PULMONARY REHABILITATION
|
|
- Neal Sharp
- 6 years ago
- Views:
Transcription
1 SOUTH CENTRAL PULMONARY REHABILITATION SURVEY 2011 PULMONARY REHABILITATION Report on the Questionnaire Survey FINAL REPORT Karen Ashton June 2011
2 EXECUTIVE SUMMARY The primary purpose of the pulmonary rehabilitation survey was to increase awareness and understanding of the pattern of services across the region. This report summarises the outcome of an on-line questionnaire via Survey Monkey distributed amongst current providers and promoted amongst over 200 clinicians and commissioners. The survey intended to elicit benchmarking details of the services to inform the regional approach to support decision making amongst current and emergent commissioners about the capacity and capability of services. The response completion rate was as follows: Target group Registered Responses % All Pulmonary N = 15 n = Rehabilitation Services The report has provided a largely descriptive account of the responses from a questionnaire survey. Responses to the on-line questionnaire revealed that even though good practice guidance for pulmonary rehabilitation has been published and recognised, there is considerable variation across the services that participated in most areas considered by the questionnaire (See Appendix 2), including: referral sources, eligibility, timing of access in the disease pathway, waiting times from referral to commencement, capacity, duration and setting for courses, the range and scope of staff involved in delivering the intervention Overall, the outcome has reinforced the recognition of the opportunity for improvement. To ensure people have access to clinically effective, safe and sustainable services it would be beneficial for service specifications to demonstrate consistent standards of intervention and risk management. It is therefore important that the providers grasp this opportunity to develop and improve to achieve the quality and consistency of clinical and self- management support that would improve outcomes. Discussion and debate with commissioners and clinical service providers to formulate next steps will be essential to gain their commitment and support. The Respiratory Programme Board should consider how the work plan covers standards of practice to meet clinical requirements as well as the systems and processes that must be consistently adopted to maintain standards. Having established a consensus, assessment of clinical outcomes, communication, workforce capability and capacity, as well as expectations of leadership behaviour should be incorporated into an on-going improvement programme. The development should be monitored and evaluated over time from both a commissioning and clinical quality perspective. This will ensure that the service meets the current and future needs of patients, whilst ensuring that it meets quality, productivity and prevention requirements of the local NHS and wider COPD outcomes strategy 2
3 CONTENTS Section Contents Page Acknowledgements 3 1. Introduction 4 2. Methodology 5 3. Sample 5 4. Ethical Considerations 5 5. Instruments 5 6. Reliability and Validity 5 7. Pilot Study 6 8. Data Collection 6 9. Data Analysis Findings Discussion Conclusion and Recommendations References 12 APPENDICES SURVEY INVITE AND INSTRUMENT USED IN ON- LINE SURVEY QUESTIONNIARE SUMMARY OF FINDINGS ACKNOWLEDGEMENTS The survey has been an exercise in communication that would not have been possible without the assistance, co-operation and support of a great many people. Thanks in particular must go to Jenny Plummer, Respiratory Specialist Physiotherapist, Heatherwood and Wexham Park Hospital Foundation Trust for her leadership and co-ordination of this survey and to Dr Maxine Hardinge, South Central SHA COPD Clinical Lead, Jo Riley, Respiratory and Home Oxygen Service Lead, Community Health Oxfordshire and Sarah Kearney, BLF Specialist Nurse / Nursing Lead for the COPD Strategy, South Central SHA for their expert advice and support. Without the individual co-operation of the front line service staff whose direct contributions were the basis of the benchmarking, it could not have been completed. We are grateful for their time and contributions. 3
4 1. INTRODUCTION 1.1 Through a series of policy statements and initiatives, the Department of Health has clearly articulated a commitment to promote accessible, sustainable, integrated services targeted on assessed needs and delivered in a personalised manner in the appropriate care setting. The Department of Health (DH) Consultation for a Strategy for Chronic Obstructive Pulmonary Disease (COPD) (DH 2010) recognised COPD as a progressive illness and that the number of people dying as a result of COPD increased with age. Pulmonary rehabilitation programmes provide a multi-disciplinary and self-management approach to COPD treatment which is supported by a strong evidence base (Cochrane reviews, GOLD guidelines and NICE). Pulmonary rehabilitation tackles the interaction between breathlessness, reduced exercise capacity, limitation of daily activities, psychological effects and disease progression resulting in respiratory disability. It has been recognised as being effective when delivered in hospital, community and nonhealthcare locations. It s core components are individually tailored exercise programmes conducted in groups, with a range of disease education delivered over a minimum of 6 weeks Furthermore the report asserted that people with mild COPD were generally not sufficiently disabled by their condition to warrant participation in formal pulmonary rehabilitation programmes (MRC dyspnoea scale grades 1or 2) but should be advised to take routine exercise. It was also noted that formal pulmonary rehabilitation programmes were not universally available across England and were not commissioned by all Primary Care Trusts. (DH 2010) 1.2 To deliver the improvement in outcomes for respiratory services key themes are being addressed within the wider respiratory programme aimed at working with commissioners locally to: Change the way services are delivered to improve outcomes Driving down costs Ensure services are safe, sustainable and provide a positive experience to increase independence 1.3 Across the region, teams providing Pulmonary Rehabilitation make a valuable contribution to this self-management agenda through the delivery of multidisciplinary programmes of care for patients with chronic respiratory impairment that is individually tailored and designed to optimise each patient s physical and social performance and autonomy. Pulmonary rehabilitation is highlighted as an effective treatment by NICE 2010, who in addition have recommended its use in post hospital discharge COPD patients. As part of the work programme the South Central Respiratory Programme commissioned a benchmark survey of pulmonary rehabilitation services. The aim of the benchmarking was to establish a baseline for current services, to inform the regional approach to support decision making amongst current and emergent commissioners about the capacity and capability of services with the aim of supporting local improvements in the quality and consistency of services. 1.5 This report summarises the outcome of the on-line questionnaire survey distributed directly to current known services leads and more than 200 respiratory clinicians and commissioners across the region in April May Sections two to nine briefly described the elements of the methodology, and sections ten and eleven describe and discuss the findings relating to the sites that participated. Section twelve draws conclusions and makes recommendations. The appendices provide a copy of the questionnaire and the detailed findings. 4
5 2 METHODOLOGY 2.1 To benchmark details of the scope and range of current services it was decided that an on-line survey approach was appropriate. It was recognised that this approach would not establish causal relationships. 3. SAMPLE 3.1 The link to the on-line survey was sent to all eight known service leads across the region personally, giving a six week timescale. Details were also sent to the representatives on the South Central Respiratory Programme Board, posted on the South Central Respiratory Programme NHS Networks site, and disseminated through respiratory specialist nursing networks. In total the survey was promoted amongst a wider group of more than 200 commissioners and clinicians. 3.2 Although a total of 15 respondents registered on the on-line survey, responses were completed by 11 self-selecting participants. 4. ETHICAL CONSIDERATION 4.1 Ethical considerations protecting individual identity were addressed in several ways. Since the survey did not involve residents or students, considered vulnerable groups, there was no need to seek ethical approval. However personalised communications were used to confirm the purpose of the survey and the contribution this would make to the south central respiratory agenda. In addition key clinical, commissioning and managerial leaders were notified to encourage their support. Voluntary participation was noted although people were encouraged to have their say and contribute. 