Delivering the QIPP programme: making existing services improve patient outcomes
|
|
- Francis Cunningham
- 5 years ago
- Views:
Transcription
1 Delivering the QIPP programme: making existing services improve patient outcomes Produced by Glyn Davies MP, Chair All-Party Parliamentary Group on AF in association with the Atrial Fibrillation Association (AFA). Introduction The Quality, Innovation, Productivity and Prevention (QIPP) programme is the largest transformational programme ever attempted within the NHS which involves all NHS staff, patients and the voluntary sector. The objectives of QIPP are to improve the quality of care in the NHS, increase productivity and make 20 billion of efficiency savings by , which would then be re-invested back into front line services. In order to help the NHS meet the aims of the QIPP programme it is important to highlight what best practice in Atrial Fibrillation (AF) prevention and treatment entails and how it can then be implemented. In order to identify this, the All-Party Parliamentary Group on Atrial Fibrillation held a meeting to discuss best practice in AF and highlight where it is currently being applied across the NHS. Attendees at the meeting focused on four areas where adopting best practice could help save the NHS money and improve patient care. 1. Integrated care 2. GP and patient education programmes 3. Greater use of Patient decision aids (PDAs) 4. Raising standards through QOF or LES Further examples of best practice and statements on quality care can be found in Healthcare Pioneers: Showcasing innovative practice in Atrial Fibrillation on the AFA s website at Healthcare Pioneers was successfully launched at a previous APGAF meeting. What is the QIPP Programme? To make efficiency savings and drive productivity, the QIPP programme aims to deliver fundamental cultural change in the NHS, challenging the view that improving quality automatically means higher costs. Similarly it aims to improve health as well as sickness services, with more emphasis on prevention, earlier intervention and standardised care based on proven methods, whilst integrating services around patient needs. The programme is also designed to make the NHS more productive by delivering a whole-scale transformation of healthcare systems to raise standards, decommission relatively ineffective interventions, shift care into more cost-effective settings and drive quality and cost improvements across providers to reduce variability. 1
2 AF within QIPP There is currently one AF QIPP case study which is part of the Long-Term Conditions work stream and focuses on the detection and optimal therapy in primary care by encouraging opportunistic screening by pulse palpitation of patients over 65. This has been used in 18 regions to improve the detection and prevention of AF. Published in November 2009, the QIPP case study aims to improve the identification, diagnosis, risk stratification and optimal management of patients with AF to reduce the risk of stroke. The roll-out of this programme was supported by the Stroke Improvement Programme and the cardiac and stroke networks which enabled Primary Care Trusts (PCTs), Practice Based Commissioners (PBCs) and General Practitioners (GPs) to apply evidence based learning. Similarly it enabled them to access tools, resources and education programmes developed for primary care through the first phase of pilot projects to improve the identification, diagnosis and optimal therapy for AF patients to reduce the risk of stroke. What was the impact of the AF QIPP Case Study? The pilot projects were delivered within a 6-18 month period and 18 priority projects were managed within Heart and Stroke networks. A further nine sites were introduced in October The pilots were assessed on whether they improved safety, effectiveness, patient experience and productivity. It was found that the pilot improved detection of AF through opportunistic and systematic pulse palpitation and that quality outcomes for patients with AF were improved through optimal therapy to reduce the risk of stroke. Similarly, improved productivity through the reduction in referrals and bed days was achieved whilst improving patient survival rates. This was delivered in Bedfordshire and Hertfordshire where opportunistic screening of over 65s was introduced. Similarly the West Yorkshire Cardiovascular Network helped pilot the GRASP- AF tool to highlight patients with a CHADS 2 score greater than one who are in need of anticoagulation. These pilots were deemed a success with consistent cash-releasing saving, productivity gain or gain in the quality of services achieved. A similar scheme in Durham, where patients received an opportunistic pulse check prompted by a flag to the GP clinical system, led to 1,569 patients receiving a pulse check; with 207 being identified as having an irregular pulse and no known AF. From this 99 patients received an ECG and 36 patients were diagnosed with previously unknown AF. A scheme in York where known AF cases were reviewed using the GRASP-AF tool, led to 3,613 patients being diagnosed with AF and 53% of them had a CHADS 2 score of two. This then lead to 41 new warfarin prescriptions. 2
