nhs southern derbyshire clinical commissioning group southern derbyshire ccg quality improvement...

NHS Southern Derbyshire Clinical Commissioning Group

Southern Derbyshire CCGQuality Improvement CQUIN

& other AKI stories

Sally Bassett SDCCG AKI Pathfinder Project

Manager

NHS Southern Derbyshire Clinical Commissioning Group

Why SDCCG got involved

• AKI impacts pathways across commissioning• Drive to improve quality & patient safety• NCEPOD report ‘Adding Insult to Injury’ • Chief Nurse & Deputy commitment & lead • CCG Board sign up: Patient Story & briefings

NHS Southern Derbyshire Clinical Commissioning Group

SDCCG• 57 local general practices• CCG is Derby City, and the

southern part of Derbyshire County covering Amber Valley, South Dales and South Derbyshire.

• Commission health services on behalf of over 525,000 patients

• Vision - continuously improve the health and wellbeing of the people of Southern Derbyshire, using all resources as fairly as possible

• Think Kidneys- a fall in the number of preventable episodes of AKI & a reduction in deaths associated with AKI

NHS Southern Derbyshire Clinical Commissioning Group

Commissioning tools

• CQUIN – quality & innovation• Locally Commissioned Service Framework for

Primary Care• National standard contract for providers –

community, Mental health, EMAS, acute etc• Contract levers & penalties consistent• Consistent quality schedules• Prescribed monitoring arrangements• Exploring Care Homes sector

NHS Southern Derbyshire Clinical Commissioning Group

AKI CQUIN 2014 -16• Agreed CQUIN worth £1,045,746 • Year 1 focus on Risk Assessments & Discharge Summaries• Year 2 Acute Kidney Injury risk assessments • 1a - all adult emergency admissions risk assessed within 24 hours of

admission & interventionsMedicines ReconciliationMedicines Optimisation Daily U&E’s

• 1b - AKI Discharge summaries • Discharge summaries that are sent to GPs to include:Stage of AKI Type and frequency of blood tests required Relevant prescribing advice (NICE guidance)

NHS Southern Derbyshire Clinical Commissioning Group

Primary Care

Locally Commissioned Service Framework (LCSF)

• Year 1 Baseline survey undertaken by clinical staff, 500 responded with peer review activity follow up - – Programme of Academic detailing & education/awareness – Quality Forum, Meds Management, Community etc– Evaluation framework – building on GP survey & Academic detailing

• Year 2 negotiating Survey 2 & extending to build work into Care Home alignment work e.g. GP

led peer review sessions in Care Homes Continued support and awareness raising

NHS Southern Derbyshire Clinical Commissioning Group

Developing resources

Policies, Procedures & Guidelines on AKI guidelines to support care planning on discharge

Shared Care Pathology PC guidance for PCSick Day RulesRead codes approved

NHS Southern Derbyshire Clinical Commissioning Group

AKI in Care Homes

Care Home Advisory Service • Power training for key trainers is visual,

motivational, empowering• C 160 homes• Think Kidney Champs• Launch days November• Resource packs• Evaluation

NHS Southern Derbyshire Clinical Commissioning Group

Lessons Learnt

Senior Leadership vital Can-do attitudes & pace Ambition & innovation to improve care Patient voice Strong team committed to a shared vision Contractual levers

NHS Southern Derbyshire Clinical Commissioning Group

Contact Details

Sally Bassett - sally.bassett@southernderbyshireccg.nhs.uk

https://www.thinkkidneys.nhs.uk/wp-content/uploads/2015/07/Southern-Derbyshire-Case-Study-Two-Perspectives-on-a-New-Approach-to-AKI.pdf