annual...the rt. hon. ed miliband mp met patients and staff at montagu hospital in mexborough, july...
TRANSCRIPT
2014/2015
ANNUAL
We Care
South Yorkshire and Bassetlaw Abdominal Aortic Aneurysm Screening Programme
REPORT
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ContentsForeword 1. Introduction 1.1 WhatisanAbdominalAorticAneurysm? 1.2 SouthYorkshireandBassetlaw 1.3 SouthYorkshireandBassetlawAbdominalAortic AneurysmScreeningProgramme
2. Strategic Direction 2.1 Aims 2.2 Strategy
3. Programme Delivery 3.1 Clinics 3.2 ProgrammeTeam 3.3 ContactDetails
4. Screening Pathway 4.1 Identification 4.2 Invitation 4.3 Inform 4.4 Test 4.5 Surveillance 4.6 Diagnose 4.7 TreatmentandIntervention 4.8 Monitor
5. Programme Performance 5.1HeadlineStatistics 5.2 Data
6. Stakeholder Engagement 6.1 EqualityandEquity 6.2 CommunityandServiceUserEngagement 6.3 HealthProfessionals 6.4 Media 6.5 Significantothers
7. Key Achievements
8. Future Developments
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Section1Foreword ThisreporthighlightstheachievementstodateoftheSouthYorkshireandBassetlawAbdominalAorticAneurysmScreeningProgramme(SYBAAA)andnotesthehighqualityofservicesthathashithertobeenachieved.TheSYBAAAScreeningProgrammehashadasuccessfulyearthroughinnovativeservicedeliveryandhasachievedveryhighpublicsatisfactionratings.
TheprogrammeworksinclosepartnershipwithbothproviderunitsinSouthYorkshireandBassetlawthusenablingeffectivetreatmentofthosewhoseaneurysmshavebeendetectedthroughscreening.
TheSouthYorkshireandBassetlawScreeningTeamisawellknitfocusedandenthusiasticteamwhoseeffortshavecontributedtomaketheSouthYorkshireandBassetlawProgrammeoneofthebestinthecountry.
R J Cuschieri MD,CHM,MEdFRCS
ConsultantVascularSurgeonClinicalDirectorSYBAAA
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Introduction ThisisthefirstAnnualReportoftheSouthYorkshireandBassetlawAbdominalAorticAneurysm(AAA)ScreeningProgramme.Thereportdetailsprogrammeperformanceforthe2014/15screeningyear.Itoutlineskeyachievementsandhighlightshowcurrentactivityandfuturedevelopementswillmaintainthehighstandardofservicedelivery,encouragealleligiblementoattendtobescreenedandcontinuetoworktoremovebarrierstotheuptakeofscreening.
FollowingconsiderationoftherequirementtoreducethenumberofdeathsfromrupturedaorticaneurysmstheUKNationalScreeningCommitteeapprovedtheintroductionoftheNHSAbdominalAorticAneurysmScreeningProgramme(NAAASP).Establishedin2009,thephasedrolloutacrossEnglandwascompletedin2013.TheSYBAAAScreeningProgramme,whichhelditsfirstscreeningclinicinSheffieldon25February2013,representsoneofthefinalprogrammesinEnglandtosuccessfullyimplementthenationalprogramme.
Therearecurrently41localscreeningprogrammesofferingAAAscreeningtomenaged65andoverresidinginEngland.NAAASPalsoworksincollaborationwiththeAAAscreeningprogrammesinWales,ScotlandandNorthernIrelandensuringequityofaccessforAAAscreeningformenthroughouttheUK.
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1.1 What is an Abdominal Aortic Aneurysm?
Anabdominalaorticaneurysm(AAA)isaswellingoftheabdominalaorta.AAAscreeningisaprocessofidentifyingmenwhoappearhealthybutmaybeatriskofhavinganAAA.Aneurysmsintheabdominalsectionoftheaortadevelopmostcommonlyinmenaged65andolder,arepredominantlyasymptomaticandareoftenonlydetectedincidentallyinthecourseofinvestigationsforoftenunrelatedconditions.Thereareanumberofassociatedriskfactorsincludingsmoking,highbloodpressureandhighbloodcholesterol.Havingacloserelativewhohad,orhas,anAAAalsoincreasestheriskofdevelopinganAAA.
LargeAAAs,over5.5cmindiameter,arelesscommon,butastheycarryanincreasedriskofrupturetheycanbeserious.IntheUKrupturedAAAaccountsfor2.1percentofalldeathsinmenaged65andover,withalmostathirdofthesedyinginthecommunitybeforereachinghospital.
Incontrast,throughscreeningandearlydetection,treatmentcanbeofferedatanearlierstage.Opensurgeryorendovascularrepairsurgeryarethetwomostcommontreatmentstorepairlargeaneurysmsandwhenofferedinhighqualityvascularcentresresultinmorethan98percentofpatientssurvivingrepairsurgery.
