What constitutes Fit for Purpose Dietetic Services? June Davis Director Allied Health Solutions 12th June 2017

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1 What constitutes Fit for Purpose Dietetic Services? June Davis Director Allied Health Solutions 12th June

2 No one knows your service better than you 2

3 Looking at Your Service What does it do? Why does it do it? What does it cost? What do patients get out of it? 3

4 What s on your label? 4

5 Knowing your population For your local area can you state the: Size of the population the service covers Key health and care issues and comparison with national trends Gender, age and ethnic mix Changes in the population and profile Joint strategic needs assessment (JSNA) and joint health and wellbeing strategy (JWBS) 5

6 What information do you hold and who do you share Service descriptions Breadth Good examples / signature products Quantitative data Patient focused Qualitative Data Patient focused Indicators it with? 6

7 Information at your fingertips?! Service descriptions & Service objectives Service level agreements Examples of best practice/signature products Audits, projects, patient experience, patient stories 7

8 Knowing your service What is the referral rate to your service? Do you know how many new and review patients you see? Can you provide an analysis of patients seen by clinical condition, geographical location etc? What are your referral sources and are there trends? Do you know the cost of a contact, package of care, training and development package? Do you know how staff in the service divide their time between different activities? Do you know your capacity and demand? Do you have a waiting list? What do service users say about your services? Can you measure the economic impact of your service? 8

9 Suggested Service Metrics Patients Numbers, types, packages, caseloads, outcomes Costs Community clinics, home visits, inpatient stay, staffing, non-pay costs 9

10 Service Metrics Quality Standards, safety, incidents, patient experiences Productivity Waiting lists, demand & capacity 10

11 Counting activity versus Measuring impact How many patients have you seen? How many complaints were received by your service? What was the DNA rate? What was the first to follow up ratio? What proportion of the at-risk population have you seen? How many patients reported improvements in their health? How patients were admitted unexpectedly? How many patients achieved the treatment goals jointly set? 11

12 What s on your Dashboard? Staffing Patient Activity Costs Quality Outcomes 12

13 Quality Are you a Lidl or a M&S? 13

14 Assessing Quality Safety /Effectiveness /Patient Experience Minimum v Gold Standard What are your service quality standards? What evidence will you provide to show you have them? 14

15 The importance of the patients voice How do you get feedback? How do you act on any feedback? How do you involve patients in your services? How do you monitor patient views? 15

16 Shared decision-making Shared decision-making is fundamental throughout the entire healthcare pathway irrespective of setting. 16

17 15 Steps Challenge Quality from a patient s perspective First impressions and improving confidence in care from the patients perspective from the first visit. 17

18 Workload and Workforce Reviewing workload Demand and capacity Waiting lists Embrace redesign Skill mix Look at skills & competencies for tasks Use KSFs Look at benchmarks Guidance on staffing requirements in certain specialities 18

19 Is your workforce fit for purpose? Generalist versus specialist Specialist generalist Healthcare support workers Advanced practitioners 7 day services 19

20 Key messages Non medical workforce Work patterns are changing Demand for highly skilled individuals is growing while automation threatens the jobs of the less skilled. Information technology is blurring the boundaries between work and home, facilitating part-time and remote working. Changes to pension provision mean that people can expect to work for longer. The shape and structure of the health and social care workforce requires careful planning to meet growing demand effectively An ageing population with a growing burden of chronic disease has implications for the numbers of staff and the skill-mix required to support people who need care both in hospital and at home. Redesign of existing roles and the development of new positions spanning health and social care could facilitate greater integration Moves to increase integration and personalisation of care may require professionals to adopt new roles and responsibilities that have a mix of health and social care competencies. Sources of informal care are shrinking while future demand from older people expands The care gap could place additional pressure on formal health and social care services. 20

21 Access to the internet By 2032 everyone everywhere will be able to access the internet No digital divide between young and old and rich and poor 21

22 Technology and Care are complementary Present and emerging technologies offer opportunities for us to transform the way we engage in, and control, our own healthcare. This is the future of healthcare. Twenty years from now, we will use technology to access our health services as a matter of course. That future is fast approaching as technologies constantly evolve, adapt and improve. Sir Bruce Keogh

23 Technology Interactive computerized therapies such as cognitive behaviour therapy. Remote personal trainers, such as smart phones and watches. Nutritional content scanning; i.e. scanning supermarket food items into a mobile phone to receive nutritional information. Improved management information, such as through the introduction of key performance indicator dashboards, to guide decision making. Increased use of video conferencing. Improved engagement with stakeholders through the web and social media. Using social media to recruit the right people with the right skills into the sector. The provision of e-learning modules. Supplying frontline staff with secure mobile equipment to enable smarter working. This means staff have instant access to support plans and can update records when working remotely; Ref: Dietetics: The current context in which we are working and the expected future Interim report Nov

24 Are Dietitians ready? Imagine the degree of personal control that could be afforded by a smart phone configured for medical applications, coupled with wearable biosensors and capable of sensing, analysing and displaying vital signs and alerting you and your clinicians to significant changes or deterioration wherever you are, rather than through check-ups at a hospital or GP practice. Any escalation in a condition could be identified and addressed in a timely and proactive way. It would lead to better health outcomes while being more convenient for the patient, their carer and their clinician. 24

25 Telehealth and dementia Patients with dementia have special needs when it comes to healthcare. They are often not able to tell the care staff that they are ill or able to explain why or how they feel unwell. Telehealth is a great way of picking up health and well being issues at an early stage. 25

26 Are you business ready? What s in your data bank? How have you packaged it? Who have you shared it with? 26

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