5. INSTRUMENT 5.1 There were no known ready-made tools or instruments available. The survey tool design was developed by a clinical specialist using the known evidence base, in consultation with the COPD Clinical Lead, British Lung Foundation input and contributions from two respiratory specialist nurses. The tool was designed to elicit information in a standardised way. The prototype of the tool was piloted amongst a small group of critical friends and adapted accordingly prior to wider dissemination with a six week completion timescale. The survey was advertised to the sample population and stakeholders electronically. The tool has been made available at Appendix RELIABILITY AND VALIDITY 6.1 The survey included quantitative and qualitative elements which explored opinions, where truth is necessarily subject-orientated and difficult to justify in terms of reliability and validity. By its nature the relatively small survey completed by a self-selecting group had low validity. Nevertheless the questionnaire tool had face validity in that the questions made sense and elicited the desired opinions and information. 6.2 It is possible that reactivity during data collection could have affected responses particularly in relation to pre-conceived opinions about adequacy of current services. It was also impossible to gauge any effect of potential suspicion about how responses might be used or indeed whether this circumstance influenced whether people participated. 5
6 7. PILOT STUDY 7.1 For reasons primarily associated with differences in interpretation of language and the potential for misinterpretation, a small group of people was asked to pilot the tool. Recommended adjustments were made before the tool was distributed. 8. DATA COLLECTION 8.1 Once the survey tool design was confirmed the Respiratory Specialist Physiotherapist took responsibility for uploading questions. Access details for the on-line questionnaire tool were distributed to the target population via giving a timescale for return. The Respiratory Specialist Physiotherapist and two Respiratory Specialist Nurses involved in piloting the tool notified their clinical networks prior to the start of the survey. The South Central Respiratory Programme Board and associated NHS Network site: was used to alert over 200 people associated with the respiratory programme of the survey and provide links. The Respiratory Specialist Physiotherapist took responsibility for targeting service providers. The on-line data collection tool provided an easy-to-use repository for respondents to input data. 9 DATA ANALYSIS 9.1 Using the on-line survey functionality the completed questionnaires were analysed in two ways. The questionnaire responses in each section were summarised in tables. Responses were also presented as a visual graphic form so that the distribution of the response was visual, complimenting numerical data. 10 FINDINGS The major findings related to responses to closed questions. These provided data which illustrated the similarities as well as variations amongst responses. The limited extent of this survey gives some insight. A brief profile of all respondents has been presented initially, to provide a background against which findings may be viewed PROFILE OF RESPONDENTS A total of 15 sites commenced the survey, 11 completed all questions [N=15 Response rate 73.3%]. The respondents were self-selecting. It is possible that the incomplete information (no response) in this section may have been due to technological difficulties at the time of inputting information. Appendix 2, Figure 1 confirmed the following sites identified themselves when registering: A. Berkshire Cluster: Heatherwood and Wexham Park NHS Foundation Trust Pulmonary Rehab Wokingham (Administrator) Wokingham Pulmonary Rehab (Primary Care) Royal Berkshire NHS Foundation Trust Berkshire West Primary Care Trust B. Oxfordshire and Buckinghamshire Cluster: NHS Buckinghamshire Buckinghamshire Healthcare Oxford Health NHS Foundation Trust C. Southampton, Hampshire, Isle of Wight and Portsmouth: Solent NHS Trust (Southampton) Southampton University Hospital NHS Trust 6
7 Solent Healthcare (Portsmouth) Isle of Wight NHS D. Milton Keynes Milton Keynes Primary Care Trust Milton Keynes Hospital NHS Foundation Trust The survey data was submitted by a range of different professionals associated with pulmonary rehabilitation services: Figure 1: Title of person completing survey: 10.2 QUESTIONNAIRE RESPONSES The detailed responses to individual questions expressed as raw numbers is provided at Appendix 2. It should be noted that in view of the small sample these figures have not been adjusted or standardised. Since this was an exploratory survey and response rates were not 100%, judgemental comparison about responses has been avoided Responses to on-line survey Section 3 Your Programme Locality coverage: responses to question 3.1 indicated more than 35% course numbers related to Berkshire cluster, 35% to Southampton, Isle of Wight and Portsmouth areas of SHIP cluster, 14.28% to Oxfordshire and Buckinghamshire and the remaining 15% to Milton Keynes. A greater proportion of responses relate to the Thames Valley area. Setting of PR: more a third of PR programmes (38.89%) were in non-nhs settings, a third (33.33%) in hospital settings and the remaining 27.8% in community NHS settings. (Appendix 2, Figure 2) Frequency of PR courses: The majority of respondents ran stand alone programmes with only 21% running rolling programmes. The frequency of programmes per annum varied greatly with a 3-4 per annum or other being the most frequent responses. (Appendix 2, Figure 3). Programme format: more than two thirds of programmes delivered two sessions per week (Appendix 2, Figure 4) 53.8% of courses ran for six weeks, with a maximum of 8 weeks (Appendix 2, Figure 5). Group size was 9-12 people in more than half of programmes (minimum group size 1-4 people, maximum 17 people) (Appendix 2, Figure 6). 7
8 Programme Staffing : more than a third of courses ran with a 1:6 staff : patient ratio, the lowest staff : patient ratio was 1:8 staff : patient in one course. Appendix 2, Figure 7) a wide variation of MDT members assisted in courses, with primarily physiotherapists involved in exercise and education sessions. Nurses and therapy assistants assisted to a lesser extent. Expert patients contributed to education in two courses. Comments in this questions indicated one respondent identified the local approach to dealing with staffing constraints when the health assistant covering the respiratory clinic is on annual leave or off sick then I have only a voluntary worker to sit with me in case of an emergency. (Appendix 2, Figure 8) Responses to on-line survey Section 4 Referrals and Completion Referral source: COPD/ Respiratory / Community MDT were most frequent referral sources, with GPs, Hospital Drs and practice nurses being equal next most usual referrers. Patients were noted as self-referring in 2 responses. (Appendix 2, Figure 8) Referral criteria: All courses recruited people with breathlessness level MRC levels 3 and 4, and ( courses included people with MRC level 2 breathlessness (Appendix 2, Figure 9). COPD was the predominant medical condition, followed by Bronchiectasis, with 8 (72%) or PR courses including people with Pulmonary Fibrosis. mentioned in responses.. (Appendix 2, Figure 10) Waiting times Average waiting time from referral to starting PR in 10 responses was weeks. Appendix 2, Figure 11 All 10 responses indicated significant variation in referral activity to PR during 2010 a range from 45 to 461 people (Appendix 2, Figure 12).. One response noted the service had been available for only three months of the benchmark period. Completion of PR 10 responses in indicated a similarly wide variation in numbers commencing pulmonary rehabilitation courses, the lowest being 25 and the highest being 269. The service with the greatest number of referrals (461) had 185 people commencing. (Appendix 2, Figure 13) There was variation in the definition of course completion, a combination of attendance from % of sessions, and final outcome measures in 5 responses. Appendix 2, Figure 14 In the 11 responses indicating numbers of people completing (Appendix 2, Figure 15) there was a variation from 17 (lowest number) to 252 (highest number). One response indicated 80% completion rate Responses to on-line survey Section 5 Early Pulmonary Rehabilitation 54.5% respondents targeted patients who have had a recent hospital admission (Appendix 2, Figure 16) 1 respondent indicated their service did not have arrangements in place to target recent hospital admission, 1 response indicated the service was trying and the remainder deployed a formal referral route from a variety of sources (Appendix 2, Figure 17). For those people targeted following hospital discharge the 10 responses indicated the average waiting time before beginning a pulmonary rehabilitation course was 5.2 weeks (Appendix 2, Figure 18). This was less than half the general average waiting time. 8