3 What additional measures should be included to help reach QIPP targets? 1. Joined up care AF is the most common heart arrhythmia, diagnosed in approximately one million people in England alone. It is further estimated that another per cent are undiagnosed. Attendees noted that whilst schemes to know your pulse were essential in order to diagnose people with AF, this is no guarantee that they will then go on to receive effective treatment. Attendees suggested that in order to treat AF and prevent stroke it would be necessary to join up all aspects of the patient pathway to ensure that when diagnosed with AF a patient does not fall off the radar. Even if you do identify an irregular pulse, that doesn t mean the patient will receive treatment Attendees highlighted the pilot taking place in NHS Corby as an example of how to ensure that all elements of the patient pathway are working together to improve outcomes. When establishing the barriers to effective AF care, the organisers highlighted reluctance from patients to take warfarin and the lack of AF commissioning focus and local guidelines. In order to rectify this, the pilot set up five different workstreams that looked at all aspects of the AF patient pathway. To ensure that these workstreams co-ordinated their activities, they included a broad range of stakeholders within the planning and delivery process. This included representatives from the primary care, secondary care, voluntary sector, local councillors, the pharmaceutical industry and medical device companies. These organisations then worked together to develop a programme of AF support which included: training on how to diagnose and manage AF, how to use GRASP-AF and a review of all patients on the AF register to assess the support that they were receiving. Full data on the effectiveness of the NHS Corby pilot will be available within the next few months. 2. GP education programmes Attendees highlighted that one of the biggest barriers to effective patient treatment was a lack of knowledge on the part of patients and clinicians on how best to cope with the condition. Two problems were identified: firstly reluctance on the part of GPs to prescribe anything apart from Aspirin and nervousness from patients about moving on to anticoagulants. GPs were considered to be reluctant to prescribe warfarin as if a patient suffered a bleed it was considered to be their fault, whereas a stroke when a patient was receiving aspirin was deemed a natural consequence of having AF. Patient concern about the affects of taking anticoagulants was the central reason why GPs were unwilling to prescribe the treatment. Attendees highlighted that patients were concerned about the suitability of warfarin both in terms of safety and the inconvenience that it would cause their day-to-day lives. The failure to effectively treat AF and the subsequent stroke risk was highlighted by attendees as a significant cost burden to 3
4 the NHS as AF related strokes are more severe than non AF strokes and therefore placed a greater cost burden on the NHS. In order to improve patient access to treatment it is important to train GPs on the need to prescribe appropriate treatments and not to rely on aspirin for treatment, which has been proven to be vastly inferior to warfarin in preventing AF-related strokes. An example of where this has been successfully implemented is in NHS Lincolnshire where they are currently in the process of sending 18 GPs on an AF diploma course. If a patient has a stroke that s seen as natural, if a patient bleeds then that s seen as the GP s fault Similarly, NHS Haringey is in the process of recruiting an AF advisor whose role is to monitor the AF pathway and ensure that it is operating effectively. This will improve the advice that Doctors are able to offer patients and provide them with the information to help patients to make a considered and informed choice as to what would prove best for them. 3. Better information for patients and the further development of an AF Patient Decision Aid AF patients were present at the meeting and they explained how one of the big problems surrounding AF is that when one is diagnosed, there is either insufficient information about what management options are or that one is unable to properly comprehend them. Consequently, this is likely to lead to patients making the wrong choice about what treatment they need to follow or even whether they would continue to receive treatment. Attendees heard how in NHS Sheffield clinicians were working to develop a patient decision aid (PDA) to guide patients through the decisions involved and the benefits of the treatments that they might receive. Patient decision aids are designed to help patients make difficult decisions about their treatments and medical tests. They are used when there is no clinical evidence to suggest that one treatment is better than another and patients need help in deciding which option will be best for them. Attendees explained how in some practices patients were asked a series of questions by their GP about their treatment options and how it might affect them. When they had completed these questions they were shown a picture of a heart which displayed their risk of stroke if they chose to continue with that treatment option. It is crucial that patients are part of the decision making process and not just told what to do Similarly, attendees also highlighted the importance of routinely using existing AF stroke risk calculators, which by calculating their CHA 2 DS2VASc score, enabled patients to accurately determine their stroke risk according to the treatment that they pursue. Whilst these tools are currently easily accessible it is not being provided to patients when they are diagnosed with AF and they are therefore unable to make a reasoned choice regarding their treatment options. 4
