The South West (SW) Patient Safety Collaborative is supporting the introduction of the SCORE culture survey methodology from Safe and Reliable Healthcare, LLC into health and care teams across the region. Further organisational debrief training and culture improvement project development are also supported utilising the SW AHSN’s bespoke Life QI improvement system.
The SW Patient Safety Collaborative, led by SW AHSN, is helping healthcare teams understand their culture and take steps to improve it because of the strong correlation between good culture and the quality of care.
Working across all levels of the health and social care system with the Institute for Healthcare Improvement (IHI). A central aim of the South West Patient Safety Collaborative (PSC) is to develop the patient safety and improvement capability of health and social care teams across the region. In delivering this objective the South West PSC and the SW AHSN, commissioned the Institute for Healthcare Improvement (IHI) - an internationally recognised healthcare organisation, to provide three patient safety training programmes.
www.beaconmedicalgroup.nhs.uk @beaconmedgroup
As a newly formed GP practice at scale we took stock of our clinical services and undertook a clinical needs analysis which showed there was a sub-group of highly vulnerable patients who lived in either residential or nursing homes. These patients had much higher health needs and difficulty in accessing services, we committed to finding ways of bringing services to them.
St Thomas Medical Group www.stthomasmedicalgroup.co.uk
St Thomas Medical Group is the largest Practice in Exeter and the second largest in the South West, serving a population of 38,000 patients. We are spread over 4 sites, the largest being the premises in St Thomas, a district of Exeter. The Group also covers a branch practice in Exwick, a short car ride away, and a small building in Pathfinder mobile home park, 10 miles outside the city. We also run the Student Health Centre on the University of Exeter campus. There are 10 partners, and 15 salaried doctors, with a large nurse team and administration staff. This Case study talks about how we implemented a Cloud Based Phone System.
www.beaconmedicalgroup.nhs.uk @beaconmedgroup
In 2014 we formed Beacon Medical Group with the merger of 3 practices in Plympton and the South Hams to form the largest GP practice in the South West. There were a number reasons that we merged to provide general practice at scale, one of which was to pool our resources and opportunities for the benefit of patients.
Our patients complained that they were waiting an unacceptably long period for many outpatient appointments. The local CCG were also concerned about breaches of referral to treatment times (RTT’s). In primary care we wanted to support our secondary care colleagues who are facing increases in demand. Beacon Medical Group analysed our referral data and explored our in-house resources in order to develop improved services for our population of 32,000 patients. Our intention was to improve the cost-effectiveness and responsiveness in certain clinical areas in primary care which would support secondary care and our patients.
St Thomas Medical Group www.stthomasmedicalgroup.co.uk
St Thomas Medical Group is the largest Practice in Exeter and the second largest in the South West, serving a population of 38,000 patients. We are spread over 4 sites, the largest being the premises in St Thomas, a district of Exeter. The Group also covers a branch practice in Exwick, a short car ride away, and a small building in Pathfinder mobile home park, 10 miles outside the city. We also run the Student Health Centre on the University of Exeter campus. There are 10 partners, and 15 salaried doctors, with a large nurse team and administration staff. This Case study talks about how we implemented using Paramedics in General Practice.
Sentinel Healthcare South West Community Interest Company (CIC), recognised the need to identify patients at risk of developing a calcium and vitamin D deficiency to prevent the morbidity and mortality associated with fragility fractures in the elderly. With support from The South West Academic Health Science Network (AHSN), Kyowa Kirin Ltd and NEW Devon CCG, a collaborative osteoporosis review was delivered Interface Clinical Services Ltd (ICS).
Bering Limited was successful in the 2014 Small Business Research Initiative (SBRI) Healthcare call on Integrated Care.
The company offers an artificial intelligence (AI) platform that allows clinicians, public health experts and data scientists to leverage the power of Big Data in everyday health and care practice. It is actively involved in systems biology research with academic and industry partners worldwide. The technology and infrastructure can be integrated into academic settings, core labs and industrial pipelines. Following the successful SBRI application, the company has worked with Somerset Clinical Commissioning Group (CCG) to develop its algorithms using real patient data.
The SW AHSN and the National Institute for Health Research Clinical Research Network South West Pennisula (CRN SWP) in collaboration with PolyPhotonix has developed Noctura 400, a revolutionary light therapy sleep mask used for the prevention and treatment of Diabetic Retinopathy.
The SW AHSN connected PolyPhotonix with the CRN SWP and clinical researchers in the region and also helped facilitate randomised controlled clinical trials across three sites in the South West Peninsula.
The South West Academic Health Science Network (SW AHSN) launched its industry/NHS Chief Executive Officer (CEO) Work Shadowing Programme in 2014 and has since paired CEOs from the pharmaceutical industry and NHS for a day spent working together. The SW AHSN introduced the CEOs and facilitated the day, including the setting of aims and objectives and collation of feedback. Participants from both sides have commented on how useful it was to gain insight into their counterpart’s world, resulting in increased empathy and a desire to work more collaboratively in the future.