9 Responses to on-line survey Section 6 Funding and Commissioning 63.6% of services had secure funding for pulmonary rehabilitation (Appendix 2, Figure 19). 45.5% of respondents stated they were involved in commissioning in their area ((Appendix 2, Figure 20). 11 DISCUSSION This on-line questionnaire survey intended to establish a baseline for current services, to inform the regional approach to support decision making amongst current and emergent commissioners about the capacity and capability of services with the aim of supporting local improvements in the quality and consistency of services. In attempting to achieve this there are a number of issues raised by the methodology used and the subject area ISSUES RELATED TO METHODOLOGY Traditional survey studies involve taking an appropriate sample that can be used to understand and / or predict directly or indirectly the behaviour of a group (Oppenheim 1966). Findings in this survey have limitations in relation to the sample used. One area, Hampshire, which commissions services for more the 25% of the regions population did not contribute: this may be a consequence of recent development work undertaken by NHS Hampshire which completed its own review of pulmonary rehabilitation services to inform recurring investment to improve access. The associated re-procurement to a revised specification may have also had an influence on current providers participation. For all other areas outside Hampshire the overall completion rate amongst respondents (73.3%) was reasonably high. Being too small a dataset to support full statistical analysis, results are presented in a descriptive fashion In spite of attempts to eliminate bias, the self-selected nature of the survey approach and variable circumstances of respondents who registered may have influenced their ability to respond. It is impossible to gauge the extent to which any personal assumptions or work pressures prevented could have affected full involvement and participation. For example in the 40% of responses that indicated their funding was insecure and the unknown impact of the re-procurement process in NHS Hampshire. Furthermore whilst the inclusion of Milton Keynes area which transferred to East Midlands Strategic Health Authority in April 2011 provided a valuable insight into local services it is likely that the local work programme for this former part of the region will be shaped by the East Midlands approach Another possible influence to responses was the extent to which respondents interpreted the questions differently may have shaped the strength of general impressions conveyed in response. The comments boxes potentially provided an opportunity for respondents to add comments without taking any responsibility for influence they themselves may have on their services e.g. Appendix 2, Figure 10. conditions pulmonary rehabilitation is provided for ; and Appendix 2, Figure 11. average waiting time between receiving referral and patient starting course (in weeks) The questionnaire tool had the potential to introduce bias of respondents because of the subjectivity as well as the unknown individual differences in access to data and information, experience, responsibility and influence of people who responded. This placed limitations on interpretation On a more positive note the descriptive data has provided very useful background data about the scope of current pulmonary rehabilitation programmes in South Central SHA that should be considered by the South Central Respiratory Programme Board in the proposed work programme. 9
10 11.2 ISSUES RELATING TO PULMONARY REHABILITATION The on-line questionnaire survey was viewed against the background of underpinning work in the wider South Central Respiratory Programme linked to the development of Department of Health outcomes strategy work stream for COPD. The survey intended to elicit details of existing services to inform the regional approach to support decision making amongst current and emergent commissioners about the capacity and capability of services that would make a positive impact on patient outcomes and experience. The questions elicited responses pertaining to: The programme Referral and completion Early pulmonary rehabilitation Funding and commissioning Responses to the on-line questionnaire revealed that even though good practice guidance for pulmonary rehabilitation has been published and recognised, there is considerable variation across the services that participated in most areas considered including: referral sources; eligibility; timing of access in the disease pathway; waiting times; capacity; duration and setting for courses; as well as the range and scope of staff involved in delivering the intervention (See Appendix 2). There is particularly variation in the availability of courses for the numbers of people affected by Chronic Obstructive Pulmonary Disease. Taking Oxfordshire system as an example, the recorded number of pulmonary rehabilitation places is 530 per year. Known reported COPD prevalence in 2008/09 (NHS Comparators QOF reported vs expected prevalence see Figure A and Table A below) indicated a population of 7232 or a ratio of 1:14 people to places available. Estimated expected prevalence in the Oxfordshire system is 12,687 giving a ratio of 1:24 people to places available. Organisation Ratio Reported Count Pop. Berks West Portsmouth City Southampton City Berks East Hampshire Isle of Wight Bucks Oxfordshire Total (Source NHS Comparators) Figure A 2008/09 Reported versus Expected Prevalence Table A Reported Count 2008/ Although there were no specific questions relating to the skills and competencies within the teams providing services included in the on-line survey, since respondents came from current services that included staff with specialist expertise, it is apparent that the need for specialist knowledge and skills is acknowledged in these sites Of particular concern were the low numbers of patients referred, and lower numbers of patients completing PR courses in each locality when the actual and estimated prevalence of COPD is considered. This raises important issues of potential capacity and / or equality of access issues These findings echoed the National Audit for COPD Report (2008) which identified that although the number of areas offering pulmonary rehabilitation had increased, 10
11 the overall quality of these services was questionable, highlighting that coverage was inequitable across England, programme content varied (potentially affecting effectiveness and benefits to the individual and the system), and access often be limited by low capacity and long waiting lists. NICE 2010 recommended that in relation to duration of the initial programme.that outpatient programmes should contain a minimum of 6 weeks and a maximum of 12 weeks of physical exercise, disease education, psychological and social interventions The British Thoracic Society recommended standards of good practice in their IMPRESS guidance (2008): Standard 1 A rehabilitation programme must contain individually prescribed, physical exercise training together with lifestyle and self-management advice. Standard 2 The programme should be delivered by a multi-disciplinary team and include two supervised sessions per week for at least four weeks. Further home training should be encouraged Standard 3 Individual progress should be assessed by the use of appropriate assessment and outcome measures (usually health status and functional exercise capacity) Standard 4 There should be evidence of programme quality control and improvement As with other aspects of longer term care (Wagner E H 1998), the findings indicate there is scope for improving the consistency of care and support in pulmonary rehabilitation. This would have a known benefit in responding to the quality, productivity and prevention challenge, improving clinical outcomes for patients whilst reducing cost longer term. However, improving services will rely on the efforts of commissioners and providers alike. To support them the Respiratory Programme Board need to consider the priorities for pulmonary rehabilitation so that local services will reflect clinical guidelines and other reliable sources of evidence for assessment and intervention. If commissioners decide to introduce and evaluate new models of care they should involve all sectors and agencies, including social care, so that high-quality care that is effective, efficient and offers value for money can be put in place to meet the needs of their local populations. Good clinical leadership will also be needed to ensure uptake across care sectors and agencies, and to reduce duplication in care provision. 12 CONCLUSIONS AND RECOMMENDATIONS 12.1 Through a series of policy statements and initiatives, the Department of Health has clearly articulated a commitment to promote accessible, sustainable, integrated services targeted on assessed needs and delivered in a personalised manner in the appropriate care setting This report has summarised the outcome of an on-line questionnaire survey was viewed against the background of underpinning work in the wider south central respiratory programme linked to the development of Department of Health outcomes strategy work stream for COPD. The survey intended to elicit details of existing services to inform the regional approach to support decision making amongst current and emergent commissioners about the capacity and capability of services that would make a positive impact on patient outcomes and experience. The survey was promoted amongst all existing services and more than 200 clinicians and commissioners. The report has provided a largely descriptive account from a response completion rate of 73.3% amongst a self-selecting group. The findings indicated considerable variation across the services that participated in most areas considered including: referral sources; eligibility; timing of access in the disease pathway; waiting times; capacity; duration and setting for courses; as well as the range and scope of staff involved in delivering the intervention (See Appendix 2). 11
