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The Journey -

The Somerset Clinical Commissioning Group (SCCG) led the review and redesign of reablement services over the last two years to help improve outcomes for patients.  We worked with local authority colleagues to lead a joint programme to review existing services and implement a redesigned service model based on systems thinking methodology.  We also worked with a range of stakeholders from the NHS, adult social care providers, and independent and voluntary sector organisations.  The programme has been discussed and supported by the Somerset Health and Wellbeing Board. Compass Disability was commissioned to bring together focus groups and develop a questionnaire giving people the opportunity to feedback their experiences of reablement services.  We held extensive stakeholder events with representatives from NHS, adult social care providers, independent and voluntary sector organisations and undertook a ‘deep dive’ exercise to understand what was happening in existing systems. A pilot integrating health and social care teams at one GP surgery has been in place for 18 months.  It has been rolled out to 15 practices in the Taunton and Area GP Federation with plans to phase in the service across the whole of Somerset. A clear message from the service users was: “I want to maintain my independence:  help me to find the solutions to do the things that matter to me”.  The key difference with this model is that we are asking patients what they feel is important to them and what goals they want to achieve.  The teams have flexibility to find solutions centred on these goals.  This is a fundamental shift from the ‘one size fits all’ approach often seen in existing services.  

Outcomes

Improved patient experience and quality of life as care delivered in a more appropriate setting; 1{79f878acaa41f375dcd804cc8c058b5459a5482f20a3b9f87269b26c8734749b} reduction in emergency admissions 7{79f878acaa41f375dcd804cc8c058b5459a5482f20a3b9f87269b26c8734749b} reduction in readmissions   Annual value of savings made 2012/13           £311,000 (Gross) Recurrent 2013/14           £1,659,000 (Gross) Recurrent  

Patient setting

In-patient          X Out-patient Community base     X
Mental health Chronic illness Cross-systems        X

 

Clinical area

Staying healthy Maternity/Newborn Children and young people Acute care    X
Planned care Mental health Long-term conditions   X End of life
 

Information, tools and techniques used 

Project Management Board jointly with Local Authority with Project Manager  

Geography

County wide Somerset Project being rolled out Somerset wide.  Population 550,000  

Timescale

2008 and ongoing April 2012 to March 2013  

Contact details and further information

Ann Anderson Director for Clinical Commissioning Development Ann.anderson@somersetccg.nhs.uk 01935 384190 [post_title] => Reablement - Contract Monitoring QIPP [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => reablement-contract-monitoring-qipp [to_ping] => [pinged] => [post_modified] => 2015-03-24 13:27:31 [post_modified_gmt] => 2015-03-24 13:27:31 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.tvhkt.org.uk/?post_type=improvement-science&p=3711 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [1] => WP_Post Object ( [ID] => 3410 [post_author] => 8 [post_date] => 2013-01-16 15:18:39 [post_date_gmt] => 2013-01-16 15:18:39 [post_content] =>

The journey -

Telehealthcare has been deployed in USA and Australasia for a number of years and after a number of pilots in the UK it is now beginning to be a mainstream option. The Wessex HIEC Partnership has recognised that not all healthcare services are convinced by telehealth/care delivery models.  The ‘Why adopt telehealth and telecare solutions in health and social care’ initiative aims to promote understanding and improve access to information about telehealth/care across the Wessex area.  The initiative will also provide support to organisations that choose to adopt and implement telehealth/care solutions as part of their wider service delivery to patients. The Wessex HIEC has implemented awareness raising activities of the potential of telehealth/care technologies that include: group training sessions and workshops with clinical and managerial staff, the provision of individual consultancy expertise and the production of video and DVDs.  

Outcomes

These results mean that telehealth now has an evidence base on which to grow. The Wessex HIEC programme has been shaping a local support network, links with local telehealth/care suppliers, workforce development materials and more recently, approaches to procurement to improve the local foundations for building telehealth/care solutions.  

Patient setting

In-patient Out-patient Community based
Mental health Chronic illness Cross-systems   X

Clinical area

Staying healthy Maternity and newborn Children and young people Acute care
Planned care Mental health Long-term conditions   X End of life
 

Information, tools and techniques used

This programme started in April 2011 and following a fact finding exercise on the extent of deployment of these technologies in Wessex staged a conference to get input from key local leaders on their issues around implementation of telehealth and telecare.  This conference gave the HIEC a mandate of work areas.  These were: training and education to staff; awareness raising to the public; input on specific areas such as business cases and funding streams; interoperability; and learning from other organisations in the UK and beyond. The HIEC has staged a number of events to address these issues; it has run training courses on specific issues such as how to write a business case on telehealth, where to find funding for adoption and produced a bi-weekly newsletter to share research, conferences, training courses, publications and news.  The Wessex HIEC was commissioned by the Strategic Health Authority to produce a range of training materials to support the roll out of telehealth in the region.  These courses are currently being trialled and will be available as a resource early in 2013. The HIEC has also offered individual consultancy to organisations and undertaken evaluations of services. The WIRES website is helping with the spread of innovation. www.wessexhiecpartnership.org.uk All resources that have been created in this work programme are available on the website. The areas where less progress has been made have been around supporting commercial companies to innovate in the health sector and around interoperability.  These are areas that are being targeted in the specification of the Academic Health Science Network.  