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1.2 South Yorkshire and Bassetlaw
DoncasterandBassetlawHospitalsNHSFoundationTrustisthelocalprovideroftheSouthYorkshireandBassetlawAAAScreeningProgramme.ComprisedoffiveClinicalCommissioningGroups(CCG’s)theprogrammecoversthelargedemographicareaof:
•Barnsley
•Bassetlaw
•Doncaster
•Rotherham
•Sheffield
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risk factors including smoking, high blood pressure and high blood cholesterol. Having a close relative who had, or has, an AAA also increases the risk of developing an AAA. Large AAAs, over 5.5cm in diameter, are less common, but as they carry an increased risk of rupture they can be serious. In the UK ruptured AAA accounts for 2.1% of all deaths in men aged 65, with almost a third of these dying in the community before reaching hospital. In contrast, through screening and early detection treatment can be offered at an earlier stage. Open surgery or endovascular repair surgery are the two most common treatments to repair large aneurysms and when offered in high quality vascular centres result in more than 98% of patients surviving repair surgery. 1.2 South Yorkshire and Bassetlaw Doncaster and Bassetlaw Hospitals NHS Foundation Trust are the local providers of the South Yorkshire and Bassetlaw AAA Screening Programme. Comprised of five clinical commissioning groups (CCG’s) the programme covers a large demographic area which is:
• Barnsley • Bassetlaw • Doncaster • Rotherham • Sheffield
Image 2: Map of South Yorkshire
Source – bing.com/images (GRAPHICS TO ADVISE IF TO INCLUDE SOURCE)
Source–bing.com/images
MapofSouthYorkshire
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MapofBassetlaw
Source–bing.com/images
Source bing.com/images
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1.3 South Yorkshire and Bassetlaw Abdominal Aortic Aneurysm Screening Programme
TheSouthYorkshireandBassetlawAbdominalAorticAneurysmScreeningProgrammeiscoordinatedandmanagedviaacentrallylocatedscreeningofficesituatedatMontaguHospital,Mexborough,S640AZ.Followingitssuccessfullaunchin2013theprogrammewasoneoftwoservicesatMontaguHospitalvisitedbytheRt.Hon.EdMiliband,theDoncasterNorthMP,tofindouthownewserviceswithinhisconstituencyweresettotransformthehealthofpeopleinSouthYorkshireandBassetlaw.
TheRt.Hon.EdMilibandMPmetpatientsandstaffatMontaguHospitalinMexborough,July2013
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Section2StrategicDirection
2.1 Aim and Mission Statement
ThegoaloftheSYBAAAScreeningProgrammeistoperformwithinthetop10percentnationallyinourcategory.Weplantoachievethisaimbyprovidinghighquality,comprehensivesystematicscreening,surveillanceandvascularreferraltotheeligiblepopulation.Indoingthiswe:
Aspire to Always be the best in delivering Accurate equitable treatment
Specificallywewill:
•PromoteAAAscreeningacrossSouthYorkshireandBassetlaw
•Increaseuptakeofscreeningappointments
•Increasethenumberofself-referralserviceusers
•Reducethenumberofclientswhodonotattendforscreening
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SouthYorkshireandBassetlawAAAStrategicMap
2.2 Strategy
TheservicehasafirmstrategicdirectionwhichisclearlyarticulatedintheSYBAAAStrategicMap.ThemissionandgoalsarealignedtothestrategicdirectionofDoncasterandBassetlawHospitalsNHSFoundationTrust,theaimoftheNAAASPandtheNHSoutcomedomainsforimprovinghealthoutcomesandimprovingquality.
South Yorkshire and Bassetlaw Abdominal Aortic Aneurysm Screening:Strategy 2016 - 2019
Darnall Health Centre2 York Road
SheffieldS9 5DH
QualityAssurance
The SYBAAA Screening Programme aim to be within the top 10 per cent nationally. Achieved by delivering high quality, consistent, comprehensive, systematic screening, surveillance and vascular
referral to the eligible population.
Aspire to be the best in Always delivering Accurate, equitable treatment
In responseto incident root cause analysis
activate quality assurance action
plan
Quality Performance
QualityStandards
and Service Objectives
Robust complianceto NAAASP
standards and objectives
Development
NationalPolicy
Changes
Timelyimplementation
of national policy
changes
Addressing healthinequalities
Eligible Screening
Population
Ensure needs are
reflected for coverage and
uptake
Staff
Serviceappropriate
recruitment tooptimise staff
retention
NationalMetrics/
KPI’s
Timely submission
of outpatient andreferral data
Staff
Raise the profileof the
programmelocally and nationally.
Identificationand Invitation
Monitoridentification in compliance with
national data. Ensureformat and language
Failsafes
Included, implemented and
functioning.Responsive to QA
action plans
SIAG
Timelysubmission of
local and national
reporting
Innovation
Develop in linewith best
practice. Use technology to
improve uptake
Championslocally andnationally
Strategically liaisewith AAA
communicationsto optimise
service promotion.Annual Report
Engagement
Escalate complaints,
embed in QAaction plan.