12 12.3 Overall, the outcome has reinforced the need for change. To ensure people have access to clinically effective, safe and sustainable services it would be beneficial for service specifications to demonstrate consistent standards of intervention and risk management. It is therefore important that the providers grasp this opportunity to develop services to achieve the quality and consistency of clinical and self- management support that would improve outcomes Discussion and debate with commissioners and clinical service providers to formulate next steps will be essential to gain their commitment and support. The Respiratory Programme Board should consider developing a work plan, covering standards of practice to meet clinical requirements as well as the systems and processes required to demonstrate consistently adopted standards. Having established a consensus, assessment of clinical outcomes, communication, workforce capability and capacity, as well as expectations of leadership behaviour should be incorporated into an on-going improvement programme. The development should be monitored and evaluated over time from both a commissioning and clinical outcome perspective. This will ensure that the service meets the current and future needs of patients, whilst ensuring that it meets local NHS quality, productivity and prevention requirements and wider COPD outcomes strategy expectations. References: Department of Health 2010, Strategy for Services for Chronic Obstructive Pulmonary Disease (COPD) in England, Consultation Document. DH. London. et/dh_ pdf Department of Health 2010, Strategy for Services for Chronic Obstructive Pulmonary Disease (COPD) in England, Consultation Impact Assessment. DH. London. et/dh_ pdf IMPRESS 2008, Principles, Definitions and Standards for Pulmonary Rehabilitation Published by IMPRESS following consultation with BAOT, ARNS and ACPRC. London. National Institute for Health and Clinical Excellence, 2010 Chronic Obstructive Pulmonary Disease: Management of Chronic Obstructive Pulmonary Disease in Adults in Primary and Secondary Care (updated), NICE. London NHS Comparators 2008/09 QOF reported PCT prevalence Royal College of Physicians, 2008, National COPD Audit, RCP. London. The Joint British Thoracic Society/ Association of Chartered Physiotherapists in Respiratory Care Guidelines for the Physiotherapy Management of the Adult, Medical, Spontaneously Breathing Patient were published in the May 2009 issue of Thorax: Vol 64 ullguideline.pdf Wagner EH. Chronic disease management: What will it take to improve care for chronic illness? Effective Clinical Practice. 1998;1(1):2-4.] 12
13 APPENDIX 1: SURVEY INVITE AND QUESTIONNAIRE South Central Respiratory Programme South Central Strategic Health Authority First Floor, Rivergate House Newbury Business Park London Road, Newbury Berkshire, RG14 2PZ The South Central respiratory programme board, which is focussed on the National COPD Strategy, are keen to find out more about the current provision of pulmonary rehabilitation in South Central. This will inform our discussions with PCT and future GP commissioners. We would be very grateful if you could complete this initial questionnaire which focuses on provision, funding and staffing. A more detailed questionnaire on programme format and patient outcomes will follow. Jenny Plummer, Respiratory physiotherapist Maxine Hardinge, COPD Lead South Central For each pulmonary rehabilitation programme you run please complete: Location: which town (s)? Setting: is this/ are these Hospital Community NHS setting Community non - NHS setting How many pulmonary rehabilitation programmes do you run on this site (s), throughout the year? Rolling Programme How many patients are referred to your pulmonary rehabilitation programme annually? What is your average waiting time between referral to and starting your pulmonary rehabilitation programme? How many patients complete your pulmonary rehabilitation programme annually? 13
14 Do you have NHS secure funding for your pulmonary rehabilitation programme(s)? YES NO Are you aware of any commissioning plans in your PCT to increase pulmonary rehabilitation provision? Please provide details: Where do your referrals come from? GP Hospital Drs Practice Nurses COPD/respiratory nursing teams Other % Which respiratory conditions do you provide pulmonary rehabilitation for? COPD Bronchiectasis Hyperventilation syndrome Pulmonary Fibrosis Cystic Fibrosis Other What MRC level do you accept? (tick all that apply) Do you target patients who have had a recent hospital admission? Yes What is the average time from discharge to beginning pulmonary rehabilitation?.weeks 14
15 APPENDIX 3 SUMMARY OF FINDINGS 1. Summary of Findings The following information is the summary of responses. It should be noted that two respondents registered with the survey but did not complete any data. These responses have not been included in the summary below. 1.1 Response Rate: Target group Total Registered Total Completed % Pulmonary Rehab n = 15 n = % 1.2 Responses to individual questions: Your Programme Figure 1: Responses to question section 3.1: Which locality / towns does your programme cover? Table 1: Number of courses by towns / locality Locality /Town % Milton Keynes % Berks E % Berks W / Newbury / Reading / Wokingham/ % Oxfordshire % Buckinghamshire % Southampton % Portsmouth % IOW % Total 14 Response 1 Figure 2 Responses to question 3.2 What setting is your programme Table 2. Setting Count & % run in? (all courses) Course Setting Count % Hospital % Community NHS % Community non-nhs % Total 18 response 2 15
16 Figure 3 Responses to question 3.3 How many courses do you run in that Site through the year? (all courses) Table 3: Count Count. % % % % % Rolling % * Other (please specify) % response 1 *Other 3 x rolling programmes 18 in total Commissioned to see 530 patients per year across Oxfordshire Block programme Several sites Figure 4 Responses to question 3.4 How many sessions a week do people attend? (all courses) Table 4. of sessions Count % % % % Total % response 2 Figure 5 Responses to question 3.5 Duration of programme Table 5: Duration of programme: Duration % < 6 weeks 0 0.0% 6 weeks % 7 weeks % 8 weeks % > 8 weeks 0 0.0% Total % response 2 16
17 Figure 6 Responses to question 3.6 Numbers of people attending Table 6: Numbers attending Count % % % % % % response 2 Figure 7 Responses to question 3.7 Staff: Patient Ratio Table 7: Staff: Patient ratio Ratio Count % 1:2 pts 0 0.0% 1:3 pts 0 0.0% 1:4 pts % 1:5 pts % 1:6 pts % 1:7 pts 0 0.0% 1:8 pts 1 7.7% Comments 2* response 2 *Comments on staff : patient ratio If the health assistant covering the respiratory clinic is on annual leave or off sick then I have only a voluntary worker to sit with me in case of an emergency We aim for 10 patients with band 5 and Band 4 rehab assistant with 6 week programme but we also run a back to back 1 x week programme x 10 weeks with Band 7 Part Time and Band 6 nurse Response to Question 3.8 Table 8a: Members of the MDT that assist MDT members Response Count Physiotherapists Nurses Occupational Therapists Therapy Assistants/Technicians Talking Therapists Doctors Fitness Instructors Expert Patients Other
18 Response to Question 3.8 Table 8b: Members of the MDT that assist with activities: Assist with: Education Only Exercise Only Both Exercise and Education Response Count Physiotherapists Nurses Occupational Therapists Therapy Assistants/Technicians Talking Therapists Doctors Fitness Instructors Expert Patients Other Responses to Individual Questions: Referrals and Completion Response to Question 4.1 Figure 8: Who refers to your service (all referrers to 11 programmes) Table 9: Who refers Who Count % GPs % Hospital Drs % Practice Nurses % COPD/ Respiratory/ community % MDT teams Community Matrons % Patients selfrefer % Other 0 0.0% Response 3 Response to Question 4.2 Figure 9: What MRC levels do You accept (all that apply) Table 10: MRC levels MRC Count % % % % % % response 3 18
