The RCPCH Epilepsy Quality Improvement Programme (EQIP) is a bespoke training programme that supports paediatric epilepsy service teams to identify sustainable improvements within their services to improve upon the care provided for children and young people with epilepsy.
In response to the wider context of the priorities set out in the NHS Long Term Plan in reducing national variation and improving the outcomes of children and young people diagnosed with epilepsy. We took the opportunity to explore a way to support teams and better understand the root cause of the issues and challenges that teams faced preventing progress.
The RCPCH in collaboration with the Epileps12, Organisation of Paediatric Epilepsy Networks in the UK (OPEN UK) and stakeholder advisory epilepsy specialist nurses to research and scope a bespoke programme supporting epilepsy services, similar to the diabetes collaborative that was also managed by the College at the time.
We developed a model for a comprehensive Quality Improvement (QI) programme. This is tailored to support paediatric epilepsy teams to work together to define their shared aims and develop practical interventions matching their capacity and resources. The Epilepsy Quality Improvement Programme is an NHS England funded project, and managed by the Royal College of Paediatrics and Child Health, who also manages the national clinical audit Epilepsy12. The training is delivered by an external QI trainer, the RCPCH &US team and our links with epilepsy charity stakeholders help to facilitate the training.
RCPCH EQIP pilot
On 17 June 2019 we launched the first paediatric epilepsy QI collaborative pilot in England and Wales. The RCPCH EQIP has supported paediatric epilepsy service teams to identify sustainable improvements within their services for children and young people with epilepsy. Our pilot provided 12 paediatric epilepsy teams with practical training and support and helped them uncover the gaps in service provision and develop interventions that meet their specific needs. Since then, we have successfully continued to train up to 40 paediatric epilepsy services, including two integrated care system (ICS) NHS Trusts and trained 184 NHS members of staff within paediatric epilepsy services. Wave four of the EQIP is now underway.
Programme aims and objectives
The RCPCH Epilepsy Quality Improvement Programme (EQIP) is the first ever such initiative in paediatric epilepsy care, ensuring that it best suits the needs of teams providing epilepsy care. Our training package was created to build from the frontline up, enabling microsystem teams with the capability to lead and develop their own improvement work with core skills in:
- Change programme design
- Person centred care
- Measurement for improvement
- Team coaching
- Values based practice
How do we achieve this
Our aim is to support paediatric epilepsy services to identify and address gaps in care provision, including forging or strengthening links with other parts of healthcare service, schools and support organisations.
We do this by:
- assessing the training and support needs of paediatric epilepsy services in order to optimise care overran eight-month period,
- provide free needs-based training to epilepsy teams to equip them with skills and capabilities to improve care,
- participant teams are given the tools to successfully develop their service, so it delivers highly reliable person-centred care and sustained improvement in clinical outcomes for children, young people and their families.
- provide ongoing advice and support to teams implementing service improvements, ensure collection of intervention measures to assess impact,
- enable information and good practice sharing via programme events, RCPCH conferences, NHS England and national epilepsy oversight group, project stakeholders and the OPEN UK network.
Training facilitators provide support for each of the teams in designing, implementing and monitoring their project interventions alongside monthly coaching sessions Ultimately, each member of the teams will feel a sense of empowerment and gain leadership skills in spreading improvement in their networks, following the programme’s completion.
Over an eight-month period, teams will attend a one-day training day in person, subsequent monthly live webinars backed by recorded videos/templates and resources to refer to throughout the programme, underpinned by monthly 1:1 team coaching and support.
Formative/Summative assessments are a great way to assess team learning and progress via monthly reporting, review of local and national data, team 1:1 support and evaluation of lessons learnt after each training session and reflection meetings that helps to evaluate and think of next steps beyond the programme to embed sustainability.
Teams showcase their learning and outcomes via final project presentations and posters that is shared at the end of the programme event, attended by the wider epilepsy community.
Working with stakeholders such as national epilepsy charities, Epilepsy12 audit team, Open UK networks and the National Epilepsy Programme board the QI Facilitators and advisors are to develop relationships encourage change and offer support to unit’s multi-disciplinary clinical teams.
Specifically, the QI activity of the Audit and Facilitators should provide;
- Achieve new skills and knowledge on QI methodology and how to make incremental changes,
- Using local and national data to identify gaps in service provision,
- Gain a greater understanding of how to become a high-performing, cohesive team,
- Develop lasting sustainable practices that will help to maintain improvements within your paediatric epilepsy service,
- Learn new approaches and how to engage effectively with patients and families,
- Network and share learning with other teams in England and Wales in a safe learning space,
- Showcase your achievements via the EQIP end of programme shared learning event, RCPCH events and other channels,
- The programme is CPD approved and you will earn certificates of completion based on summative assessments and your participation on the programme.
National reports and events
RCPCH EQIP has published updates on the team projects and outcomes and achievements within the Epilepsy12 2022 combined summary report, chapter 5, page 45, published on 15 July 2022. Epilepsy12 2020 combined summary report, chapter 5, page 46, published on 10 September 2020. Four EQIP teams presented their completed projects at the 2020 Epilepsy12 & Organisation of Paediatric Epilepsy Networks (OPEN UK) national conference as a live webinar. which took place on 10 September 2020.