As a result of a partnership between the SW AHSN and Resonance, a social investment organisation in Cornwall, the Health & Wellbeing Challenge Fund South West was established.
This £5 million social impact investment fund supports the development of innovative models of care from the voluntary, community and social enterprise (VCSE) sector in the South West.
It provides NHS organisations access to expertise and resources to identify, scope and develop partnerships between the NHS and charity and social enterprise sector. The aim is to help them turn their best ideas into effective solutions to big issues like dementia, diabetes, obesity, depression and enabling older people to live more independent and fulfilling lives.
Introduction
Tina Campbell is Associate Director Medicines Optimisation and Controlled Drugs Accountable Officer at Devon Partnership NHS Trust. She has been successfully using the SCORE Safety Culture Survey from the SW AHSN and talks about her positive experiences. Tina started the first survey in February 2016, she explains: “We have used the SCORE safety culture survey to review and inform current and future practice, and although at first it was a bit tricky to get our heads around the results and what that meant to us as a team and service, I’ve found the whole process immensely helpful. Not least to understand and improve my own leadership style and capabilities.”
www.beaconmedicalgroup.nhs.uk @beaconmedgroup
The challenge
Major changes, resulting from the merger of five practices into one organisation, were causing unease among some patients. People feared losing the ability to book a same day appointment with a GP they had known for years and many were alarmed by new and unfamiliar initiatives such as triage over the phone and e-prescribing. Overworked practice staff were frustrated that many patients were seeking appointments where no clinical input was needed.
Why
Practices were asked to do this?
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The GP Forward View
recommends that primary care must adapt to provide effective ‘joined up’ care
that includes multi disciplinary working
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In order to provide
services at an economic and sustainable level, practices need to review how
they offer services and how they can work effectively together
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As practices are now
working collaboratively it is likely that future commissioning will be offered
by cluster, therefore practices need to understand any issues and opportunities
for each cluster
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The Stocktake and PRAQ
information will enable clusters to more fully understand how they can improve
services and efficiencies for both themselves and the patient
Why the Stocktake and the PRAQ
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The stocktake was commissioned by NHSE to paint a picture of
how things actually are for Primary Care in BNSSG. There have been many studies
done on acute care and it was felt essential that a similar understanding was
obtained for Primary Care to inform decision making not just for practices and
clusters but also for the STP
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The PRAQ has been utilised for practices to take a
temperature check on where they are individually against a certain number of
benchmarks, and collectively as a cluster. The latter will inform whether there
are strengths or potential weaknesses across the whole cluster or whether the
opportunity for collaborative working can mitigate individual practice concerns
or not
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These are two different lenses demonstrating the overall
position facing practices and we need to ensure that we use the information to
inform our planning
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The process is based over
a number of phases, funding has been provided for practices to create the ‘head
space’ to consider priorities for their practice and cluster
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The resilience plan
process commenced mid March and will conclude by the end of August 2017
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The output of the PRAQ and
the Stocktake (giving two perspectives from both internally and externally
sourced information) will inform your resilience plan.
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Initial meetings run by
the Primary Care Foundation and One Care to report back on the findings of the
Stocktake and these are taking place between mid May to mid June
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Following these a further
resilience planning meeting for each cluster will be facilitated by Change
Managers to identify three opportunities on which clusters will be expected to
work together over the next twelve to eighteen months
Opportunities
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It is anticipated that the
Stocktake /PRAQ along with cluster discussions will identify at least three
opportunities that link in with the 10 High Impact actions from the GP Forward
View
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These can be prioritised
by short, medium and longer term objectives for the cluster to work on.
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One outcome could be how
the cluster works with other provider organisations to deliver a more effective
service, or how by sharing services clusters can improve efficiency and save
time or costs.
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All the opportunities
selected are aimed at enabling practices within a cluster to achieve greater
resilience and improve patient services
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They do not need to be
major changes but demonstrate a growing understanding of the potential benefits
of sharing services, people and potentially even premises.
Resilience
templates and plans
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Resilience templates will
need to be completed by each cluster at the end of phase one and forwarded to
your CCG by the end of August 2017
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These will identify three
projects/interventions that each cluster will work on to demonstrate which of
the GP Forward View elements they work towards
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The cluster resilience
plan will form a high level project strategy for each cluster.
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Assuming the plans are
approved by the CCG, clusters will then receive the second payment of this
resilience funding to the nominated lead practice
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There will be ongoing
monitoring of progress on all resilience plans to ensure successful delivery of
agreed objectives
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The Change Managers will
assist clusters in the completion of the resilience template
The Medicine Support Service; a referral to community pharmacy scheme.
Utilising existing services in community pharmacy to support patients with their medicines following discharge from hospital. Improving the transfer of care to help patients better understand their medicines, improve patient outcomes, increase adherence, reduce re-admissions and reduce medicines waste.