quality (AQ) programme data […]
AQ: Improving Care for Patients with Sepsis in an Acute Trust
Southport and Ormskirk Hospital NHS Trust provides acute hospital services to 258,000 people across Southport, Formby and West Lancashire. Acute care is provided at Southport and Formby District General Hospital and Ormskirk and District General Hospital. Sepsis accounts for around 1,200 acute admissions to the trust each year.
AQ: Aintree Improvement Journey for Patients with Alcohol Related Liver Disease
Aintree University Hospital NHS Foundation Trust joined the Advancing Quality (AQ) programme at its launch in 2008 and is currently participating in eight clinical focus areas (CFA), this includes Alcohol Related Liver Disease (ARLD).
AQ: Reducing Avoidable Harm through Patient Assessment & Escalation
In patients who are, or become acutely unwell in hospital, there is evidence that deterioration is not always recognised or it is not acted on rapidly enough (NICE, 2007). The Walton Centre NHS Foundation Trust wanted to improve observation recording, recognition and response to deteriorating patients using the NEWS assessment tool.
AQ: Reducing Mortality in Community Acquired Pneumonia (Liverpool University Hospitals NHS Foundation Trust)
The NICE (2014) guidance publication ‘Pneumonia in Adult: Diagnosis & Management’ covers diagnosing and managing Community Acquired Pneumonia (CAP) in adults. Its aim is to improve the accurate assessment and diagnosis of pneumonia to help guide antibiotic prescription and ensure that people receive the right care. It estimates a mortality rate between 5% and 14% for patients admitted to hospital with CAP.
AQ: Serum Lactate in the Treatment of Sepsis
he Royal Liverpool & Broadgreen University Hospitals NHS Trust (RLBUHT) identified an opportunity to improve the early diagnosis of patients with sepsis. Evidence suggests that the sickest sepsis patients have high levels of serum lactate. Timely measurement of serum lactate levels in patient pathways can improve early diagnosis which will lead to improved outcomes.
AQ: Embedding Early Assessment In Out of Hours Primary Care
Sepsis and deterioration is a huge clinical problem and 70% of sepsis cases originate in Primary Care. In the last five years we have experienced a culture shift in primary care; from seeing sepsis as an acute condition that is difficult to detect, to recognising the need to actively assess patients where infection could be causing significant illness or deterioration.
AQ: Effective Management of Frailty in Hip & Knee Replacement (Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust)
NHS England defines frailty as ‘where someone is less able to cope with and recover from accidents, physical illness or other stressful events’1. As the population ages, so frailty rates increase, presenting challenges to care systems. Elective hip and knee replacement patients undergo pre-surgical checks to ensure they are able to cope with their procedure.
AQ: Improving the Management of Acute Kidney Injury (AKI)- Role of the AKI Pharmacist
The 2009 NCEPOD report, Adding Insult to Injury, reviewed outcomes for patients with acute kidney injury (AKI) in hospital. The report found that medication was the most common AKI risk factor not assessed and only 15% of patients had their medication altered to renal doses. The national AKI programme Think Kidneys advises that medicines optimisation is essential to reduce the risk of AKI and mitigate its severity if it occurs.
AQ: Improving Care for Patients with Sepsis in an Acute Trust
Sepsis is a life-threatening condition which has in recent years become a high priority for healthcare providers. Early recognition and prompt management of sepsis can improve outcomes for patients, reducing the risk of mortality and morbidity. This could potentially save 14,000 lives and result in 400,000 fewer days in hospital for patients every year, according to estimates by the Sepsis Trust.
AQ: A Collaborative Approach to the Management of Acute Kidney Injury (AKI)
Southport and Ormskirk Hospitals NHS Trust has established a steering group to improve care for patients with AKI. The group is using the care bundle data from the Advancing Quality Alliance (AQuA) Advancing Quality (AQ) AKI programme to monitor care delivery for patients with AKI and to provide a framework for improvement.
AQ: Improving the Ultrasound Scanning Process for Patients with Acute Kidney Injury
Acute kidney injury (AKI) may sometimes be caused by an obstruction in the urinary tract, which can require treatment with a nephrostomy. It is important that people with AKI who are suspected of having a urinary obstruction receive an ultrasound scan early in their management, as outlined in national guidance (NICE, 2019).