5 Attendees agreed that through the development of PDAs and the greater use of existing stroke risk calculators, such as the one created by the AFA, patients would be better informed and would be able to make better decisions throughout their patient journey. This would lead to better engagement with clinicians, which would increase the likelihood of GPs prescribing alternatives to aspirin. 4. Raising standards through existing incentive schemes At the meeting attendees highlighted the issue of whether using existing NHS incentive systems such as the Locally Enhanced Services (LES) system, would improve standards of patient care. The LES system covers optional commissioning of services based on local needs and PCTs determine what funding to provide based on the needs of the local area. NHS North West London was cited as an effective example of using incentive schemes to improve care as the LES system was used to encourage practices to undertake quarterly GRASP-AF assessments to monitor and evaluate their stroke risk. Under this system attendees heard how practices are only paid when they have utilised GRASP-AF in this way and have put in place measures to continuously monitor stroke risk. A further example of this is North East Essex where 37 out of 43 practices signed up to the LES incentive scheme. As a result, 34,201 patients were screened at flu clinics, 3,154 were diagnosed with an irregular pulse, 189 with AF, 342 with other arrthymias and 77 patients were CHADS 2 stratified as being at risk of stroke and anticoagulated. This was achieved at a screening cost of 2 per patient and an outlay of 68,402. It is estimated that this led to five strokes being prevented within the next year. Concluding comments At this meeting attendees highlighted clear instances of how AF best practice which could be rolled out across the NHS. There was widespread support for measures to better join up the planning of AF care, GP education programmes, better information for patients and the development of further patient decision aids as well as using existing incentive systems to encourage PCTs and later CCGs to implement AF best practice. Attendees agreed that a piecemeal approach to adopting best practice would be insufficient and for the NHS to meet the objectives of the QIPP programme, these instances of AF best practice would need to be rolled out across the patient pathway across the country. For more information on this meeting, please contact Glyn Davies MP on or glyn.davies.mp@parliament.uk. About the APGAF On 8 June 2011 the All-Party Parliamentary Group on Atrial Fibrillation held its inaugural meeting in Parliament. It was agreed at the meeting that the aim of the group is to: Raise awareness of the issues affecting patients diagnosed with Atrial Fibrillation (AF), and work to ensure the diagnosis, care, treatment, management, and research of AF is a priority for the NHS. For more information, please see the Parliamentary Register at: 5
6 About the Atrial Fibrillation Association The AFA is a UK registered charity which focuses on raising awareness of AF by providing information and support materials for patients and medical professionals involved in detecting, diagnosing and managing AF. 6
West Midlands Strategic Clinical Network & Senate Improving the detection and management of Atrial Fibrillation in Primary Care
West Midlands Strategic Clinical Network & Senate Improving the detection and management of Atrial Fibrillation in Primary Care Good Practice Guide Improving the detection and management of Atrial Fibrillation
More informationSurvey into the diagnosis, management and treatment of patients with Atrial Fibrillation
CHRIS RUANE MP, PRIMARY CARE CARDIOVASCULAR SOCIETY and ATRIAL FIBRILLATION ASSOCIATION FREEDOM OF INFORMATION REQUEST Survey into the diagnosis, management and treatment of patients with Atrial Fibrillation
More informationAHSN AF Programme The Results So Far. Kate Mackay AF Programme Manager
AHSN AF Programme The Results So Far Kate Mackay AF Programme Manager Atrial Fibrillation Programme Aim To decrease the number of AF-related strokes by: Decreasing the prevalence gap and finding the missing
More informationHEALTHCARE PIONEERS SHOWCASING BEST PRACTICE IN AF
ALL-PARTY PARLIAMENTARY GROUP HEALTHCARE PIONEERS SHOWCASING BEST PRACTICE IN AF Supported by the All-Party Parliamentary Group on Atrial Fibrillation (APGAF) April 2015 Registered Charity No. 1122442
More informationCommissioning effective anticoagulation services for the future: A resource pack for commissioners
Commissioning effective anticoagulation services for the future: A resource pack for commissioners The development of this commissioning toolkit was supported by Bayer HealthCare. Bayer HealthCare paid
More informationAtrial Fibrillation in Primary Care
NHS NHS Improvement CANCER DIAGNOSTICS HEART STROKE Heart Improvement Atrial Fibrillation in Primary Care National Priority Project Atrial Fibrillation in Primary Care is a national priority project of
More informationMain body of report Integrating health and care services in Norfolk and Waveney
Item 18.73a ii Norfolk and Waveney Sustainability and Transformation Plan Update for governing bodies and trust boards September 2018 Purpose of report The purpose of this paper is to update members of
More informationPreventing Heart Attacks and Strokes The Size of the Prize
Preventing Heart Attacks and Strokes The Size of the Prize Dr Matt Kearney General Practitioner and National Clinical Director for CVD Prevention NHS England and Public Health England The NHS needs a radical
More informationThe pathway highlights a clear strategy for managing these patients which includes the following:
James Cook University Hospital Streamlining the pathway for patients identified in surgical pre admission clinics (PAC) with previously undetected atrial fibrillation. Why was this project implemented?
