cheshire and merseyside strategic clinical networks ...€¦ · evaluate impact 2016/17...

Cheshire and Merseyside Strategic Clinical Networks Business Plan 2015-16

Opening the door to improved outcomes for patients and carers

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Cheshire and Merseyside Strategic Clinical Networks (SCN) are committed to improving health outcomes for our population. We are therefore delighted to be able to share our refreshed Business Plan for 2015/16.

This Business Plan builds on our existing work and supports the future of the NHS as envisioned in NHS England’s Five Year Forward View with its focus on how collaborative local leaders can deliver improvements in health and care. We will support local health and care systems to move from vision to implementation.

Our objectives are ambitious, evidence based, broad in range, and consistent with the current and likely future aspirations of NHS England and key partner organisations. They have been produced after extensive consultation with a very wide range of stakeholders, including, of course, members of the public. We are confident therefore that the priorities which are described therein are pertinent to the development of high quality services for our current population and for future generations.

These priorities very much replicate those of the national agenda and those that are more locally focused, reflect the concerns that our local partners convey to us via our Clinical and Quality Improvement Leads, indicating that a collective improvement approach will be of benefit.

It is important to note that this Business Plan may be subject to refinement when the outcome of the National review of leadership development and improvement is known and implemented.

We will have to deliver our plans in a tough and demanding financial environment and one which will see our resources cut by 25% this year. However, by working closely with partner improvement organisations, such as the North West Coast Academic Health Science Network, the Advancing Quality Alliance (AQuA), and Cheshire and Merseyside Public Health Collaborative Service (Champs), we are confident of our ability to deliver our objectives and, in doing so, drive improvement and better outcomes for patients and carers.

We do hope that you will take the opportunity to read this document and very much look forward to working with you all to achieve our ambitions. Please do get in touch with us (see our website for contacts) if you wish to contribute to our work and are not already engaged with us.

This document will be available to read on our web-site www.cmscnsenate.nhs.uk and will be available in print form on request. We will ensure that the progress made against our work programme is regularly reported and updated on the web site and in other media.

Jan Vaughan Andrew Coley Associate Director Clinical Director

Foreword

http://www.bing.com/search?q=5+year+forward+view&src=IE-SearchBox&FORM=IE10SR&adlt=strict

http://www.cmscnsenate.nhs.uk/

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Working together for patients Patients come first in everything we do. We fully involve patients, staff, families, carers, communities, and professionals inside and outside the NHS. We put the needs of patients and communities before organisational boundaries. We speak up when things go wrong. Respect and dignity We value every person – whether patient, their families or carers, or staff – as an individual, respect their aspirations and commitments in life, and seek to understand their priorities, needs, abilities and limits. We take what others have to say seriously. We are honest and open about our point of view and what we can and cannot do.

Commitment to quality of care We earn the trust placed in us by insisting on quality and striving to get the basics of quality of care – safety, effectiveness and patient experience – right every time. We encourage and welcome feedback from patients, families, carers, staff and the public. We use this to improve the care we provide and build on our success. Compassion We ensure that compassion is central to the care we provide and respond with humanity and kindness to each person’s pain, distress, anxiety or need. We search for the things we can do, however small, to give comfort and relieve suffering. We find time for patients, their families and carers, as well as those we work alongside. We do not wait to be asked, because we care.

Improving lives We strive to improve health and wellbeing and people’s experiences of the NHS. We cherish excellence and professionalism wherever we find it – in the everyday things that make people’s lives better as much as in clinical practice, service improvements and innovation. We recognise that all have a part to play in making ourselves, patients and our communities healthier. Everyone counts We maximise our resources for the benefit of the whole community, and make sure nobody is excluded, discriminated against or left behind. We accept that some people need more help, that difficult decisions have to be taken – and that when we waste resources we waste opportunities for others.