Bi annualpatient
satisfaction survey
RegionalNetworking
Meeting
Benchmarksperformance
regionally.Network for best
practice
Technology
Equipmentup to date,
quality assuredand electrically
safe
GovernancesupportingEquity anddiversity
Monitor and evaluate diversity of population at
quarterlyintervals
The NHS AAA Screening Programme aims to reduce AAA-related mortality by providing asystematic population-based screening programme for the male population during
their 65th year, and on request, for men over 65
S711TH
Iden
tity
Invi
te In
form
Test
Sur
veill
ance
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Section3ProgrammeDelivery
3.1 Clinics
ProvidingwidespreadaccessacrossSouthYorkshireandBassetlaw,thereare35screeningclinicsiteswithinthefiveCCGcohortboundaries.Thisincludesprovisionatthefollowingtypesofpremises:
•GPpractices
•LIFTbuildings
•Localcommunity hospitals
Tabletoshowavailablescreeningclinicsitevenues
AbdominalAorticAneurysm(AAA)screening
Barnsley Bassetlaw Doncaster Rotherham Sheffield
Hill Brow SurgeryLongCroftMapplewell
BarnsleyS756FH
Bassetlaw DistrictHospitalBlythRoad
WorksopS810BD
Bentley Surgery128HighStreet
BentleyDoncasterDN50AT
Aston Customer Services
WorksopRoadSwallownestS264WD
Baslow Road Surgery148BaslowRoadTotley
SheffieldS174DR
Park Grove Medical Centre
124-126ParkGroveBarnsleyS701QE
Harworth Medical Centre
104ScroobyRoadBircotesDoncaster
DN118JT
ConisboroughMedical CentreTheStoneCastle
CentreGardensLaneConisboroughDN123JW
CliftonMedical CentreDoncasterGateRotherhamS651DA
Crystal PeaksMedical Centre15PeaksMount
SheffieldS207HZ
RoundhouseMedicalCentreWakefieldRoad
AthersleyBarnsleyS711TH
Retford HospitalNorthRoadRetford
DN227XF
Montagu HospitalAdwickRoadMexboroughS640AZ
Maltby Joint Services CentreBraithwellRoad
MaltbyRotherhanS668AB
Darnall Health Centre2YorkRoadSheffieldS95DH
The cudworth centreCarlton Street Cusworth
BarnsleyS728SU
Sandringham Road Health
SandringhamRoadIntake
DoncasterDN25JH
Northern RoadSurgery
2MorthenRoadWickersley
RotherhamS661EU
Dovercourt Surgery3SkyeEdgeAvenueSheffieldS25FX
The Flying Scotsman Centre
StSepulchreGateWestDoncasterDN13AP
Ravenfield Surgery8HollingsRoadRavenfield
RotherhamS654PU
High Green SurgeryThompsonHillHighGreen
SheffieldS354NF
The White Wings Centre
SpaPoolRoadAskern
DoncasterDN60HZ
Rawmarsh Joint Services
CentreBarbersAvenue
RawmarshS626AE
RichmondRoad Surgery400Richmond
RoadSheffieldS138LZ
Tickhill Road HospitalTickhill RoadDoncasterDN48QN
Rotherham Community Health
CentreGreasboroughRoadRotherhamS601RY
Sheffield City GP Medical Centre
RockinghamHouseBroadLane
SheffieldS14BT
Vermuyden Centre32 FieldsideThorne
DoncasterDN84BQ
New York StadiumNewYorkWayRotherham
S60 1AH
Tramways Medical Centre
54 Holme LaneSheffieldS64JQ
The Health Bus
various sites available
Kiveton Park Primary Care
ChapelWay,KivertonParkS266QU
Valley Medical Centre JohnsonStreetStocksbridgeSheffieldS361BX
Dinnington GroupPractice
NewStreetDinningtonS252EZ
Wincobank Medical Centre
205TylerStreetSheffieldS91DJ
South Yorkshire and
Bassetlaw AAA Screening
ProgrammeClinical Venues
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Widespreadprovisionthroughthe35sitesisenhancedbytheuniquelocalinitiativeofamobileclinicdeliveredonthe“HealthBus”,allowingtheservicetoprovideclinicswithin:
•WorkingMen’sClubs
•LocalCommunityCentres
•GolfClubs
TheSouthYorkshireandBassetlawAbdominalAorticAneurysmScreening“HealthBus”
AAAsceeningisofferedanddeliveredtoeligiblemenatlocalprisonsandplacesofdetentionthankstoexcellentliaisonwithhealthcareandadministrativestaffatthecentres.
3.2 Programme Team Theserviceisprovidedbyahighlymotivatedmulti-disciplinaryteamofclinicalandadministrativestaff.Theirdedicatedworkiskeytothelocalprovisionofahighquality,safe,effectiveservice.
IncompliancewithNAAASPrecommendationsallclinicalstaffpossess,asaminimum,thefollowingqualificationandcompetenciesandundertakethemandatorytrainingwithinthenationalframework:
•NAAASPapprovedtrainingandaccreditationcourseforscreeningtechnicians
•NAAASPapproved‘FastTrack’trainingandaccreditationcoursefortheClinicalSkills,TrainerandNursepractitioner
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TheTeam:
MrRayCushieri HelenMcAlinney AAAClinicalDirector Screening ConsultantVascularSurgeon ProgrammeCo-ordinator
PamelaHinchliffe SarahPantry Screening AAAScreening ProgrammeAdministrator Technician
SimonLindley Amanda Ford AAAScreening AAAScreeningTechnician Technician
LouiseWalters LyndseyMcCabe AAAClinicalSkillsTrainer NursePractitioner AAAScreeningTechnician
RachelLambert NicolaWilkinson NursePractitioner TraineeAAA ScreeningTechnician
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3.3 Contact Details
Theprogrammecanbecontactedbytelephone,email,SMStextorbypost.
