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Learning and Best Practice Tips from Nottinghamshire

Dawn Jameson Commissioning Manager, Nottinghamshire City CCG

Dawn.Jameson@nottinghamcity.nhs.uk

Natalie Shouler Service Improvement Manager, NNE CCG

Natalie.shouler@nottinghamnortheastccg.nhs.uk

Key factors Tools Communication

Practice Engagement

Leadership

Patient Expectations

Mobilisation NHS DPP

Communication

• Trickle feed information – Before, during and after

• Its more than just an email – Practice bulletin, newsletter, meetings, PLT’s

(Protected Learning Time), education events, phone calls, FAQs…..

• Involve the Provider.

• Keep people updated.

Leadership

• Have a dedicated lead in your CCG.

• Make NHS DPP a priority in your CCG.

• Remember your why?

“and the rest will follow”

Practice Engagement

• Incentivise practices – Care & quality contract or LIS (local implementation

scheme)

• Trailblazer sites.

• Patient pathway.

• Make things easy – Patient information, patient letter & clinical

templates

Care & Quality Contract • Enhanced specification aimed at improving

quality of care.

• Financially incentivise practices for referrals.

• NHS DPP is mandatory standard.

• GPs have to sign up to the contract.

6

LIS (Local Implementation Scheme)

• Define local outcomes

• Aims and objectives

• Buy in from impartial clinician to outline incentives

7

Trailblazers

• Identified in each of the 8 CDG (Care Delivery groups).

• Their role:

– To review patient letters

– Develop patient pathway

– To test templates

8

Notts Patient Pathway

9

Patient at risk of developing diabetes

HbA1c or fasting plasma glucose blood

test not completed in last 12 months

HbA1c <42mm/mol (6.0%) or fasting

plasma glucose <5.5mmol/mol

HbA1c 42-47mmol/mol (6.0-6.4%) or fasting

plasma glucose 5.5-6.9mmol/mol

HbA1c >47mmol/mol or fasting plasma

glucose >7mmol/mol

Consider review in 12 months

Refer to NDPPTreat diabetes accordingly

Existing register

NHS Health Check

Risk tools

Patient Expectations

• Manage patient expectations

• Promotion is key

X not a 9 months education programme

4 information sessions (each 1.5hrs)

with top up sessions.

• Provide patients with information

Mobilisation • Geographical mapping

• Locality hotspots

• Cross boundary access

Tools

• Support practices with a risk identification tool (Diabetes UK/Primis Diabetes).

– Clinical system reporting.

• Develop a clinical template.

• Develop a patient letter

(80% uptake)

12

13

SystmOne instruction for adding referral template to clinical tree

If practice has been accepted to the connecting Nottingham Group then from setup menu

go to organisation preferences

Under clinical policy – highlight Tree Configuration and the practice default tree then click “amend tree”

In search bar type DPP and click search, then highlight the template and where in the tree you want the template to sit then press the “move to selection” arrow

Click OK to close the menu boxes – when a patient record is now opened the template appears in the clinical tree

To import a template:

Select Setup>Data Entry>New Template Maintenance from the Main Menu.

Click Import Templates.

Upload consultation template for the NDPP (EMISWEB) : Save the template from the e-mail to your desktop. In EMISWEB click on the EMIS icon and go to template manager/ documents and templates/new web templates

Top tips

Have a dedicated lead.

Trickle feed information asap.

Launch all practices at once.

Develop a clinical referral form.

Remember your why?

Keep communicating.

Lessons Learnt

• Develop your clinical template asap.

• Be involved in the testing of the template.

• Start communication asap.

• Ensure you have baseline blood testing resolved or focus on 3 months blood tested patients.

• Be clear on roles and responsibilities.