19 Response to Question 4.3 Figure 10: What Respiratory Conditions do you provide pulmonary rehabilitation for? Table 11: What conditions Condition Count % COPD % Bronchiectasis % Hyperventilation Syndrome % Pulmonary Fibrosis % Cystic Fibrosis 1 8.3% Other % Response 3 Comments Please comment on proportions i.e. 50% COPD 50% Bronchiectasis 2% fibrosis 80% COPD 17% bronchiectasis 1% other COPD 75 Bronchiectasis 10 Asthma 5 Pulmonary Fibrosis 8 Hyperventilation 1 CF 1 70% COPD 10% Bronchiectasis 20% Asthma If COPD patients also have bronchiectasis then we accept - but not pure Bronchiectasis as not commissioned for this COPD only - all other respiratory conditions are classed as inappropriate based on the criteria for our programmes set by commissioning Kypho-scoliosis, NMD. Contact is 1:12 for non-copd:copd. Currently running at about 2:12 mainly Bx and ILD Service commissioned for COPD but included bronchiectasis 90% COPD 10% others 80% COPD 20% asthma/bronchiectasis/fibrosis 80% Mainly COPD Majority are COPD approx 85% the remaining 15% are bronchiectasis/fibrosis 90% COPD but we do not turn anyone down based on disease Response to Question 4.4 Figure 11: What is the average waiting time between receiving referral and patient starting course? (in weeks) Table 12: Average wait Average wait (weeks weeks) Count 11 response 4 19
20 Response to Question 4.5 Figure 12: How many patients were referred to this programme between January 2010 and January 2011? (Please include all those that you receive even if they did not commence programme). Response to Question 4.6 Figure 13: Of those referred between 1 January 2010 and 1 January 2011 how many patients commenced rehab? Response to Question 4.7 Figure 14: What is your Criteria for completion Table 13: Referrals. Response Count (Since Sept 10) 53 response 5 Table 14: Number Commencing Response Number Commenced Table 15: Criteria for Completion 5 Criteria Count % Attends 50% 1 9.1% Attends 60% % Attends 70% 1 9.1% Attends 80% % Attends 90% % Attends All % Completes final outcome % measures Other 1 9.1% response 4 20
21 Response to Question 4.8 Figure 15: Of those patients referred who commenced between 1 January 2010 and 1 January 2011, how many completed a course Table 16: Number completing Number Response Completing % response Responses to Individual Questions: Early Pulmonary Rehabilitation Response to Question 5.1 Figure 16:Do you target patients who have had a recent hospital admission? Table 17: Target recent admission Count % Yes % % response 4 Response to Question 5.2 Figure 17: How do you target this group Table 18: Route Route Count % COPD Early discharge 2 20% Direct referral respiratory ward staff 2 10% GP 1 10% Direct Referral form 2 20% Referral on discharge 1 10% Trying 1 10% t applicable 1 10% response 5 21
22 Response to Question 5.3 Figure 18: Average waiting time from hospital discharge to beginning Pulmonary Rehabilitation? Table 19: Average Wait Average wait (weeks) 5.2 Count 10 response Responses to Individual Questions: Funding and Commissioning Response to Question 6.1 Figure 19: Do you have NHS secure Funding for your Pulmonary Rehabilitation programme? Table 20: Secure funding? Count % Yes % % response 4 Response to Question 6.2 Figure 20: Are you involved with Commissioning in your area? Table 21: Involvement in Commissioning? Count % Yes % % About to be % response 4 22
Powys Teaching Health Board. Respiratory Delivery Plan
Powys Teaching Health Board Respiratory Delivery Plan 2016-17 CONTENTS 1. BACKGROUD AND CONTEXT 1.1 The Vision 1.2 The Drivers 1.3 What do we want to achieve? 2. ORGANISATIONAL PROFILE 2.1 Overview 3.
More informationIntegrated respiratory action network for patients with COPD
Integrated respiratory action network for patients with COPD In this Future Hospital Programme case study Dr Helen Ward describes how a team from The Royal Wolverhampton NHS Trust established a respiratory
More informationMy Discharge a proactive case management for discharging patients with dementia
Shine 2013 final report Project title My Discharge a proactive case management for discharging patients with dementia Organisation name Royal Free London NHS foundation rust Project completion: March 2014
More informationEvaluation Tool* Clinical Standards ~ March 2010 Chronic Obstructive Pulmonary Disease** Services
Evaluation Tool* Clinical Standards ~ March 2010 Chronic Obstructive Pulmonary Disease** Services *Formerly known as Self-Assessment Framework ** Chronic Obstructive Pulmonary Disease (COPD) Standard 1:
More informationImproving Access to Psychological Therapies. Guidance for Commissioning IAPT Training 2012/13. Revised July 2012
Improving Access to Psychological Therapies Guidance for Commissioning IAPT Training 2012/13 Revised July 2012 IAPT Programme Department of Health Wellington House 133-155 Waterloo Road London SE1 8UG
More informationSolent. NHS Trust. Allied Health Professionals (AHPs) Strategic Framework
Solent NHS Trust Allied Health Professionals (AHPs) Strategic Framework 2016-2019 Introduction from Chief Nurse, Mandy Rayani As the executive responsible for providing professional leadership for the
More informationThe PCT Guide to Applying the 10 High Impact Changes
The PCT Guide to Applying the 10 High Impact Changes This Guide has been produced by the NHS Modernisation Agency. For further information on the Agency or the 10 High Impact Changes please visit www.modern.nhs.uk
More informationLondon Councils: Diabetes Integrated Care Research
London Councils: Diabetes Integrated Care Research SUMMARY REPORT Date: 13 th September 2011 In partnership with Contents 1 Introduction... 4 2 Opportunities within the context of health & social care
More informationPsychological Therapies for Depression and Anxiety Disorders in People with Longterm Physical Health Conditions or with Medically Unexplained Symptoms
Psychological Therapies for Depression and Anxiety Disorders in People with Longterm Physical Health Conditions or with Medically Unexplained Symptoms Guide for setting up IAPT-LTC services 1. Aims The
More informationCosting report. Pulmonary Rehabilitation April Improvement
Costing report Pulmonary Rehabilitation April 2011 Improvement Healthcare Improvement Scotland is committed to equality and diversity. This document, and the research on which it is based, have been assessed
More informationExecutive Summary 10 th September Dr. Richard Wagland. Dr. Mike Bracher. Dr. Ana Ibanez Esqueda. Professor Penny Schofield
Experiences of Care of Patients with Cancer of Unknown Primary (CUP): Analysis of the 2010, 2011-12 & 2013 Cancer Patient Experience Survey (CPES) England. Executive Summary 10 th September 2015 Dr. Richard
More informationPROJECT REPORT DELIVERING AN INTEGRATED GP AND MEDICINES MANAGEMENT SERVICE FOR THE RESIDENTS OF CARE HOMES
PROJECT REPORT DELIVERING AN INTEGRATED GP AND MEDICINES MANAGEMENT SERVICE FOR THE RESIDENTS OF CARE HOMES 1 Contents Contents... 2 1 Executive Summary... 3 2 Introduction... 4 2.1 Background... 4 2.1.1
More informationCOPD Management in the community
COPD Management in the community Anne Jones Independent Respiratory Nurse Consultant RN,BSc(Hons),PGDip(RespMed)/MA Content of session Will consider the impact of COPD COPD Strategy recommendations and
More informationNorth West COPD Report Nov 2011
North West COPD Report Nov 2011 Working together to improve respiratory care in the North West 1 Contents Introduction foreword by NW Respiratory Leads... 3 4 reasons why COPD is important in the North
More informationLincolnshire JSNA: Chronic Obstructive Pulmonary Disease (COPD)
Disease (COPD) What do we know? Summary is a long-term condition, which is affecting increasing numbers of people. There is a wide range of interventions to address COPD, from prevention to the ongoing
More informationInpatient and Community Mental Health Patient Surveys Report written by:
2.2 Report to: Board of Directors Date of Meeting: 30 September 2014 Section: Patient Experience and Quality Report title: Inpatient and Community Mental Health Patient Surveys Report written by: Jane
More informationTOPIC 9 - THE SPECIALIST PALLIATIVE CARE TEAM (MDT)
TOPIC 9 - THE SPECIALIST PALLIATIVE CARE TEAM (MDT) Introduction The National Institute for Clinical Excellence has developed Guidance on Supportive and Palliative Care for patients with cancer. The standards
More informationNHS ISLE OF WIGHT CLINICAL COMMISSIONING GROUP CLINICAL FUNDING AUTHORISATION POLICY
NHS ISLE OF WIGHT CLINICAL COMMISSIONING GROUP CLINICAL FUNDING AUTHORISATION POLICY AUTHOR/ APPROVAL DETAILS & VERSION CONTROL Author Version Reason for Change Date Status IW CCG Acute V1 New policy Sept
More informationSCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATED JOINT BOARD UPDATE ON THE DRAFT COMMISSIONING & IMPLEMENTATION PLAN
Appendix-2016-59 Borders NHS Board SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATED JOINT BOARD UPDATE ON THE DRAFT COMMISSIONING & IMPLEMENTATION PLAN Aim To bring to the Board s attention the Scottish
More informationDeveloping out of hospital care: Update on community hubs pilot April 2017 August 2017