More informationATRIAL FIBRILLATION & STROKE INSIGHTS TOOL
ATRIAL FIBRILLATION & STROKE INSIGHTS TOOL CAN REAL WORLD/PUBLICALLY AVAILABLE DATA COUPLED WITH TTR DATA HELP THE NHS STOP STROKES? Andrzei Orlowski -Programme Development Lead for Health and Implementation
More informationHASTE-Network In Guildford and Surrey. Background. Arrhythmia Screening in Primary care to reduce Stroke. HASTENinGS 2013
HASTE-Network In Guildford and Surrey Arrhythmia Screening in Primary care to reduce Stroke Background Atrial Fibrillation is a very common heart condition which causes 15-20% of all Stroke. Its incidence
More informationRising to the challenge: Delivering QIPP by preventing AF-related stroke. Foreword
2 Foreword Rising to the challenge: Delivering QIPP by preventing AF-related stroke Opportunities to improve the quality, safety and cost-effectiveness of NHS services that reduce the risk of stroke in
More informationThe interface between primary and secondary care Key messages for NHS clinicians and managers
The interface between primary and secondary care Key messages for NHS clinicians and managers In partnership with: NHS England and NHS Improvement 2 Good organisation of care across the interface between
More informationCommissioning for Value insight pack
Commissioning for Value insight pack NHS England Gateway ref: 00525 Contents Introduction: the call to action The approach Where to look using indicative data Phase 2 & 3 Why act what benefits do the population
More informationYour Care, Your Future
Your Care, Your Future Update report for partner Boards April 2016 Introduction The following paper has been prepared for the Board members of all Your Care, Your Future partner organisations: NHS Herts
More informationOpportunities for partnership working between the NHS and the pharmaceutical industry in the Department of Health s innovation strategy
Opportunities for partnership working between the NHS and the pharmaceutical industry in the Department of MAY 2012 The policy context The NHS has always faced increasing demands: a growing population
More informationThe Role of the Arrhythmia Nurse
The Role of the Arrhythmia Nurse RACHEAL JAMES BHF SUPPORTED ARRHYTHMIA NURSE SPECIALIST UHW The Role of the Arrhythmia Nurse Specialist It is now widely recognised that the skills and expertise that nurses
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 informationANTI-COAGULATION MONITORING
ANTI-COAGULATION MONITORING 2016-17 a) Purpose of Agreement This Agreement outlines the service to be provided by the Provider, called an Anti-coagulation monitoring service. b) Duration of Agreement This
More informationCoordinated cancer care: better for patients, more efficient. Background
the voice of NHS leadership briefing June 2010 Issue 203 Coordinated cancer care: Key points There are two million people with cancer in the UK. It is suggested that by 2030 there will be over four million
More informationImproving General Practice for the People of West Cheshire
Improving General Practice for the People of West Cheshire Huw Charles-Jones (GP Chair, West Cheshire Clinical Commissioning Group) INTRODUCTION There is a growing consensus that the current model of general
More informationIntegrated heart failure service working across the hospital and the community
Integrated heart failure service working across the hospital and the community Lynne Ruddick Professional Lead (South) British Heart Foundation 31st October 2017 Heart Failure is an epidemic. NICE has
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 informationHM Government Call to Evidence on Open Public Services Right to Choice
HM Government Call to Evidence on Open Public Services Right to Choice The Chartered Society of Physiotherapy response By email: openpublicservices@cabinet-office.x.gsi.gov.uk 1. The Chartered Society
More informationImproving the prevention, early detection and management of Acute Kidney Injury (AKI) in Wessex
Improving the prevention, early detection and management of Acute Kidney Injury (AKI) in Wessex The case for change AKI is recognised as a major public health and patient safety concern nationally and
More informationJOB DESCRIPTION. Pharmacy Technician