Geography

NHS (Portsmouth to Isle of Wight, down to Poole and up to Winchester), ambulance and university facilities (Portsmouth, Southampton and Bournemouth).  

Timescale

Started April 2011 and ends March 2013  

Contact details and further information

Further details of this and other change programmes managed by Wessex HIEC can be found at http://hiec.wessexhiecpartnership.org.uk

Contact: Katherine Barbour, Faculty of Health Sciences, University of Southampton, k.j.barbour@soton.ac.uk

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The journey -

The Small Business Research Initiative is an innovation challenge to industry. The object of this particular SBRI was to develop technology solutions to help reduce secondary care admissions and deliver new services and products to the NHS. The solution featured here is Message Dynamics’ ‘COPD Monitor’ which uses interactive voice technology to monitor patients’ wellbeing.  It is designed to improve patients’ quality of life, improve disease management, reduce admissions and reduce costs.  

Outcomes

The COPD monitor calls patients twice a week to record their state of health. Between September 2011 and February 2012, almost 1,500 calls were completed (a response rate of 91 per cent). Of these, 13 per cent generated an alert which starts an automatic escalation process. An initial follow up call by the unit’s nurses resolved 80 per cent of issues and the remaining 20 per cent required home visits. These home visits prevented nearly forty emergency admissions (representing a saving of at least £80,000). The investment in this project by the SHA has been £48,775. However, excluding the development cost the cost of the service to deliver this service is £375 – ie 25p per call. The return on investment ratio of this pilot is in excess of 200:1. An unanticipated benefit is that patients like talking to a computer; they do not feel they are wasting people’s time and patients report feeling less isolated. Clinicians are also noting that patients are becoming better equipped to understand and manage their own conditions.  

Patient setting

In-patient   X Out-patient   X Community based   X
Mental health Chronic illness   X Cross-systems   X
 

Clinical area

Staying healthy   X Maternity and newborn Children and young people Acute care   X
Planned care Mental health Long-term conditions    X End of life
 

Information, tools and techniques used

SBRIs start with a ‘problem space’ which can be defined quite closely to respond to a specific issue.  Prince project management underpins the thinking of the programme management team and helps provide a balance between process structure and outcome focus.  

Geography

The programme covers the South Central SHA area.  

Timescale

SBRI was launched in July 2010 and companies were given six weeks to bid. Sixty-nine companies from the UK and overseas responded in September 2010 and in November, Message Dynamics was one of four companies that received funding to take their proposal to a ‘proof of concept’ (POC) by February 2011. The product was adopted in September 2011 and is now offered to all patients referred to the specialist COPD service at Heatherwood and Wexham Park Hospital.  

Contact details and further information

Duncan Goodes, Head of Innovation Promotion: Duncan.Goodes@nesc.nhs.uk [post_title] => Small Business Research Initiative [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => small-business-research-initiative [to_ping] => [pinged] => [post_modified] => 2013-01-16 15:15:37 [post_modified_gmt] => 2013-01-16 15:15:37 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3408 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [3] => WP_Post Object ( [ID] => 3407 [post_author] => 8 [post_date] => 2013-01-16 15:09:54 [post_date_gmt] => 2013-01-16 15:09:54 [post_content] =>

The journey -

This programme aimed to improve quality, reduce spend and increase efficiency inmusculoskeletal (MSK) services in East Sussex. Data on efficiency and spend in MSK services were presented to 70 participants at an event called Shaping the Future, where a number of key issues and possible solutions were identified.  These included high rates of fractures and falls admissions, high rates of arthroscopy and of elective admissions, fragmented MSK services and variation in referral rates. The programme has since focussed on pursuing solutions to these issues, including peer-review by GPs of referrals, agreeing surgical policies for arthroscopy and eight further orthopaedic procedures and introducing physiotherapy triage as an alternative to orthopaedic referral.  In order to achieve change in systems and results, it has been necessary to influence culture and behaviour and seek consensus across a number of systems. Alongside this, an integrated MSK service has been procured in Hastings and Rother and commissioning of a similar service is being considered for the remainder of East Sussex in conjunction with other local commissioners.  

Outcomes

Savings achieved in arthroscopy totalled £1.8million in 2010/11 and a further £600K in 2011/12 Interim outcomes for physiotherapy triage are encouraging, and there is increased interest in MSK from a primary care perspective.  A service specification and business case has been agreed for a Falls and Fracture Liaison service for East Sussex and work is underway to implement Shared Decision Making – critical to ensuring that patients are fully aware and have the option to participate in decisions about their care, particularly where more than one treatment option may be available.  

