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“Enabling allied health professionals to lead and shape new models of care”

Andrew WaltonExecutive Chair, Connect

AWalton_Connect#kfahps

Cost Patient safety

Productivity/Efficiency

Clinical Effectiveness

Patient Experience

VALUABLE PRODUCTIVITY

Steve Tolan, CSP

Breakfast Workshop

“How can AHPs play an active role within multi-specialty community providers?”

8th December 2015

Aimee RobsonNational Clinical Manager – [email protected]

Guy PilkingtonGP & Chair of Newcastle West Clinical Commissioning [email protected]

What were we trying to change?

• High prevalence / high morbidity

• Long waitso Chronicityo Poor experience

• Poor access to physiotherapy

• Low conversion rates

The existing services and pathways were failing people with musculoskeletal complaints AND failing the workforce

A B

What were we trying to achieve?

• Build a system capable of:

• Create alliances between organisations

• Responding within a short time• Early advice and treatment to prevent escalating difficulty• Access to the appropriate professional

• Collective responsibility• Shared accountability

o Right place, right time, right treatmento Encourage self management

How did we initiate change?

• Careful and thoughtful engagement with hospital clinicianso Establishing shared goalso Returning to patient perspective and outcomeo Benefit to clinicians only tangible once pilot went live

• Strong GP practice involvement in roll-out phase

• Quick and responsive feedback loops

Inspire

Align

Measure

What was new?

“It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is most adaptable to change.”

What was new - patients

• Altered how patients access service

• Telephone advice (Physioline)

• 48 hour waiting time for Physiotherapy

• Locations in Primary care – “care closer to home”

• Empowering of patients to self-manage technology and service access

What was new - staff

• Consultant led clinical triage

• MDT – generalist versus specialist

• Community care skill seto Shared decision makingo Care planning

• Orthopaedic surgeons in community with direct listing

• Best use of strengths and abilities

Patient/family goals and preferences

Clinical evidence and expertise

Biologicial, Sociological & Psychological

Context

SDM

Result; effective patient-centred care

What was new - service

• Chronic Pain service integration to MSK pathway (1st step of)

• SPOA – avoid direct hospital referrals (except for exclusions)

• IT visibility on performance – real time data

• Inter-provider Clinical Leadership –facilitate change and improve quality

Our shared

purpose

Leadership for change Spread of

innovation

Improvement methodology

Rigorous delivery

Transparent measurement

Systems drivers

Engagement to mobilise

GP referral

Referral Management Centre SystmOne

ESP

GPwSI

SEM ConsultantOrthopaedic Surgeons

(direct wait listing)

PhysioLineTelephone

Consultation (48 hrs)

Community Physiotherapy

Exclusions

Secondary Care

MSK CATS

What were the outcomes?

• Waiting times

• Activity – secondary care and community therapies

• Patient experience

• GP experience

• Patient outcome measures - PROMs

Waiting times in (days)

PhysioLine (telephone) 2

Physiotherapy (face to face) 6

MSK CATS 19

Service Activity

2010 2012 % Variance

Orthopaedics * 760 455 -40%

Rheumatology* 252 231 -8%

Neurosurgery* 87 49 -44%

CATS** 424 769 +81%

Physiotherapy** 860 2356 +174%

Total 2,383 3,860 +62%

*Hospital SUS data

**Connect SystmOne data

2010 – 46% assessed in hospital2012 – 19% assessed in hospital

Patient experience (PREMS)

GP Feedback

PROM – EQ5D-5L

6 month saving £42,018(population 77,424)

PCT Financial analysis:

Lessons learnt

• Collaboration with GPs, providers and commissioners

• Integrated planning

• Inter-provider Clinical Leadership – facilitate change and improve quality

• Investment in communications with all stakeholders

• SPOA

• Evaluation of quality and cost effectiveness

• Clinical effectiveness balanced with Operational efficiency

Integrated

Effective

TimelyQuality

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Questions and discussion

#kfahps

to participate in today’s discussion download the event app ......guy pilkington gp & chair of...

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