South Yorkshire and Bassetlaw AAA Screening Programnme MontaguHospital,AdwickRoad Mexborough SouthYorkshire. S640AZ Tel:01709649100 Mobile:07771388783 Email:[email protected] Website:aaa.screening.nhs.uk
Section4ScreeningPathwayAbidingbytheNHSPublicHealthFunctionspecification,theserviceandscreeningpathwayprovidedbySYBAAAScreeningProgrammeisdividedintotheeightfollowingstages:
4.1 Identification
Thecohortdetailsofmenwhowillbe65withinthecohortyear1Aprilto31MarchareuploadedannuallyviatheScreeningManagementandRecallTracking(SMaRT)database,theNAAASPapproveddatabaseformanagingcallandrecallofAAAscreeningandsurveillanceclients.Thecohortdetailsarerestrictedtoclientname,dateofbirth,NHSnumber,residentialCCGandaddressplusgeneralpractitionerCCGandaddress.
4.2 Invitation
ComplyingwithNAAASPspecifiedstandardsSYBAAAScreeningProgrammegeneratesandpostsoutinvitationlettersthreeweeksbeforetheclinicappointmentdate.
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4.3 Inform
Theinformationprovidedintheappointmentletterisprovidedinavarietyofformatsincluding:
•Paperformat
•Electronicformat
•Otherlanguagesonrequest.
•Easyreadformat
ClientsarealsosignpostedtocontacttheSYBAAAscreeningofficeshouldtheyrequirefurtherinformationortoaccesstheUKNationalScreeningCommitteedecisionaidatthefollowingwebaddresshttp://sdm.rightcare.nhs.uk/pda/aaa-screening
4.4 Test Uponarrivalattheclinicmenaremetbyascreeningtechnicianwhowillexplainthescreeningprocess,possibleoutcomes,benefitsandanyrisks.Thetechnicianwillalsoaskfortheman’sconsentforthescreeningandforhispersonalinformationtoberetainedbyNAAASPforthepurposeofprogrammeevaluation,auditandresearch.Themanisofferedtheopportunitytoaskanyquestions.
Asimpleultrasoundscanisthencarriedoutwhichproducesanimageoftheabdomenenablingthetechniciantomeasurethewidthoftheaorta.Themeasurementistakenatthewidestpointandrecordedinpaperandelectronicform.
4.3.1.ScreeningOutcomesMenreceiveverbalandwrittenconfirmationoftheirresultatthescreeningclinic.TheirGPisthensentaletterconfirmingtheresult.
Therearefivepossibleoutcomestothescanasfollows:• Normal:theaortameasureslessthan3cmandisnotenlarged,meaningthereisnoaneurysm.Notreatmentormonitoringisrequired,themanwillbeinformedheisdischargedfromscreeningandwillreceivenofurtherinvitationsforscreening.
• Small aneurysm:theaortameasuresbetween3cmand4.4cm.Anymanwithasmall aneurysmisinvitedbackforscanseverytwelvemonthsformonitoring.
• Medium aneurysm:theaortameasuresbetween4.5cmand5.4cm.Menwhoarefoundtohavea mediumaneurysmareinvitedbackeverythreemonthstomonitorthesize.
• Large aneurysm:theaortameasures5.5cmorabove.Thesemenarereferredtoavascularsurgeon forfurtherinvestigationandtodiscusspossibletreatmentwhichisusuallyanoperation.
• Non visualisation:theaortacouldnotbevisualisedatthescreeningattendance.Themanwillbeinvitedtore-attendforanotherappointmentorreferredtoaMedicalImaging departmentforfurtherimaging.
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4.5 Surveillance
Anymanwithascreendetectedsmallormediumaneurysmisinvitedbackforsurveillanceappointmentsasfollows:
•Small(3.0–4.4cm)aneurysmwillbeinvitedforannualsurveillancescans
•Medium(4.5–5.4cm)aneurysmwillbeinvitedforquarterlysurveillancescansatthreemonthly intervals
WhenasmallormediumAAAisdiagnosedmenarealsoofferedahealthpromotionfollow-upappointmentwithoneofSYBAAANursePractitioners.Theseareofferedasafacetofacediscussion.Theappointmentcovers:
•Height
•Weight
•BMI
•Smoking
•Medications–Statins/Aspirins
•Exercise
•AnyConcerns–3monthfollow-upwhererequested
ThemanandhisGPreceiveawrittensummary.
4.6 Diagnose
DetectionofalargeaneurysmtriggerspatientreferraltoaNAAASPapprovedvascularunitforconfirmationofthediagnosisandconsiderationoftreatmentoptions.
MenfromSYBAAAScreeningProgrammearereferredtooneoftwovascularreferralcentres,theyare:
•DoncasterVascularCentre(DVC),DoncasterandBassetlawNHSFoundationTrust
•SheffieldVascularInstitute(SVI),SheffieldTeachingHospitalsNHSFoundationTrust
SYBAAAScreeningProgrammeacknowledgesclientchoiceanddoesnotinfluencethereferralpathway.