Developing out of hospital care: Update on community hubs pilot April 2017 August 2017 Contents Heading 1 Executive summary 3 2 Developing out of hospital care: what we have done 5 3 How have we improved
More informationAllied Health Review Background Paper 19 June 2014
Allied Health Review Background Paper 19 June 2014 Background Mater Health Services (Mater) is experiencing significant change with the move of publicly funded paediatric services from Mater Children s
More informationBetter Healthcare in Bucks Reconfiguring acute services
service redesign case study March 2013 No. 3 Reconfiguring acute services Key points Reach a shared understanding of the case for change across the local health economy. Start public engagement as early
More informationDocument Details Clinical Audit Policy
Title Document Details Clinical Audit Policy Trust Ref No 1538-31104 Main points this document covers This policy details the responsibilities and processes associated with the Clinical Audit process within
More informationEvaluation of the Links Worker Programme in Deep End general practices in Glasgow
Evaluation of the Links Worker Programme in Deep End general practices in Glasgow Interim report May 2016 We are happy to consider requests for other languages or formats. Please contact 0131 314 5300
More informationStockport Strategic Vision. for. Palliative Care and End of Life Care Services. Final Version. Ratified by the End of Life Care Programme Board
Stockport Strategic Vision for Palliative Care and End of Life Care Services Final Version Ratified by the End of Life Care Programme Board on 8 th February 2012 Clinical Commissioning Pathfinder Contents
More informationPhysiotherapy outpatient services survey 2012
14 Bedford Row, London WC1R 4ED Tel +44 (0)20 7306 6666 Web www.csp.org.uk Physiotherapy outpatient services survey 2012 reference PD103 issuing function Practice and Development date of issue March 2013
More informationDRAFT. Rehabilitation and Enablement Services Redesign
DRAFT Rehabilitation and Enablement Services Redesign Services Vision Statement Inverclyde CHP is committed to deliver Adult rehabilitation services that are easily accessible, individually tailored to
More informationPublic Health Skills and Career Framework Multidisciplinary/multi-agency/multi-professional. April 2008 (updated March 2009)
Public Health Skills and Multidisciplinary/multi-agency/multi-professional April 2008 (updated March 2009) Welcome to the Public Health Skills and I am delighted to launch the UK-wide Public Health Skills
More informationTrust Board Meeting in Public: Wednesday 11 July 2018 TB NIHR Clinical Research Network Thames Valley and South Midlands Progress Report
Trust Board Meeting in Public: Wednesday 11 July 2018 Title NIHR Clinical Research Network Thames Valley and South Midlands Progress Report Status History For approval The Trust hosts the NIHR CRN Thames
More informationThe new mental health access & waiting time standards
The new mental health access & waiting time standards Dr Frank Burbach Consultant Clinical Psychologist Somerset Partnership NHS Foundation Trust frank.burbach@sompar.nhs.uk 1 NHS Presentation to [XXXX
More informationNational COPD Audit Programme
National COPD Audit Programme Pulmonary Rehabilitation: Time to breathe better National Chronic Obstructive Pulmonary Disease (COPD) Audit Programme: Resources and organisation of Pulmonary Rehabilitation
More informationEvaluation of a Pilot Community Forensic Child and Adolescent Mental Health Service (FCAMHS) for Hampshire and the Isle of Wight (HIoW)
Evaluation of a Pilot Community Forensic Child and Adolescent Mental Health Service (FCAMHS) for Hampshire and the Isle of Wight (HIoW) Mike Griffin Nain Hussain Gail Pittam Evaluation of FCAMHS in Hampshire
More informationNHS North Yorkshire and York
CASE STUDY NHS North Yorkshire and York Managing long term conditions through redesigning the care pathways and integrating telehealth North Yorkshire and York The challenge Strategic plans NHS North Yorkshire
More informationSERVICE SPECIFICATION
SERVICE SPECIFICATION Service Rotherham Hospice Lead Gail Palmer Provider Lead Paula Hill / Mike Wilkerson Period 21 st July 2010 20 th July 2013 1. Purpose This specification describes the services which
More informationNorth School of Pharmacy and Medicines Optimisation Strategic Plan
North School of Pharmacy and Medicines Optimisation Strategic Plan 2018-2021 Published 9 February 2018 Professor Christopher Cutts Pharmacy Dean christopher.cutts@hee.nhs.uk HEE North School of Pharmacy
More informationLEARNING FROM THE VANGUARDS:
LEARNING FROM THE VANGUARDS: STAFF AT THE HEART OF NEW CARE MODELS This briefing looks at what the vanguards set out to achieve when it comes to involving and engaging staff in the new care models. It
More informationOrganisational factors that influence waiting times in emergency departments
ACCESS TO HEALTH CARE NOVEMBER 2007 ResearchSummary Organisational factors that influence waiting times in emergency departments Waiting times in emergency departments are important to patients and also
More informationThe adult social care sector and workforce in. Yorkshire and The Humber
The adult social care sector and workforce in Yorkshire and The Humber 2015 Published by Skills for Care, West Gate, 6 Grace Street, Leeds LS1 2RP www.skillsforcare.org.uk Skills for Care 2016 Copies of
More informationNHSGGC Respiratory Managed Clinical Network Annual Report 2010/11 Executive Summary and Table of Contents
NHSGGC Respiratory Managed Clinical Network Annual Report 2010/11 Executive Summary and Table of Contents The full report is available on the Respiratory MCN Website www.nhsggc.org.uk/respmcn 1. Executive
More informationDate of publication:june Date of inspection visit:18 March 2014
Jubilee House Quality Report Medina Road, Portsmouth PO63NH Tel: 02392324034 Date of publication:june 2014 www.solent.nhs.uk Date of inspection visit:18 March 2014 This report describes our judgement of
More informationEnd of Life Care. LONDON: The Stationery Office Ordered by the House of Commons to be printed on 24 November 2008
End of Life Care LONDON: The Stationery Office 14.35 Ordered by the House of Commons to be printed on 24 November 2008 REPORT BY THE COMPTROLLER AND AUDITOR GENERAL HC 1043 Session 2007-2008 26 November
More informationImproving the quality of diagnostic spirometry in adults: the National Register of certified professionals and operators
Improving the quality of diagnostic spirometry in adults: the National Register of certified professionals and operators September 2016 Improving the quality of diagnostic spirometry in adults: the National
More informationReducing Variation in Primary Care Strategy
Reducing Variation in Primary Care Strategy September 2014 Page 1 of 14 REDUCING VARIATION IN PRIMARY CARE STRATEGY 1. Introduction The Reducing Variation in Primary Care Strategy should be seen as one
More informationGOVERNING BODY REPORT
GOVERNING BODY REPORT 1. Date of Governing Body Meeting 16 th November 2017 2. Title of Report: 3. Key Messages: BUPA ceased to be the registered provider of Crawfords Walk Nursing Home in October. The
More informationNHS ENGLAND BOARD PAPER
NHS ENGLAND BOARD PAPER Paper: PB.28.09.2017/07 Title: Update on Winter resilience preparation 2017/18 Lead Director: Matthew Swindells, National Director: Operations and Information Purpose of Paper:
More informationLiving With Long Term Conditions A Policy Framework
April 2012 Living With Long Term Conditions A Policy Framework Living with Long Term Conditions Contents Page Number Minister s Foreword 3 Introduction 4 Principles 13 Chapter 1 Working in partnership
More informationBackground and progress
the voice of NHS management briefing MARCH 2004 ISSUE 96 Electronic booking an initial guide to implementation Keeping abreast of IT Everyone who plays a leading or frontline role in the delivery of high-quality
More informationNHS DORSET CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING CASE FOR CHANGE - CLINICAL SERVICES REVIEW
NHS DORSET CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING CASE FOR CHANGE - CLINICAL SERVICES REVIEW Date of the meeting 19/03/2014 Author Sponsoring Board Member Purpose of Report Recommendation
More informationMedicines Governance Service to Care Homes (Care Home Service)
Medicines Governance Service to Care Homes (Care Home Service) Locally Enhanced Service Authors: Ruth Buchan, Senior Pharmacist Medicines Management 4th Floor F Mill Dean Clough Halifax HX3 5AX Tel-01422
More informationRESPIRATORY HEALTH DELIVERY PLAN
RESPIRATORY HEALTH DELIVERY PLAN 1. BACKGROUND AND CONTEXT Together for Health a Respiratory Health Delivery Plan was published in April 2014 and provides a framework for action by Health Boards and NHS
More informationKingston Primary Care commissioning strategy Kingston Medical Services
Kingston Primary Care commissioning strategy Kingston Medical Services Kathryn MacDermott Director of Planning and Primary Care Kathryn.macdermott@kingstonccg.nhs.uk kmacdermott@nhs.net 1 Contents 1. Introduction...