JOB DESCRIPTION Pharmacy Technician Issued by AT Medics Primary Care Pharmacy Technician Job Description Job Title: Reporting to: Location: Salary: Job status: Contract: Notice Period: Primary care pharmacy
More informationBelfast ICP Pathways. Dr Dermot Maguire GP Clinical Lead North Belfast ICP
Belfast ICP Pathways Dr Dermot Maguire GP Clinical Lead North Belfast ICP QOF Disease Register & NHAIS Global Sum Findings 2013. ICP Area No of practices & patients Frail Elderly -over 65 Resp COPD Diabetes
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 informationAnti-Coagulation Monitoring (warfarin, acenocoumarol, phenindione) Primary Care Service (PCS:01) NHS Standard Contract Service Profile Pack ( )
Anti-Coagulation Monitoring (warfarin, acenocoumarol, phenindione) Primary Care Service (PCS:01) This pack contains: Standard Contract Service Profile Pack () 1. Service Specification: (to be inserted
More informationHERTFORDSHIRE COMMUNITY NHS TRUST INTERMEDIATE CARE SERVICE UPDATE WINDMILL HOUSE MAY 2011
HERTFORDSHIRE COMMUNITY NHS TRUST INTERMEDIATE CARE SERVICE UPDATE WINDMILL HOUSE MAY 2011 1. Purpose This paper provides an update on the outcome of the consultation to re-provide Intermediate Care Services
More informationNorth Central London Sustainability and Transformation Plan. A summary
Sustainability and Transformation Plan A summary N C L Introduction Hospitals, local authorities, GPs, commissioners, and mental health trusts across north central London have all come together to transform
More informationEmergency admissions to hospital: managing the demand
Report by the Comptroller and Auditor General Department of Health Emergency admissions to hospital: managing the demand HC 739 SESSION 2013-14 31 OCTOBER 2013 4 Key facts Emergency admissions to hospital:
More informationTitle: Climate-HIV Case Study. Author: Keith Roberts
Title: Climate-HIV Case Study Author: Keith Roberts The Project CareSolutions Climate HIV is a specialised electronic patient record (EPR) system for HIV medicine. Designed by clinicians for clinicians
More informationQuality Accounts: Corroborative Statements from Commissioning Groups. Nottingham NHS Treatment Centre - Corroborative Statement
Quality Accounts: Corroborative Statements from Commissioning Groups Quality Accounts are annual reports to the public from providers of NHS healthcare about the quality of services they deliver. The primary
More informationAgenda for the next Government
Agenda for the next Government General election 2017 The Richmond Group of Charities We are the Richmond Group of Charities and we help people of all ages who have serious long term physical and mental
More informationNHS Innovation Accelerator. Implementation Toolkit. mycopd
NHS Innovation Accelerator Implementation Toolkit mycopd Introduction NHS England s Innovation and Technology Tariff (ITT) went live on 1 April 2017. This new Tariff was introduced to incentivise the adoption
More informationWestminster Partnership Board for Health and Care. 17 January pm pm Room 5.3 at 15 Marylebone Road
Westminster Partnership Board for Health and Care 17 January 2018 4.30pm - 6.00pm Room 5.3 at 15 Marylebone Road Agenda Item # Item and discussion points Lead Papers Timing 1 Preliminary business Welcome
More informationBRIEFING PACK. WatchBP Office ABI Microlife Health Management Ltd
BRIEFING PACK WatchBP Office ABI Microlife Health Management Ltd Prepared by: NHS Technology Adoption Centre Suite 3E 1 Portland Street Manchester M1 3BE Telephone: 0161 200 1620 www.ntac.nhs.uk MICROLIFE
More informationTransformation of Services and Care Pathway Redesign in the NHS: Further Reforms in Health Policy
Transformation of Services and Care Pathway Redesign in the NHS: Further Reforms in Health Policy Mike Mallinson Access Partnership ISPOR May 2013 London Philadelphia Singapore Agenda Objective Approach
More informationThe Value of Working in Partnership with Care Homes to Provide a Unique and Sustainable Approach to Malnutrition
The Value of Working in Partnership with Care Homes to Provide a Unique and Sustainable Approach to Malnutrition A presentation delivered by: Vittoria Romano, Registered Dietitian & Catherine Blanchard,
More information5. Does this paper provide evidence of assurance against the Governing Body Assurance Framework?