Allmenreferredtoavascularunitmustbeseenbyavascularsurgeonwithintwoweeksofthereferralbeingmade.
Thevascularsurgeonthentakesoverthemanagementoftheman’streatmentoftenschedulingfurtherdiagnostictestsandofferingeitherfurthersurveillanceortreatment,whichiseithersurgicalorendovascular.
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Ifafurtherdiagnostictestatthevascularunitshowstheaneurysmtobelessthan5.5cmindiameter,orthepatientisunfitforsurgery,continuedfollowupisarrangedunderthecareofthevascularsurgeon,notthescreeningprogramme.
4.7 Treatment and Intervention
ClinicaldecisionsfortreatmentandinterventionaremadebytheVascularTeam.
4.8 Monitor
SYBAAAScreeningProgrammemonitorsthevascularservicemanagementofreferredclientstoestablishwhethermanagementtimeframescomplywithNAAASPservicespecifications.Thisincludesmonitoringtoensurethat:
•AttendanceataVascularoutpatientappointmentwithin 2 weeks of screen detection has been undertaken.
•Ifclinicallyappropriatesurgicalinterventionisundertakenwithin 8 weeks of screen detection.
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Section5ProgrammePerformance
5.1 Headline Statistics
TabletoshowSouthYorkshireandBassetlawheadlinestatisticsfor2014/2015
5.2 Data
Thereportfocusesonthedataforthescreeningyear2014/2015andincludesreferencestodatafromthescreeningyear2013/2014.
ThedataisderivedfromNAAASPreportspublishedontheScreeningManagementandRecallTracking(SMaRT)database,theNAAASPapprovedcallandrecallsystemtomanagescreening,surveillanceandvascularreferraldata.
5.2.1 WithintheSouthYorkshireandBassetlawcohortboundaries7,997menintheir65thyear,1April2014to31March2015,wereeligibleforAAAscreeningandweresentaninvitationtoattendanAAAscreeningappointment.Fromthiseligiblecohortof7997men,6,641menattendedtheirscreeningappointmentresultinginanuptakeof83percent.
South Yorkshire and Basselaw Abdominal Aortic Anneurysm Screening
2014/2015
Uptake 83%
AAA’sdetected94
(prevalence1.1%)
Referralsmade13
(prevalence0.2%)
Surgeryundertaken 11
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Thegraphbelowshowstheeligiblecohortandthenumbermenwithadefinitivescan result2013/2014and2014/2015.
Graphtoshowpercentageuptake2013/2014and2014/2015
Summary
•Cohortuptakehasremainedover80percent
•Thepercentageofeligiblemenscreenedhasincreasedovertwoyears
WecontinuetoworktounderstandDNA(DidNotAttend)levelsbyfollowinguprandomsamplesof20menonaquarterlybasistoestablishthereasonsbehindnon-attendanceofscreening.
010002000300040005000600070008000900010000
900080007000600050004000300020001000 0
10000
8374 6875 7997 6641
SYBAAAScreeningProgramme2013/14
SYBAAAScreeningProgramme2014/15(SMaRT)database.
Eligiblecohort
Cohortscreening
75
80
85
75
80
85
82.1 83.04
SYBAAAScreeningProgramme2013/14
SYBAAAScreeningProgramme2014/15
SYBAAAScreeningProgramme2013/14
SYBAAAScreeningProgramme2014/15
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Thisresultsinanumberofscreensbeingrebooked.Italsorevealsthereareasmallnumberofmen,whoregardlessofengagementandeducationdonotwishtotakepartinthescreeningprogramme.
5.2.2 Thecohortnumberswereboostedbytheself-referralforscreeningofmenagedover65intheyear1April2014to31March2015.
Piecharts1and2:Piechartstoshowthecontributionofself-referralstooverallnumberofmenscreened2013/14and2014/15
5.2.3 Inthescreeningyear2014/2015,189surveillancescanswereperformedbySYBAAAScreeningProgramme.
5.2.4 Inthescreeningyear2014/2015,13AAA’s≥5.5cmweredetectedandreferred,onthebasisofserviceuserpreferenceandchoice,toDoncasterVascularCentreorSheffieldVascularInstitute.Allserviceusers(100percent)receivedvascularconsultationatthevascularreferralcentreoftheirchoicewithintwoweeksoftheirscreendate.SixserviceusersoptedtorefertoDVCandseventoSVI.
Table3:TabletoshowVascularReferralPatterns
Cohortscreening
Totalselfreferrals
SYBAAA Screening Programme 2013/14 SYBAAA Screening Programme 2014/15
24%
76%
Cohortscreening
Totalselfreferrals
17%
85%
South Yorkshire and Basselaw Abdominal Aortic Anneurysm Screening 2014/2015
Referral ResidentialCCG Size(cm) ReferralCentre123456789
10111213
BassetlawDoncasterDoncasterDoncasterDoncasterRotherhamRotherhamSheffieldSheffieldSheffieldSheffieldSheffieldSheffield
5.55.65.65.766
7.35.55.66.16.66.9
Acceleratedgrowth
DVCDVCDVCDVCDVCSVIDVCSVISVISVISVISVISVI
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5.2.5 Elevenofthethirteenmenwerefoundtobesuitableforsurgeryandhavereceivedopenrepairorendovascularrepair.Twomenhadtheirsurgerycompletedwithineightweeksofthescreendatetriggeringreferral.Fourhadtheirsurgerydelayedforvalidreasons.