More informationCA1 Enhanced Supportive Care for Advanced Cancer Patients
CA1 Enhanced Supportive Care for Advanced Cancer Patients Scheme Name QIPP Reference Eligible Providers CA1 Enhanced Supportive Care (ESC) Access for Advanced Cancer Patients QIPP 16-17 S23- Cancer Cancer
More informationThe adult social care sector and workforce in. North East
The adult social care sector and workforce in 2015 Published by Skills for Care, West Gate, 6 Grace Street, Leeds LS1 2RP www.skillsforcare.org.uk Skills for Care 2016 Copies of this work may be made for
More informationAbout me. This page was updated by. Date (dd/mm/yy) Name. has been diagnosed with. My home address. My date of birth is (dd/mm/yy) My NHS number is
About me This page was updated by Date (dd/mm/yy) Name has been diagnosed with My home address My date of birth is (dd/mm/yy) My NHS number is My hospital number is The hospital I go to is My contact at
More informationTHE VIRTUAL WARD MANAGING THE CARE OF PATIENTS WITH CHRONIC (LONG-TERM) CONDITIONS IN THE COMMUNITY
THE VIRTUAL WARD MANAGING THE CARE OF PATIENTS WITH CHRONIC (LONG-TERM) CONDITIONS IN THE COMMUNITY An Economic Assessment of the South Eastern Trust Virtual Ward Introduction and Context Chronic (long-term)
More informationEvaluation of the NHS Breathlessness
Evaluation of the NHS Breathlessness Pilots Report of the Evaluation Findings Report for NHS England 31 March 2016 Client Company Title Subtitle NHS England OPM Evaluation of the NHS Breathlessness Pilots
More informationAn improvement resource for the district nursing service: Appendices
National Quality Board Edition 1, January 2018 Safe, sustainable and productive staffing An improvement resource for the district nursing service: Appendices This document was developed by NHS Improvement
More informationHow to use NICE guidance to commission high-quality services
How to use NICE guidance to commission high-quality services Acknowledgement We are grateful to the many organisations and individuals who have contributed to the development of this guide. A list of these
More informationAnnex 3 Cluster Network Action Plan South Ceredigion and Teifi Valley Cluster Plan
Annex 3 Network Action Plan 06-7 South Ceredigion and Teifi Valley Plan The Network Development Domain supports GP Practices to work to collaborate to: Understand local needs and priorities. Develop an
More informationAny Qualified Provider: your questions answered
Any Qualified Provider: your questions answered September 8, 2011 These answers cover a range of questions about the detail of Any Qualified Provider on integrated care, competition and procurement, liability
More informationUK Renal Registry 20th Annual Report: Appendix A The UK Renal Registry Statement of Purpose
Nephron 2018;139(suppl1):287 292 DOI: 10.1159/000490970 Published online: July 11, 2018 UK Renal Registry 20th Annual Report: Appendix A The UK Renal Registry Statement of Purpose 1. Executive summary
More informationFreedom of Information Request NHS Continuing Healthcare
Dear Further to your request under the Freedom of Information Act 2000, please find attached your completed questionnaire. Please note that in line with section 12.1 of the Freedom of Information Act (exemption
More informationINCENTIVE SCHEMES & SERVICE LEVEL AGREEMENTS
MAY 2007 INCENTIVE SCHEMES & SERVICE LEVEL AGREEMENTS Practice Based Commissioning North and South Essex Local Medical Committees CLARIFYING THE RELATIONSHIP BETWEEN PBC GROUPS AND PCTS AIMS The aim of
More informationNHS Bradford Districts CCG Commissioning Intentions 2016/17
NHS Bradford Districts CCG Commissioning Intentions 2016/17 Introduction This document sets out the high level commissioning intentions of NHS Bradford Districts Clinical Commissioning Group (BDCCG) for
More informationPre Assessment Policy. Trust Policy Forum March 2004
Policy No: OP19 Version 1.0 Name of Policy: Pre Assessment Policy Effective From: March 2004 Approved by: Trust Policy Forum March 2004 Next Review Date: March 2005 Reviewed by: This policy supercedes
More information5. Improving Asthma Awareness in Schools. What has been learnt so far?
In this issue: Asthma UK Study Managing Respiratory disease : A holistic approach COPD toolkit Publication of Respiratory Annual Report 2012 Home Oxygen Service World COPD day Respiratory Network News
More informationWigan Borough. Integrated Neighbourhood Teams Evaluation. Final Report. September 2016
Wigan Borough Integrated Neighbourhood Teams Evaluation Final Report September 2016 Contents 1 Introduction... 1 1.1 Background Integrated Care in Wigan Borough... 1 1.2 Evaluation - Purpose and scope...