Item Number: 6.3 Governing Body Meeting: 4 February 2016 Report Sponsor Anthony Fitzgerald Director of Strategy and Delivery Report Author Anthony Fitzgerald Director of Strategy and Delivery 1. Title
More informationNorth Central London Medicines Optimisation Network. Terms of Reference. North Central London Medicines Optimisation Network 1 of 8
North Central London Medicines Optimisation Network Medicines Optimisation Committee Terms of Reference North Central London Medicines Optimisation Network 1 of 8 Document control Date Version Amendments
More informationUpdate on NHS Central London CCG QIPP schemes
Update on NHS Central London CCG QIPP schemes NHS Central London CCG has identified circa 11m for QIPP during 2013/14. Commissioning Intentions approved by the governing body included transformational
More informationReview of Local Enhanced Services
Review of Local Enhanced Services 1. Background and context 1.1 CCGs are required to prepare for the phasing out of LESs by April 2014 by reviewing the existing LES portfolio and developing commissioning
More informationQOF Quality and Productivity (QP) Indicators. Supplementary Guidance and Frequently Asked Questions for PCTs and Practices in England
QOF Quality and Productivity (QP) Indicators Supplementary Guidance and Frequently Asked Questions for PCTs and Practices in England May 2011 Contents Introduction 2 Summary of QP indicators 3 Prescribing
More informationOptimising Systems and Processes of Wound Care - A QIPP resource of good practice. Developing and Implementing a Wound Care Prescribing Policy
East & outh East England pecialist Pharmacy ervices East of England, London, outh Central & outh East Coast Medicines Use and afety Optimising ystems and Processes of Wound Care - A QIPP resource of good
More informationKidney Health Australia
Victoria 125 Cecil Street South Melbourne VIC 3205 GPO Box 9993 Melbourne VIC 3001 www.kidney.org.au vic@kidney.org.au Telephone 03 9674 4300 Facsimile 03 9686 7289 Submission to the Primary Health Care
More informationNHS Dorset Clinical Commissioning Group Governing Body Meeting Financial Position as at 31 st July C Hickson, Head of Management Accounts
NHS Dorset Clinical Commissioning Group Governing Body Meeting Financial Position as at 31 st July 2013 9.4 Date of the meeting 18/09/2013 Author Sponsoring GB member Purpose of report Recommendation Resource
More informationFACTS AND FIGURES 120, ,000 - The estimated number of people with FH in the UK
HEART UK FH Primary Care Audit Programme There is an enormous opportunity to prevent the occurrence of coronary heart disease (CHD) by exploiting the information contained within GP electronic patient
More informationHealth and care in South Yorkshire and Bassetlaw. Sustainability and Transformation Plan a summary
Health and care in South Yorkshire and Bassetlaw Sustainability and Transformation Plan a summary Introduction This is the summary version of the South Yorkshire and Bassetlaw Sustainability and Transformation
More informationHealthy lives, healthy people: consultation on the funding and commissioning routes for public health
Healthy lives, healthy people: consultation on the funding and commissioning routes for public health December 2010 The coalition Government published Healthy Lives, Health people: consultation on the
More informationStrategic Risk Report 4 July 2016
Strategic Report 4 July 20 Haringey CCG Register Introduction The Strategic Report (historically known as the Board Assurance Framework) evidences Haringey Clinical Group s control over the delivery of
More informationTrust Board Meeting 05 May 2016
Trust Board Meeting 05 May 2016 Title of the paper: Sustainability and Transformation Plan (STP) Update Agenda item: 15/37 Lead Executive: Trust objective: Purpose: Link to Board Assurance Framework (BAF)
More informationFULL TEAM AHEAD: UNDERSTANDING THE UK NON-SURGICAL CANCER TREATMENTS WORKFORCE
FULL TEAM AHEAD: UNDERSTANDING THE UK NON-SURGICAL CANCER TREATMENTS WORKFORCE DECEMBER 2017 Publication date 04/12/17 Registered Charity in England and Wales (1089464), Scotland (SC041666) and the Isle
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 informationPersonal Budgets and Direct Payments
Personal Budgets/Direct Payments Date of resource : April 20 Page 1 of Learning Aims The learning aims of this briefing are to enable you to 1 Understand how personal budgets can be requested for special
More informationLinda Cutter / Dr Charles Heatley. GP Practices and Community Pharmacies
Schedule 2 Part A Service Specification Service Specification No. 04 Service Anti-coagulation Monitoring Levels 3, 4 & 5 Commissioner Lead Provider Lead Linda Cutter / Dr Charles Heatley GP Practices and
More informationNHS e-referral Service Vision Optical Confederation response
NHS e-referral Service Vision Optical Confederation response Questions: 1.) What benefit can you see in having greater integration and interoperability between the NHS e-referral Service and other clinical
More informationLiberating the NHS: No decision about me, without me Further consultation on proposals to shared decision-making
Liberating the NHS: No decision about me, without me Further consultation on proposals to shared decision-making Royal Pharmaceutical Society response The Royal Pharmaceutical Society (RPS) is the professional
More informationImperial College Health Partners - at a glance
Imperial College Health Partners - at a glance Imperial College Health Partners - at a glance Our vision and purpose This document is intended to provide an introduction to Imperial College Health Partners