5.2.6 Feedbackfromthebi-annualclientsatisfactionsurveysfor2014/2015indicatesserviceusersarehappywiththefacilitiesoffered,theservicedeliveredand100percentofthoserespondingwouldrecommendSYBAAAScreeningProgrammetofamilyandfriends.
Graph3:Graphtoshowclientsatisfactionsurveyresults-facilities
Graph4:Graphtoshowclientsatisfactionsurveyresults-staffandclientexperience
020406080100120140
Environment and Facilities
020406080100120140Numberofpatients
YES
NO
Notanswered
115(99%)
116(100%)
1(1%)
3(2.5%)112(96.5%)
3(3%)
112(97%)
115(99%)
1(1%)
Wastheclinicsiteconvenient?N=116
Wastheclinicmapclear?N=115
Weretheinstructiononwheretositonattendanceattheclinicclear?N=116
Wasthewaitingareapleasanttowaitin?N=116
Wasthereadequateseatinginthewaitingarea?N=116
satisfaction survey results
020406080100120140
Staff and overallexperienceN = 116
YES
NO
020406080100120140Numberofpatients
115(99%)
116(100%)
116(100%)
116(100%)
116(100%)
1(1%)
Didthescreeningtechniciancheckyourname,dateofbirthandfirstlineofaddress?
Werethestaffperformingyourexaminationhelpful?
Werethestaffperformingyourexaminationconsiderate?
Didyoufeelcomfortableaskingquestionsabouttheexamination?
Wereyougivenyourresultsoncompletionoftheexamination?
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Section6StakeholderEngagement
6.1 Equality and Equity
Screeningisavailabletoallmenaged65whoareregisteredwithaGP,andhavenotbeenpreviouslydiagnosedwithanAAA.Allmenover65whohavenotpreviouslybeenscreenedcanself-referdirectlytotheprogramme.
TheSYBAAAScreeningProgrammeiscommittedtoensuringscreeningisequallyavailabletoalleligiblemen.
6.2 Community and Service User Engagement
ThehealthprofileacrossSouthYorkshireandBassetlawisapictureofhighdeprivationwiththelifeexpectancyofmenlowerthannationalaverage.SYBAAAScreeningProgrammeensuresindividuals,orgroupsofindividualsaretreatedfairlyandequally,specifictotheirneeds.Therearevariedcommunitieswithinthecohortboundariesincludinggypsyandtravellergroups,LGBTandBMEcommunities,learningdisabilitygroups,refugeesandasylumseekers,alargeprisonpopulationaswellasanex-miningcommunity.Consequently,SYBAAAScreeningProgrammeemploysavarietyofinnovativescreeningandpromotionalopportunitiestoensureequitableservicedelivery.
InordertoreachalleligiblemembersofourcommunitiesSYBAAAScreeningProgrammehasworkedto:
•Developrelationshipswithorganisationsandinfluentialgroupswhowillcomeinto contactwithSouthYorkshireandBassetlawmenaged65andabove.
•HaveapresenceinareaswhereSouthYorkshireandBassetlawmenaged65and above,theirpartnersandfamilyarelikelytobefound.
•Maximisetheopportunitiestoraiseawarenessthroughthemediabydevelopingcase studiesandorganisinguniquescreeningopportunities.
Toachievethis,in2014/2015serviceswerepromotedandclinicsheldatawidevarietyoflocationsincludingshoppingcentres,footballgrounds,golfclubsandtowncentrelocations.Casestudies,serviceuserchampionsandmembersofparliamentwereutilisedtoraiseawareness.Examplesofthesemethodsareshownintheimageoverleaf.
6.2.1 Barnsley,asmalltownsurroundedbyseveralsmallervillages,containsalargeex-coalminingcommunity.Deprivationishigherthanaverageandthelifeexpectancyformencanbeupto8.5yearslowerthanthenationalaverage.In2014/2015therewere1,219eligibleforscreeningwithinBarnsleyCCG.
AsignificantamountofengagementworkhastakenplaceinBarnsley,rangingfromhavingapresenceatvariousfairsinvillagesacrossthedistrict,healthpromotionstandsatteadancevenuesandinformationtoraiseawarenessincludedontheBarnsleyLGBTForumwebsite.
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Communicationand Engagement
BarnsleyCasestudywith
champion
Health BusMPat
Meadowhall
SheffieldCrystalPeaks
Centre
BassetlawClinicatRetford
GolfClub
DoncasterClinicatIntakeSocialClub
RotherhamRotherhamFootballClub
ImagetoshowthevarietyofmethodsemployedtopromoteSouthYorkshireandBassetlawAAAScreeningServiceswithinthecohortboundaries
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Acasestudyofalocalmanwithanincidentallydetectedaneurysmwhichwasincludedinpublicationsacrosstheboroughandonlocalradiohashelpedraiseawarenessoftheimportanceofscreeningtoothermeninthecommunity.
