1 a consistent approach to personalised care designing for care dr paul whatling senior clinical...
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A consistent approach to personalised care
Designing for care
Dr Paul Whatling
Senior Clinical Consultant
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A consistent approach to personalised care
there were 325 million consultations with GPs or nurses in primary carethere were 325 million consultations with GPs or nurses in primary care
In 2003-2004:In 2003-2004:
13.3 million people attended a first outpatient appointment with a consultant13.3 million people attended a first outpatient appointment with a consultant
nearly 13.9 million people attended A&E and there were 4.2 million emergency admissionsnearly 13.9 million people attended A&E and there were 4.2 million emergency admissions
over 5.4 million people were admitted to hospital for planned treatmentover 5.4 million people were admitted to hospital for planned treatment
over 649 million prescription items were dispensed in the communityover 649 million prescription items were dispensed in the community
6.4 million calls were made to NHS Direct6.4 million calls were made to NHS Direct
6.5 million hits to NHS Direct Online6.5 million hits to NHS Direct Online
over 1.5 million patients visited walk-in centresover 1.5 million patients visited walk-in centresSource: Chief Executive’s Report to the NHS, May 2004
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A consistent approach to personalised care
Sept 1998Jan 2001
June 2002
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A consistent approach to personalised care
Eastern ClusterAccenture
North East ClusterAccenture
Southern ClusterThe Fujitsu Alliance
North West & West Midlands ClusterThe CSC Alliance
London ClusterCapital Care Alliance, led by BT
National Application Service Providers
Infrastructure Service Provider
Choose and Book ServiceAtos Origin (formerly Schlumberger Sema)
NHS Care Records ServiceBT
Local Service Providers
N3, the National NetworkBT
Service Providers
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A consistent approach to personalised care
We have 6 years to deliver healthcare IT solutions
Those solutions must meet the needs of the service
We must ensure effective engagement of service users and providers
Three facts
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A consistent approach to personalised care
Impl
emen
tatio
n Schedule
of delivery
Challenge
current practice
Raise aspirations
NPfIT Aims &Objectives
CreateDissatisfaction
User driven
Com
mitm
ent
GenerateSatisfaction
Communication
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A consistent approach to personalised care
User driven
Focus at the local level
National dissemination of local work
Enabling national strategy locally
“Making the local national and the national local”
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A consistent approach to personalised care
The work
Design of systems and processes
• Ethical principles
• Safety
• Best practice
• Standards
Support implementation
• Change in ways of working
• Inform education and training agenda
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A consistent approach to personalised care
CRDB - Structural Overview
Board
Executive Team
Stakeholder Network
Cyril Chantler
Jo WiliamsBoard Member
TalibYaseen
Harry Cayton
12 Board Members
Director
Executive Team Members
ActionTeam
ActionTeam
ActionTeam
ActionTeam
ActionTeam
John BaconNational
Programme Board
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A consistent approach to personalised care
CRDB - assurance process
Identify the values, principles and processes of care and ensure that these are taken into account in the implementation of systems for NHS and social care
Ensure that ethical issues are adequately addressed and that agreed ethical principles are consistently applied
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A consistent approach to personalised care
Design for care
“Action Teams”
• Nationally led core team
• Local groups’ work
• Clear objectives
• Short time-frame
Stakeholder network
• Links existing networks
• Resource for expertise
• Communications
• Peer support
• Open to all
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A consistent approach to personalised care
Defining Action Teams
CRDBPrioritisation
Action Team Defined
NPfITdeliverables
NewRequirements
NationalPriorities
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A consistent approach to personalised care
Action Team Uses Network
Action Team
Suppliers
DesignAuthority
InformationStandards
NPSA
NICE
HealthcareCommission
Front linestaff
RoyalCollegesPatients
InformationCentre
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A consistent approach to personalised care
NPfIT Deliverables – Bundle 6
View, construct and modify care plans and pathways within care settings
Integration of care plans and pathways within the common patient record across all care settings.
Integrated care pathways including advanced decision support across all care settings, process monitoring alerts and branching.
Phase1
Phase 2
Phase 3
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A consistent approach to personalised care
NPfIT deliverables – the scale
3000 line items – LSP contracts
1600 Clinical input required!
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A consistent approach to personalised care
NPfIT deliverables Symphysis-fundus height – 118.2.5
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A consistent approach to personalised care
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A consistent approach to personalised care
Action Team Outputs
Type 1
Type 2
Type 3
DH and otherpolicy teams
Technicaldesign teams
Service deliveryand improvement
Visionor policy
document
CommonSpecification
Carepathway map
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A consistent approach to personalised care
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A consistent approach to personalised care
Example of local process
Local team definecare journey
Local team definecare journey
Local team definecare journey
Local team definecare journey
Local team definecare journey
Core Action Teamreview outputs
with stakeholderreview and input
Local team definecare journey
Local team definecare journey
Local team definecare journey
Local team definecare journey
Local team definecare journey
Furtheriteration
Final Output onceiteration process and
sign off completed
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A consistent approach to personalised care
Our goals
To develop a system for moving and sharing health information that is:
• Patient focused
• Improves patient outcomes
• Improves choice and control for patients
• Helps clinicians to make better decisions
• Reduces errors
• Is practicable/usable/effective