Our Vision: To improve the health & wellbeing of our population through collaborative working

Our values reflect the shared values of all NHS organisations, as defined in the NHS

Constitution, and underpin all that we do

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Clinical Lead: Dr Chris Warburton ([email protected])

Network Manager: vacancy

Quality Improvement Leads: Kathy Collins ([email protected]); Caroline Flynn ([email protected]); Anna Bass ([email protected]); Sarah Griffiths ([email protected])

Priorities/Aims Project Title Deliverables SMART Objectives Improvement Partners

Improving the quality of care and access to cancer treatment

Reduce variation and improve access in cancer services

Network agreed commissioning intentions for lung cancer services

Final report with recommended commissioning intentions July 2015

Network agreed commissioning intentions for colorectal cancer to include the reduction of variation in access and waiting times

Final report with recommended commissioning intentions November 2015

Network agreed NICE compliant pathway to support timely diagnosis and treatment of Malignant Spinal Cord Compression (MSCC)

Agree project brief Including financial support June 2015

Macmillan Cancer Support

Network agreed pathway for non- obstetric ultrasound to support timely diagnosis of ovarian cancer which will include the reduction of variation in access and waiting times

Agree diagnostic pathway June 2015 Implement diagnostic pathway August 2015 Evaluate impact of pathway March 2016

Cancer Work Plan

mailto:[email protected]





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Network Strategy for ovarian cancer to reduce variation in clinical outcome and patient experience across C&M

First draft of Ovarian Strategy August 2015; Agree strategy October 2015; Implement strategy November 2015 - March 2016; Evaluate impact 2016/2017

Network strategy for addressing head & neck cancer

First draft of Head & Neck Strategy August 2015; Agree strategy October 2015; Implement strategy November 2015 – March 2016; Evaluate impact 2016/2017

Earlier diagnosis of cancer A Service Improvement Plan for lung and colorectal cancer diagnosis made through emergency presentation

Agree project brief July 2015; Data collected and analysed November 2015; Service Improvement Plan produced January 2016

CRUK

Living with and beyond cancer

Adopt and implement survivorship charter to support assessment and care planning which includes Holistic Needs Assessment and treatment summaries for all tumour groups and to re-design follow up for breast and colorectal cancers

Assessment and care planning project brief agreed with Lead Nurse Group by September 2015; Redesigned follow up project brief agreed with Breast CNG August 2015; Redesigned follow up project brief agreed with Colorectal CNG October 2015; Implementation December 2016; Evaluate impact March 2017

Macmillan Cancer Support

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Clinical Leads: Aftab Ahmad (Diabetes) ([email protected]); Abraham Abraham (Kidney) ([email protected]); Debbie Lowe (Stroke) ([email protected]) Joseph Mills (Cardiac) ([email protected]) Bruce Taylor (Cardiac GP Lead) ([email protected])


Quality Improvement Leads: Wendy O’Connor ([email protected]) Tracie Keats ([email protected]) Claire Hammill ([email protected]) Dawn Hannah ([email protected]) Gemma Ingham ([email protected]) Karen Duxbury ([email protected])


Improving cardiovascular disease prevention, self- care, treatment and rehabilitation

Prevention and treatment of CVD

The development of an Atrial Fibrillation (AF) pathway

AF pathway agreed by June 2015; Implemented by September 2015; Evaluate impact 2016/17

NWC AHSN Pharmaceutical Industry

Development of a service specification for familial hypercholestrolimia (FH)

Agree by December 2015; Implement by March 2016; Evaluate impact 2016/17

Pharmaceutical Industry

Formulation of a Hypertension (HTN) Strategy

Contribute to the delivery of an end to end HTN pathway 2015/16

PHE NNW HEE NW NWC AHSN

The development of educational programmes for primary care, secondary care and patients to help manage acute kidney Injury to include nationally developed and accredited tools

Complete scoping by October 2015; Programme agreed and piloted by March 2016; Impact evaluation 2016/17 An education event will be delivered to Primary Care Health Care Practitioners on the 9th September 2015; Impact will be evaluated by December 2015

Cardiovascular (CVD) Work Plan



mailto:([email protected]









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Network agreed pathway for Chronic Kidney Disease

Agree pathway March 2016; Implementation and impact evaluation 2016/17

Development of a stroke strategy across the whole patient pathway

Agree strategy by March 2016; Implement and evaluate impact 2016/17

Develop network agreed pathways for Acute Coronary Syndrome and Heart Failure services.