DavidSalmonaged71ofParkgate,Goldthorpesubsequentlyreceivedvascualarconsultation.
6.2.2 Bassetlawispredominantlyruralwithtwotowns,WorksopandRetford.Itseesdeprivationwhichishigherthanthenationalaverageandrecordsalifeexpectancyat5.9yearslowerformenthanthenationalaverage.Theeligiblepopulationforscreeningin2014/2015was920men.ThescreeningteamheldaneventatRetfordGolfClubresultingascreendetectedsmallAAAforclubmemberDavidMoore.
6.2.3 Doncaster isalargetownwherethehealthofpeopleisgenerallyworsethantheEnglandaverageresultinginlifeexpectancybeing9.4yearslowerthanthenationalaverage.Atotalof2,015menwereeligibleforscreeninginDoncasterCCGin2014/2015.
TherehasbeenasubstantialamountofengagementinthetownandsurroundingareasrangingfromhostingahealthpromotionstandatGoldenYearsRoadshowforover50’sheldattheMansionHousewhereinformationwasofferedandself-referralpacksweredistributedtomenaged65andover,todeliveringscreeningandhealthpromotionatLakesideVillage.
AnAAAscreeningeventhostedbyaSocialClubinMaywasahugesuccess.IntakeSocialClubSecretary,TomForestercollaboratedwithSYBAAAScreeningProgrammetoorganisetheclinicattheclub.
Mr Salmon said:“I couldn’t be more grateful to Helen for finding the AAA; I had no signs or symptoms whatsoever, it’s scary to think the aneurysm could have ruptured at any time! If it wasn’t for Helen, I might not have been here today.”
HelenMcAlinneywithclubmember,DavidMoore
Mr Moore said:“I’m so glad the AAA team held the screeing event at Retford Golf Club, I had the scan and it was no trouble at all. “It picked up a small aneurysm which I had no idea I had got! Visited the nurse the following week, she explained everything and put me at ease; and I can go for my 12 month surveillance appointments at Retford Hospital so it’s not far to go at all.“
DavidSalmonwithHelenMcAlinney
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6.2.4 Rotherhamisacommercialtowninalargelyruraldistrict.Recordeddeprivationishigherthanaverageandmenherehavealifeexpectancy8.9yearslowerformenthanthenationalaverage.Rotherhamsaw1,148meneligibleforscreeningin2014/2015.
Engagementactivitiesfor2014/2015haveincludedanAAAclinichostedontheHealthBusatMorrison’ssupermarketinBramleyandcollaborationwithRotherhamUnitedCommunitySportsTrusttohostapromotionaleventusingtheHealthBusonmatchdaysinadditiontoregularclinicsutilisingthefacilitieswithinthefootballgroundpremises.
Mr Forestor said:
“I was surprised how quick and simple the screening process was and it’s great that within five minutes I had peace of mind of having the all clear.”
AAAteamwithMrForestor
JamieNoblewiththeAAAteam
Head of Community forRotherham United Community SportsTrust, Jamie Noble, said:
“Promoting the AAA Screening Programme to our fans is something we are totally passionate about in order to keep them healthy. I am aware that AAA’s can have no signs or symptoms so it’s paramount that men aged 65 and over have the screening – it can be a life saver.”
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6.2.5 SheffieldisalargegeographicallydiversecityinSouthYorkshire.Againthedeprivationishigherthanaverageandlifeexpectancyformencanbe10yearslowerthanthenationalaverageformeninthemostdeprivedareas.3,382menlivingwithinSheffieldCCGwereeligibleforscreeningin2014/2015.
RelationshipshavebeenestablishedwithcommunityleadersinspecificBMEcommunitiestoeducateandraiseawarenessinSheffieldincludingpromotionalandscreeningsessionsatSheffieldChineseCommunityCentreandSADACCAaregisteredcharitywhichprovidesfortheAfrican-Caribbeancommunity.
6.3 Health Professionals
SYBAAAscreeningteamhaveworkedcloselywithhealthprofessionalsacrossSouthYorkshireandBassetlawtoraisetheprofileoftheAAAscreeningprogramme.AwarenesssessionshavebeendeliveredatGPprotectedlearningeventswithinallfiveCCGs.
InadditionahealthprofessionalsawarenesssessionhasbeenheldatHMPRanbyandahealthdayeventatRotherhamGeneralHospital,whichassistedinservicepromotion.
MPCliveBettswithAAAscreeningteam
A great amount of engagement work has taken place in Sheffield, including AAA screening clinics at Meadowhall and Crystal Peaks Shopping Centres where the AAA team screened Sheffield MP, Clive Betts
RotherhamCCFGPProtectedLearningEvent
Kate Wales, Primary Care Clinical MatronOffender Health, Nottinghamshire Healthcare NHS Trust, HMP Ranby.“The South Yorkshire and Bassetlaw AAA Screening Team attended HMP Ranby Prison to screen the men aged 65 years and above. The morning ran smoothly and the team were professional and responsive. One gentleman was identified as having a medium size AAA and appropriate health advice and education was given regarding follow up and care. The AAA team will be returning in October for quarterly review of the identified patient and any new patients will be seen.”