More informationNorthern Ireland COPD Audit
Northern Ireland COPD Audit A regional audit of chronic obstructive pulmonary disease (COPD) care September 2017 www.rqia.org.uk Assurance, Challenge and Improvement in Health and Social Care Contents
More informationTogether for Health A Respiratory Health Delivery Plan. A Delivery Plan up to 2017 for the NHS and its partners
Together for Health A Respiratory Health Delivery Plan A Delivery Plan up to 2017 for the NHS and its partners Date of Issue: 29 April 2014 Digital ISBN 978 1 4734 1110 4 Crown copyright 2014 WG21465 CONTENTS
More informationservice users greater clarity on what to expect from services
briefing November 2011 Issue 227 Payment by Results in mental health A challenging journey worth taking Key points Commissioners and providers support the introduction of Payment by Results for adult mental
More informationNHS England Thames Valley. Thames Valley Children and Maternity SCN Perinatal Mental Health Report
Insert heading depending on line length; please delete other cover Insert heading options once you depending on Insert line heading depending on line length; please delete have chosen length; please other
More information2. The mental health workforce
2. The mental health workforce Psychiatry Data provided by NHS Digital demonstrates that in September 2016 there were 8,819 psychiatrists (total number across all grades). This is 6.3% more psychiatrists
More informationPATIENT AND SERVICE USER EXPERIENCE STRATEGY
PATIENT AND SERVICE USER EXPERIENCE STRATEGY APRIL 2017 TO MARCH 2020 Date 24 March 2017 Version Final Version Previously considered by The Patient Experience Group version 0.1 draft The Executive Management
More informationGreater Manchester Neuro-Rehabilitation Services information for patients and carers
THIS BOOKLET IS BEING TRIALLED Greater Manchester Neuro-Rehabilitation Services information for patients and carers Greater Manchester Neuro-Rehabilitation Services gmnrodn@srft.nhs.uk All Rights Reserved
More informationBusiness Case Authorisation Cover Sheet
Business Case Authorisation Cover Sheet Section A Business Case Details Business Case Title: Directorate: Division: Sponsor Name Consultant in Anaesthesia and Pain Medicine Medicine and Rehabilitation
More informationIndependent Hospital Pricing Authority Tier 2: Non-Admitted Care Clinic Definitions NEW NUMBER
Independent Hospital Pricing Authority Tier 2: Non-Admitted Care Clinic Definitions NEW NUMBER 1 PULMONARY REHABILITATION 40.60 The IHPA has introduced a new Activity based Funding item specifically for
More informationRespiratory and Home Oxygen Service
Respiratory and Home Oxygen Service Who are the Respiratory and Home Oxygen Assessment Service? We are a team of nurses, physiotherapists and support staff with specialist training and experience of supporting
More informationASPIRE. Allied Health Professions Supporting and Promoting Improvement, Rehabilitation and Enabling Others ADVANCED PRACTICE SPECIALIST GENERALIST
ASPIRE Allied Health Professions Supporting and Promoting Improvement, Rehabilitation and Enabling Others ADVANCED PRACTICE SPECIALIST GENERALIST ENABLING OTHERS AHP Strategy 2017 2021 CONTENTS Introduction
More informationTHAMES VALLEY PRIORITIES COMMITTEE ETHICAL FRAMEWORK
NHS Aylesbury Vale Clinical Commissioning Group NHS Bracknell and Ascot Clinical Commissioning Group NHS Chiltern Clinical Commissioning Group NHS Newbury and District Clinical Commissioning Group NHS
More informationChapter 2. At a glance. What is health coaching? How is health coaching defined?
Chapter 2 What is health coaching? This chapter describes: What health coaching is and it s applications How health coaching relates to wider systems and programmes of care How health coaching relates
More informationSOUTH CENTRAL AMBULANCE SERVICE NHS FOUNDATION TRUST
SOUTH CENTRAL AMBULANCE SERVICE NHS FOUNDATION TRUST CLINICAL SERVICES POLICY & PROCEDURE (CSPP No. 19) STROKE CARE POLICY AND PROCEDURES September 2016 DOCUMENT INFORMATION Author: Dave Sherwood Assistant
More informationUKMi and Medicines Optimisation in England A Consultation
UKMi and Medicines Optimisation in England A Consultation Executive Summary Medicines optimisation is an approach that seeks to maximise the beneficial clinical outcomes for patients from medicines with
More informationOur five year plan to improve health and wellbeing in Portsmouth
Our five year plan to improve health and wellbeing in Portsmouth Contents Page 3 Page 4 Page 5 A Message from Dr Jim Hogan Who we are What we do Page 6 Page 7 Page 10 Who we work with Why do we need a
More informationNHS Somerset CCG OFFICIAL. Overview of site and work
NHS Somerset CCG Overview of site and work NHS Somerset CCG comprises 400 GPs (310 whole time equivalents) based in 72 practices and has responsibility for commissioning services for a dispersed rural
More informationNorthumberland, Tyne and Wear NHS Foundation Trust. Board of Directors Meeting. Meeting Date: 25 October Executive Lead: Rajesh Nadkarni
Agenda item 9 ii) Northumberland, Tyne and Wear NHS Foundation Trust Board of Directors Meeting Meeting Date: 25 October 2017 Title and Author of Paper: Clinical Effectiveness (CE) Strategy update Simon
More informationNational COPD Audit Programme
National COPD Audit Pulmonary rehabilitation: An exercise in improvement National Chronic Obstructive Pulmonary Disease (COPD) Audit : Clinical and organisational audits of pulmonary rehabilitation services
More informationIslington Practice Based Mental Health Care: Roll-out plans and progress
Report to: Board of Directors (Public) Paper number: 3.2 Report for: Information Date: 26 th October 2017 Report author/s: Emily van de Pol, Divisional Director, Community Mental Health and Primary Care
More informationIntensive Psychiatric Care Units
NHS Highland Argyll & Bute Hospital, Lochgilphead Intensive Psychiatric Care Units Service Profile Exercise ~ November 2009 NHS Quality Improvement Scotland (NHS QIS) is committed to equality and diversity.
More informationNHS Grampian. Intensive Psychiatric Care Units
NHS Grampian Intensive Psychiatric Care Units Service Profile Exercise ~ November 2009 NHS Quality Improvement Scotland (NHS QIS) is committed to equality and diversity. We have assessed the performance
More informationUK Renal Registry 13th Annual Report (December 2010): Appendix A The UK Renal Registry Statement of Purpose
Nephron Clin Pract 2011;119(suppl 2):c275 c279 DOI: 10.1159/000331785 Published online: August 26, 2011 UK Renal Registry 13th Annual Report (December 2010): Appendix A The UK Renal Registry Statement
More informationCranbrook a healthy new town: health and wellbeing strategy
Cranbrook a healthy new town: health and wellbeing strategy 2016 2028 Executive Summary 1 1. Introduction: why this strategy is needed, its vision and audience Neighbourhoods and communities are the building
More informationQuick guide: planning for increased seasonal demand in respiratory illness
Quick guide: planning for increased seasonal demand in respiratory illness Published by NHS England and NHS Improvement December 2017 The British Thoracic Society is pleased to endorse this quick guide,
More informationMotivational Interviewing and COPD Health Status Project 4 July-30 December 2016
Project Overview Motivational Interviewing and COPD Health Status Project 4 July-30 December 2016 Applying the principles of motivational interviewing to everyday patient interactions has proven effective
More informationPublic Attitudes to Self Care Baseline Survey
Public Attitudes to Self Care Baseline Survey Department of Health February 2005 1 Contents Executive Summary 3 Introduction 7 Background and objectives of the research 7 Methodology 8 How Healthy is the
More information21 March NHS Providers ON THE DAY BRIEFING Page 1
21 March 2018 NHS Providers ON THE DAY BRIEFING Page 1 2016-17 (Revised) 2017-18 (Revised) 2018-19 2019-20 (Indicative budget) 2020-21 (Indicative budget) Total revenue budget ( m) 106,528 110,002 114,269
More informationGuidelines for the appointment of. General Practitioners with Special Interests in the Delivery of Clinical Services. Respiratory Medicine
Guidelines for the appointment of General Practitioners with Special Interests in the Delivery of Clinical Services Respiratory Medicine April 2003 Respiratory Medicine This General Practitioner with a
More informationNCPC Specialist Palliative Care Workforce Survey. SPC Longitudinal Survey of English Cancer Networks
NCPC Specialist Palliative Care Workforce Survey SPC Longitudinal Survey of English Cancer Networks 3 November 211 West Hall Parvis Road West Byfleet Surrey KT14 6EZ UK T +44 ()1932 337 Contents Contents...
More informationReview of approval and monitoring UK ambulance service pre-registration programmes
Review of approval and monitoring 2007 10 UK ambulance service pre-registration programmes Contents Introduction 2 About us (the Health Professions Council) 2 Our main functions 2 Brief overview of the
More informationImprovement and assessment framework for children and young people s health services
Improvement and assessment framework for children and young people s health services To support challenged children and young people s health services achieve a good or outstanding CQC rating February
More informationTITLE OF REPORT: Looked After Children Annual Report
NHS BOLTON CLINICAL COMMISSIONING GROUP Public Board Meeting AGENDA ITEM NO: 13 Date of Meeting:..27 th October 2017.. TITLE OF REPORT: Looked After Children Annual Report 2016-2017 AUTHOR: Christine Dixon,
More information