More informationSouth East London Area Prescribing Committee (APC) 9 October at Lower Marsh. Final minutes
South East London Area Prescribing Committee (APC) 9 October at Lower Marsh Final minutes 1. Welcome, Introductions and Apologies received. 2. Conflicts of Interest declarations The Chair requested any
More informationVanguard Programme: Acute Care Collaboration Value Proposition
Vanguard Programme: Acute Care Collaboration Value Proposition 2015-16 November 2015 Version: 1 30 November 2015 ACC Vanguard: Moorfields Eye Hospital Value Proposition 1 Contents Section Page Section
More informationShaping the best mental health care in Manchester
Clinical Transformation Plans Manchester Shaping the best mental health care in Manchester Meeting the needs of our communities Improving Lives OUR SHARED WAY AHEAD... Clinical Service Transformation in
More informationNHS 111 urgent care service
NHS 111 urgent care service Frequently Asked Questions (FAQs) Contents Background 2 Operational 3 NHS Direct 5 999 5 101 6 Training 7 Service Impact 7 Telephony 8 Marketing 8 1 Background Why are you introducing
More informationWest Yorkshire and Harrogate Joint Committee of Clinical Commissioning Groups
West Yorkshire and Harrogate Joint Committee of Clinical Commissioning Groups Annual Report 2017-2018 2 Chair s foreword I m proud to introduce the first Annual Report of the West Yorkshire and Harrogate
More informationNewcastle Healthy Lungs Programme
Newcastle Healthy Lungs Programme A passion for care. A partner for you. BOC: Living healthcare 02 03 Contents Overview 3 Overview 4 Newcastle Healthy Lungs Programme 6 Our values 8 Complaints 10 How we
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 informationInitiation of Warfarin for patients not registered with Provider Practice
Initiation of Warfarin for patients not registered with Provider Practice 2017-18 1. Purpose of Agreement This Agreement outlines the service to be provided by the Provider, called Initiation of Warfarin
More informationMEETING OF THE GOVERNING BODY
MEETING OF THE GOVERNING BODY Agenda Item: 9 Date: 5 February 2014 Subject: Report of: Summary: Enhanced Services Chief Operating Officer Following national guidance all former local enhanced services
More information2016/17 Quality Framework for General Practice
2016/17 Quality Framework for General Practice Contents Section 1 NHS Standards Contract Service Specification Section 2 Quality Framework Domain 1 Supporting New Models of Care Domain 2 Self- Management,
More informationYorkshire & Humber AHSN 2017/18 Business Plan
Yorkshire & Humber AHSN 2017/18 Business Plan Contents Vision and Purpose 4 Strategic Priorities 5 Our Approach 6 Supporting Frontline Teams 7 Supporting New Ways of Working 8 Spreading Proven Innovation
More informationThe North Central London Sustainability and Transformation Plan. and. Camden Local Care Strategy. Caz Sayer Chair, Camden CCG
The North Central London Sustainability and Transformation Plan and Camden Local Care Strategy Caz Sayer Chair, Camden CCG About the Sustainability & Transformation Plan (STP) N C L North Central London
More informationHillingdon 111 Programme: An introduction to the new 111 telephone helpline and Directory of Services (DOS) Helen Delaitre, Lead for Unscheduled Care
Hillingdon 111 Programme: An introduction to the new 111 telephone helpline and Directory of Services (DOS) Helen Delaitre, Lead for Unscheduled Care Introducing NHS 111 The easy to remember, free to call
More informationINNOVATION, HEALTH AND WEALTH A SCORECARD
INNOVATION, HEALTH AND WEALTH A SCORECARD Page 2 CONTENTS 4 EXECUTIVE SUMMARY 6 INTRODUCTION 7 3 MILLION LIVES 9 INTRA-OPERATIVE FLUID MANAGEMENT/OESOPHAGEAL DOPPLER MONITORING 11 CHILD IN A CHAIR IN A
More informationWOLVERHAMPTON CCG. Governing Body Meeting 8 April 2014
WOLVERHAMPTON CCG Governing Body Meeting ` Agenda item:12 TITLE OF REPORT: REPORT PRESENTED BY: Commissioning Committee Summary Dr Kamran Ahmed Title of Report: Update from the Commissioning Committee
More informationIntegrated Care in North Central London
Integrated Care in North Central London 5 th July 2012 Sylvia Kennedy AD Strategy & Planning Strategic context Many of our frailest and sickest groups receive care in a fragmented and disorganised way
More informationOUTLINE PROPOSAL BUSINESS CASE
OUTLINE PROPOSAL BUSINESS CASE Name of proposer: Dr. David Keith Murray, General Practitioner, Leeds Student Medical Practice, 4, Blenheim Court, Blenheim Walk, LEEDS LS2 9AE Date: 20 Aug 2014 Title of
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 informationA Review of Gatekeeping in Medium Secure Services. Dr Paul Gilluley Chair of the Advisory Group
A Review of Gatekeeping in Medium Secure Services Dr Paul Gilluley Chair of the Advisory Group Introduction Background What is the gatekeeping process? What has been done so far? Outcomes so far Possible
More informationImproving Health Services for Carers
Improving Health Services for Carers A carer is someone who, without payment, looks after or provides help and support to somebody who could not manage otherwise due to age, physical or mental illness,
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 informationStrategic Risk Report 12 September 2016
Strategic Report September 20 Haringey CCG Register Introduction The Strategic Report (historically known as the Board Assurance Framework) evidences Haringey Clinical Commissioning Group s control over
More informationThis will activate and empower people to become more confident to manage their own health.