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6.4 Media
AfterinitialTVcoverageonlocalITVnewsprogramme,Calendaratitslaunchin2013,SYBAAAScreeningProgrammehascontinuedtobuildrelationshipswithlocalmediateamswhichhasbeeninvaluableinordertoraiseawarenessofAAAamongstboththetargetaudienceandthegeneralpublic.ThishasincludedcoverageinlocalnewspapersandradiointerviewsabouttheAAAscreeningonPenistoneFM(Barnsley)andSineFM(Doncaster).
6.5 Significant others
AscreeningclinictookplaceatDoncasterGolfClubinApril.AmongthefirsttoteeoffforAAAscreeningattheclubwas79yearoldDonaldSibson,akeengolferwiththeclubforover30years.SpurredonbyhisdaughterAmandaFord,aScreeningTechnicianwiththeSYBAAAScreeningTeam,Donaldbookedhimselfintothescreeningclinic.
YorkshireMainOfficialsClubinEdlingtonplayedhosttoanAAAscreeningclinic,whichtookplaceasaresultofthestoryoflocalman,JackShawwhoinMarch2014hadtohaveemergencysurgerytorepairananeurysm,foundafterhetookuphisfreescreeninginvitation.
65yearoldEdlingtonman,Jack,wentforhisAAAultrasoundscaninmid-March,thinkinglittleoftheimportanceoftheprocedure,butwentalongatthebehestofhiswife.Duringhisscanhowever,Jackwasfoundtohavelargeaneurysminsidehimthatrequiredamajoroperation.HewassenttoDRIandunderwentsurgeryonthe31March.
AAAScreeningTechnicians,MandyFordwithherfatherDonaldSibsonatDoncasterGolfClub
Mr Sibson said:
“I have always been a strong believer in health screening programmes. My daughter works as a screener for the AAA programme, so I know better than most how important it is to take up the screening offer. When I found out that she was holding a clinic at the clubhouse I made a self-referral. I got my appointment in just a couple of weeks and attended at the clubhouse. Thankfully I got the all clear which is a great relief to the family. I would certainly encourage other men to be screened.”
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ThenewsofJack’ssituationquicklycaughttheattentionofhisfriendsattheYorkshireMainOfficialsClubwho,keentoensurethattheywerecheckedforthesymptomlessconditionthemselves,contactedtheAAAteamaskingthemtovisittheclubtoscanmembers.Asaresult,13menturnedupfortheirscansattheclub.
Jack said: “If it hadn’t been for my wife I would probably have backed out of the scan, but I am glad I went along now! I would encourage every man to have the scan; it saved my life!”
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Section7KeyAchievements
TheAAAscreeningteamwontheprestigiousawardof‘Team of the Year’atDoncasterandBassetlawHospitalsannualawardsnightinSeptember2014.Theywontheawardfortheiroutstandingcontributiontothescreeningprogrammeandtheworktheyundertookinraisingawarenessoftheconditionacrosstheregionwhichresultedthehighest numbers of self-referrals into an AAA Screening Programme nationally.
In2014/15theHealthBusmobilescreeningunithasbecomewellestablished.SYBAAAscreeningteamaretheonlyAAAscreeningteaminthecountrytohaveamobilescreeningfacility,enablingustotakethebusintohardtoreachanddeprivedcommunitieswheretheuptakeofscreeninghaspreviouslybeenpoor.Thecostattachedtousingthehealthbusisminimalandseenasagoodinvestmentpernumberofscreeningsitenablestheservicetocompleteonlocationinthecommunity.
TheAAAScreeningcoordinatoractivelyparticipatesinthenationalprovisionofScreeningTechnicianandClinicalSkillsTrainertheoreticaltrainingandaccreditationattheUniversityofSalford,contributingtoexcellentlocalcompliancetonationalstandards.
Section8FutureDevelopments
FutureplansforthepromotionofSYBAAAScreeningProgrammecontinuetogrowasrelationshipsareestablishedwithspecialisthospitalteamsacrosstheregion,linkswillbemadewithinfluentialmembersofthecommunity,includingsecretariesoffaithgroupsandtravellercommunities,maximisingmediaopportunitiesbypromotinganddevelopingbespokepartnershipevents.
Partnershipworkingisessentialmovingforward,workingwithorganisationssuchasHealthwatch,Mencap,MIND,locallibraries,GPpractices,pharmacies,CCGsandhospitals,localauthorities,prisons,parishcouncilsandthevoluntarysector,allofwhomhaveadutyofcareandwishtolookafterthehealthandwellbeingofpeopleinthewidercommunity.
Our priorities for 2015/2016 are to: •Continuetoimproveaccess,sourcingnewvenuesformobileclinicsutilisingtheHealthBusand ensuringtheSYBAAAservicemodelisfitforpurposetomeetallserviceusers’needs•FurtherpromotetheservicewithinSouthYorkshireandBassetlaw•Enhancestafftrainingandprofessionaldevelopmenttoenableaqualityandsafeservice•Consolidateprisons/placeofdetentionactivity•IncreaseinHomeVisitswheretheclinicalneedarises•DevelopmentofalocalSouthYorkshireandBassetlawprogrammewebsite.
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