Patient setting

In-patient  X Out-patient   X Community based   X
Mental health Chronic illness   X Cross-systems   X
 

Clinical area

Staying healthy Maternity and newborn Children and young people Acute care
Planned care  X Mental health Long-term conditions   X End of life
 

Information, tools and techniques used

The programme has used a range of national and regional best practice tweaked for local use. For example, the Framework for Musculoskeletal Services, National Institute of Clinical Excellence, surgical policies from other PCT areas, data from the NHS Atlas of Variation and the South East Public Health observatory.  

Geography

The programme covers East Sussex, including East Sussex Downs and Weald and Hastings and Rother PCTs; in the process of becoming three CCGs in Hastings and Rother; Eastbourne, Hailsham and Seaford; High Weald Lewes and Havens. Partners involved in the work include East Susses Healthcare Trust, The Horder Centre (a private orthopaedic service), Brighton and Sussex University Hospitals and a range of independent physiotherapy, MSK and orthopaedic outpatient services.  

Timescale

The programme started in 2010 and is still ongoing.  

Contact details and further information

Fiona Streeter, Service Development Team Leader, East Sussex: fiona.streeter@nhs.net

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The journey -

The vision of POPP is to build supportive communities to enable older people to remain living in their own homes for as long as they wish by developing responsive, appropriate services and activities at a localised level. Dorset POPP is primarily a partnership between Dorset County Council, NHS Dorset, the Third Sector and older people. However the programme has developed a robust working partnership that extends beyond this and includes a range of other service providers; including Dorset Fire and Rescue, Dorset Police, Libraries, Community Matrons, Community Pharmacies and others. The programme aims to ensure that less is spent on acute care and more emphasis is given to prevention and services designed to keep older people healthy and independent. By co-designing services with communities of older people, solutions are tailored to local needs and delivered by local people, encouraging people to take more responsibility for their own health and well-being, reducing the requirement for acute services.  

Outcomes

All programmes are now monitored against eight desired outcomes and the team has built up a huge body of evidence to illustrate the benefits of POPP. This approach has allowed the programme to demonstrate its impact much more effectively and to garner support for its work; it has received numerous awards for its work. On average, POPP provides services, activities or information to 63,000 people annually. It sees its central achievements as the engagement and empowerment of older people and the rebalancing of services from disease to health.  

Patient setting

In-patient Out-patient Community based   X
Mental health Chronic illness Cross-systems   X
 

Clinical area

Staying healthy  X Maternity and newborn Children and young people Acute care
Planned care Mental health Long-term conditions   X End of life
 

Information, tools and techniques used

No specific change tools were used during the project.  Instead, there was a pragmatic approach to delivery within the confines of the vision.  

Geography

The programme extended across Dorset.  

Timescale

The main implementation phase of the programme was from 2006-2008.  From 2008 to date it has continued to provide and develop its services.  

Contact details and further information

Sue Warr, Strategic Commissioning Manager and Programme Manager for, Dorset POPP email:-  sue.warr@dorsetcc.gov.uk

[post_title] => Partnership for Older People Programme (POPP) [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => partnership-for-older-people-programme-popp [to_ping] => [pinged] => [post_modified] => 2013-01-16 15:07:06 [post_modified_gmt] => 2013-01-16 15:07:06 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3406 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) ) [post_count] => 5 [current_post] => -1 [in_the_loop] => [post] => WP_Post Object ( [ID] => 3711 [post_author] => 8 [post_date] => 2013-03-27 15:11:05 [post_date_gmt] => 2013-03-27 15:11:05 [post_content] =>

The Journey -

The Somerset Clinical Commissioning Group (SCCG) led the review and redesign of reablement services over the last two years to help improve outcomes for patients.  We worked with local authority colleagues to lead a joint programme to review existing services and implement a redesigned service model based on systems thinking methodology.  We also worked with a range of stakeholders from the NHS, adult social care providers, and independent and voluntary sector organisations.  The programme has been discussed and supported by the Somerset Health and Wellbeing Board. Compass Disability was commissioned to bring together focus groups and develop a questionnaire giving people the opportunity to feedback their experiences of reablement services.  We held extensive stakeholder events with representatives from NHS, adult social care providers, independent and voluntary sector organisations and undertook a ‘deep dive’ exercise to understand what was happening in existing systems. A pilot integrating health and social care teams at one GP surgery has been in place for 18 months.  It has been rolled out to 15 practices in the Taunton and Area GP Federation with plans to phase in the service across the whole of Somerset. A clear message from the service users was: “I want to maintain my independence:  help me to find the solutions to do the things that matter to me”.  The key difference with this model is that we are asking patients what they feel is important to them and what goals they want to achieve.  The teams have flexibility to find solutions centred on these goals.  This is a fundamental shift from the ‘one size fits all’ approach often seen in existing services.  