Mid Nottinghamshire Self Care Strategy 2014-2019 Forward The Mid Nottinghamshire Self Care Strategy will be the vehicle which underpins our vision to deliver an increased understanding of and knowledge
More informationDELIVERING THE LEFT SHIFT IN ACUTE ACTIVITY THE COMMUNITY MODEL
DELIVERING THE LEFT SHIFT IN ACUTE ACTIVITY THE COMMUNITY MODEL 1. Introduction The Strategic Outline Case (SOC) and subsequent developing Outline Business Case (OBC) for the reconfiguration of acute hospital
More informationEngagement Summary. North London Partners Urgent and Emergency Care Programme. Camden Barnet Enfield Haringey Islington
Engagement Summary North London Partners Urgent and Emergency Care Programme Camden Barnet Enfield Haringey Islington Introduction This report summarises a year-long programme of engagement undertaken
More informationIntegration learning to support responding to the Parliamentary Review of Health and Social Care in Wales and the delivery of new models of care
Integration learning to support responding to the Parliamentary Review of Health and Social Care in Wales and the delivery of new models of care WelshConfed18 Integration learning to support responding
More informationBusiness Case Advanced Physiotherapy Practitioners in Primary Care
1 Business Case Advanced Physiotherapy Practitioners in Primary Care 1.0 Introduction This scheme supports the sustainability of primary care and the move towards a first line prudent multi-professional
More informationCOPD SERVICE RE-DESIGN
COPD SERVICE RE-DESIGN Dr Mukesh Singh GP Principal & GPwSI Respiratory Medicine, Horse Fair Practice, Rugeley Clinical Lead LTC & Governing Body member Cannock Chase CCG COPD DRIVERS FOR RE-DESIGN DOH
More informationNHS Pathways and Directory of Services
NHS Pathways and Directory of Services Core Narrative Purpose The NHS Pathways and the Directory of Services core narrative has been designed to support NHS communications leads and/or project managers
More informationMEASURING YOUR BLOOD PRESSURE AT HOME
MEASURING YOUR BLOOD PRESSURE AT HOME Helping you to lower your blood pressure BLOOD PRESSURE UK About this booklet This is one of a series of booklets produced by Blood Pressure UK, to help people with
More informationCity and Hackney Clinical Commissioning Group Prospectus May 2013
City and Hackney Clinical Commissioning Group Prospectus May 2013 Foreword We are excited to be finally live as a CCG, picking up our responsibilities as commissioners for the bulk of the NHS. The changeover
More informationStrategy & Business Plan: Executive Summary
Strategy & Business Plan: Executive Summary May 2016 Overview The 2016/17 Strategy and Business Plan puts Yorkshire and Humber Academic Health Science Network at the heart of the sustainability and transformation
More informationSt Helens CCG Financial Recovery Consultation
Background Who are we? St Helens CCG Financial Recovery Consultation St Helens Clinical Commissioning Group (CCG) is the local NHS organisation responsible for planning, organising and buying NHS funded
More informationIncreasing Access to Medicines to Enhance Self Care
Increasing Access to Medicines to Enhance Self Care Position Paper October 2009 Australian Self Medication Industry Inc Executive summary The Australian healthcare system is currently at a crossroads,
More informationMarginal Rate Emergency Threshold. Executive Summary
Part 1 meeting of the Castle Point and Rochford CCG Governing Body held on 29 th September 2016 Agenda item 16 Marginal Rate Emergency Threshold Submitted by: Prepared by: Status: Robert Shaw, Joint Director
More informationMilton Keynes CCG Strategic Plan
Milton Keynes CCG Strategic Plan 2012-2015 Introduction Milton Keynes CCG is responsible for planning the delivery of health care for its population and this document sets out our goals over the next three
More informationSupervising pharmacist independent
Supervising pharmacist independent prescribers in training Summary of responses to the discussion paper Introduction 1. Two of the General Pharmaceutical Council s core activities are setting standards
More informationNHS DORSET CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING FINANCIAL POSITION AS AT 30TH NOVEMBER C Hickson, Head of Management Accounts
NHS DORSET CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING FINANCIAL POSITION AS AT 30TH NOVEMBER 2013 Date of the meeting 15/01/2014 Author Sponsoring GB member Purpose of report Recommendation Resource
More informationSummary report. Primary care
Summary report Primary care www.health.org.uk A review of the effectiveness of primary care-led and its place in the NHS Judith Smith, Nicholas Mays, Jennifer Dixon, Nick Goodwin, Richard Lewis, Siobhan
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 information