Local practice Case Studies
The NHS South West Quality and Patient Safety Improvement Programme
The project is a regional collaboration of South West hospital NHS trusts to improve patient outcomes by using a best practice model for improvement to implement a series of care bundles.
The project focused on five workstreams:
• Critical Care
• General Ward
• Medicines Management
Devon Access and Referral Team
DART (Devon Access & Referral Team) was set up in April 2010 as a NHS Devon wide referral management service with the aim to support the quality and consistency of Devon referrals, ensuring the patient has a smooth pathway into the correct service.
Inpatient to Community Services
A review and rationalisation of inpatient and community
mental health services for adults across Devon.
Improving Asthma Management in Bristol
To improve asthma management in Bristol through:
• Improving healthcare professionals and patients’ knowledge of asthma
• Improving patient access to advice and asthma medication reviews
• More cost-effective prescribing
• Better management of inhaler devices and improved patients’ use of inhalers
• Targeting resources at areas of high risk e.g. areas of deprivation, ethnic minority groups.
My Way to Health
During 2009 and into 2010, the Primary Care Trust has been working with local people with a learning disability to improve access to all health services, but also to focus on improving discharge planning from local acute hospitals. There are 2,189 people with a learning disability in Cornwall.
The Telehealth service in Cornwall was initially a Whole System Demonstrator and was the largest trial of Assistive Technology of its kind in the world. The system allows patients to take daily biometric readings, such as blood pressure and pulse oximetry, at home. These are then transmitted to a clinician for monitoring. Appropriate action can then be quickly taken if there are signs of deterioration or a change in the patients’ condition.
The project is being nationally evaluated, with the results due in Spring 2011.
Developing the clinical service line for stroke care for Plymouth
It was recognised that there was a need for fundamental improvements to the Stroke Pathway in the Plymouth Health Community.
This was a strategic aim of NHS Plymouth, but was also a high level target initiative following the publication of the National Stroke Strategy in December 2007, and the independent review into stroke services commissioned by the SHA in July 2008.
A clinical service line for stroke was agreed as a concept in January 2009 and formally launched in April 2009, to coordinate the development of stroke services with the two healthcare providers Plymouth Hospitals NHS Trust and Plymouth Primary Care Trust provider arm.
Somerset Community COPD Service
Research by the NHS Institute for Innovation and Improvement showed a potential 20 per cent reduction in emergency admissions for people with chronic obstructive pulmonary disease when comprehensive community services were in place.
NHS Somerset redesigned community COPD services with full involvement from patients, carers and professionals.
The service is the first in the country to deliver a comprehensive community COPD service designed around the needs of the patient and delivered through a partnership between the public and private sector.
Intravenous Antibiotics Service
The Intravenous Antibiotics Service was the first community based IV service in the South West when it was launched.
Initially, a few patients were being seen by the Intermediate Care Team if capacity was available.
The Primary Care Trust was aware that other areas of the country had established IV services through separate specialist teams and wanted to provide a robust service embedded within community nursing. This will enable community nurses to provide holistic care to their patients, including Intravenous Antibiotic therapy as an additional treatment option to support patients to remain in their own homes.
Transforming the role of the Community Matron through the implementation of the Virtual Ward
An opportunity was identified to refocus the role of the Community Matrons in NHS Swindon in order to:
• Provide more intensive multi-disciplinary care management of specifically identified high intensity users
• Improve the quality and consistency of care for these patients
• Reduce readmission to hospital where appropriate
• Develop the virtual ward concept using the community matrons as the orchestrator of care.
The very high intensive user project was launched to pilot an integrated model of care across primary care and the Community Matrons. The project was led by the Practice Based Commissioning GP across one of the three localities.
The project was launched in January 2010 and the implementation was phased over three months with plans to roll out across all three integrated teams within nine months.
Neighbourhood Teams are a new way of delivering communitybased health services in Wiltshire.
The 11 multi-disciplinary teams consist of nursing, therapy and support staff, co-located with social care staff, who together provide care for patients and service users, seven days a week.
By providing modern, responsive, accessible health and care for patients – normally in their own homes and certainly within their community areas – the teams have reduced inpatient hospital stays and enabled many people to maintain their independence and to enjoy a better quality of life for longer.
Colorectal – faster diagnosis and access to treatment for bowel cancer patients
Bowel cancer is the third most common cause of cancerrelated death in the UK. Around 100 new cases of bowel cancer are diagnosed each day in the UK and the vast majority present on a symptomatic basis. The importance of symptoms or collection of symptoms can be difficult to assess and the scheme sought to deliver faster access to treatment for patients with suspected bowel cancer and to improve the speed and accuracy of bowel cancer diagnosis.
Enhanced Recovery Innovation Site
Torbay Hospital – working in collaboration with its health communities and other local NHS services – has become an Innovation site for the Department of Health’s Enhanced Recovery Partnership Programme.
The programme is designed to extend learning and best practice from the few hospitals which already offer enhanced recovery, or are introducing it, to other NHS hospitals.
As an Innovation Site, Torbay Hospital is helping build evidence on how effective enhanced recovery methods can be, helping patients to get better sooner after surgery.