Outcomes

Improved patient experience and quality of life as care delivered in a more appropriate setting; 1{79f878acaa41f375dcd804cc8c058b5459a5482f20a3b9f87269b26c8734749b} reduction in emergency admissions 7{79f878acaa41f375dcd804cc8c058b5459a5482f20a3b9f87269b26c8734749b} reduction in readmissions   Annual value of savings made 2012/13           £311,000 (Gross) Recurrent 2013/14           £1,659,000 (Gross) Recurrent  

Patient setting

In-patient          X Out-patient Community base     X
Mental health Chronic illness Cross-systems        X

 

Clinical area

Staying healthy Maternity/Newborn Children and young people Acute care    X
Planned care Mental health Long-term conditions   X End of life
 

Information, tools and techniques used 

Project Management Board jointly with Local Authority with Project Manager  

Geography

County wide Somerset Project being rolled out Somerset wide.  Population 550,000  

Timescale

2008 and ongoing April 2012 to March 2013  

Contact details and further information

Ann Anderson Director for Clinical Commissioning Development Ann.anderson@somersetccg.nhs.uk 01935 384190 [post_title] => Reablement - Contract Monitoring QIPP [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => reablement-contract-monitoring-qipp [to_ping] => [pinged] => [post_modified] => 2015-03-24 13:27:31 [post_modified_gmt] => 2015-03-24 13:27:31 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.tvhkt.org.uk/?post_type=improvement-science&p=3711 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [comment_count] => 0 [current_comment] => -1 [found_posts] => 19 [max_num_pages] => 4 [max_num_comment_pages] => 0 [is_single] => [is_preview] => [is_page] => [is_archive] => 1 [is_date] => [is_year] => [is_month] => [is_day] => [is_time] => [is_author] => [is_category] => [is_tag] => [is_tax] => 1 [is_search] => [is_feed] => [is_comment_feed] => [is_trackback] => [is_home] => [is_privacy_policy] => [is_404] => [is_embed] => [is_paged] => [is_admin] => [is_attachment] => [is_singular] => [is_robots] => [is_favicon] => [is_posts_page] => [is_post_type_archive] => [query_vars_hash:WP_Query:private] => d59683feb845e454168ad16d35905f2e [query_vars_changed:WP_Query:private] => [thumbnails_cached] => [stopwords:WP_Query:private] => [compat_fields:WP_Query:private] => Array ( [0] => query_vars_hash [1] => query_vars_changed ) [compat_methods:WP_Query:private] => Array ( [0] => init_query_flags [1] => parse_tax_query ) ) [1] => derp )

Category: Long-term conditions

Reablement – Contract Monitoring QIPP

The Journey – The Somerset Clinical Commissioning Group (SCCG) led the review and redesign of reablement services over the last two years to help improve outcomes for patients.  We worked with local authority colleagues to lead a joint programme to review existing services and implement a redesigned service model based on systems thinking methodology.  We […]

Posted on Mar 27th Cat: , , , , , Comments: Comments are off for this post

Wessex HIEC Telehealthcare programme

The journey – Telehealthcare has been deployed in USA and Australasia for a number of years and after a number of pilots in the UK it is now beginning to be a mainstream option. The Wessex HIEC Partnership has recognised that not all healthcare services are convinced by telehealth/care delivery models.  The ‘Why adopt telehealth […]

Posted on Jan 16th Cat: , , Comments: Comments are off for this post

Small Business Research Initiative

The journey – The Small Business Research Initiative is an innovation challenge to industry. The object of this particular SBRI was to develop technology solutions to help reduce secondary care admissions and deliver new services and products to the NHS. The solution featured here is Message Dynamics’ ‘COPD Monitor’ which uses interactive voice technology to […]

Posted on Jan 16th Cat: , , , , , , , , Tags: Comments: Comments are off for this post

Reducing spend and increasing efficiency in MSK services

The journey – This programme aimed to improve quality, reduce spend and increase efficiency inmusculoskeletal (MSK) services in East Sussex. Data on efficiency and spend in MSK services were presented to 70 participants at an event called Shaping the Future, where a number of key issues and possible solutions were identified.  These included high rates […]

Posted on Jan 16th Cat: , , , , , , , Comments: Comments are off for this post

Partnership for Older People Programme (POPP)

The journey – The vision of POPP is to build supportive communities to enable older people to remain living in their own homes for as long as they wish by developing responsive, appropriate services and activities at a localised level. Dorset POPP is primarily a partnership between Dorset County Council, NHS Dorset, the Third Sector […]

Posted on Jan 16th Cat: , , , , Comments: Comments are off for this post