Agree by November 2015; Implement by March 2016; Evaluate impact 2016/17

Review and develop appropriate pathways and tools to support patients with diabetes in primary care:

Diabetes dashboard

Footcare

Impaired glucose regulation (IGR)

Dashboard Agree roll out plan by September 2015; Increase number of CCGs using dashboard by March 2016; Evaluate impact 2016/17 Footcare Evaluation of implementation of pathway December 2015; Increase number of CCGs utilising a footcare pathway in line with national guidance March 2016 IGR Review implementation September 2015; Continuous evaluation of impact March 2016

Development of a pathway for diabetes in pregnancy

Agreed pathway by July 2015; Implement by September 2015; Evaluate impact 2016/17.

North West CSU, AQUA

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Development of a cardiac imaging strategy

Agreed strategy March 2016; Implement and evaluate impact 2016/17

North West Specialised Commissioning

Self-care and rehabilitation Develop Network agreed patient education programme for Cardiac Rehabilitation Service

Agree programme by March 2016; Implement and evaluate 2016/17

Implementation of the Network post renal transplant pathway

All Nephrology units to be trained by March 2016; Repatriation to commence 2016/17

Development of a diabetes patient education curriculum

Curriculum outline developed by March 2016; Module development 2016/17

NWC AHSN

CVD professional training for Stroke Nurse Specialists, Practitioners with a special interest in cardiology and generalist health care professionals

Deliver and evaluate impact throughout 2015/16

University of Bradford University of Central Lancashire

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Clinical Lead: Professor John Ellershaw ([email protected])

Network Manager: Bernadette Hurst ([email protected])

Quality Improvement Leads: Kathy Collins ([email protected]) Caroline Flynn ([email protected]) Pam Bailey ([email protected])


Improving quality of care and reducing variation in access to end of life care services

Patient preferences and wishes

Advance Care Planning Guidance

Guidance agreed July 2015; Disseminate guidance August 2015; Evaluate impact 2016/17

Marie Curie Palliative Care Institute Liverpool

Electronic Palliative Care Co-ordinating Systems (EPaCCS) implementation strategy

Updated implementation guidance and revised project plan by June 2015; Monitor roll out and implementation by locality on a quarterly basis

Care of the Dying Evaluation (CODE)

Agree plan for dissemination of results by July 2015; Analysis of Care of the Dying Evaluation (CODE) by October 2015; Service Improvement Plan by November 2015

Marie Curie Palliative Care Institute Liverpool

Education and training A strategic plan for end of life care within care homes to support service improvement, education and support of staff

Care Home Summit November 2015; Strategy agreed by March 2016

Palliative and End of Life Care Work Plan






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Priorities/Aims

Project Title Deliverables SMART Objectives Improvement Partners

Position Statement outlining local responses to the ‘priorities of care for the dying person’ which will include examples of good practice

Collation and presentation of findings by July 2015; Develop recommendations for further improvement September 2015

Clinical standards and guidelines for palliative and end of life care supporting best practice clinical care accredited by NICE

Planned programme of audits for the year April 2015; Accreditation December 2015

NICE

A network agreed programme of education and training reflecting national eolc and HENW priorities to support a competent skilled workforce for patients at end of life

Sign off SLA by Health Education North West (HENW) June 2015; Agree delivery plan June 2015; Quarterly progress reports

HENW

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Clinical Leads: David Rowlands (Maternity) [email protected]); Tim McDougall (Children & Young People) [email protected])

Network Manager: Bernadette Hurst ([email protected])

Quality Improvement Leads: Hannah Hague ([email protected]); Claire Hammill ([email protected]); Gemma Ingham ([email protected]); Jayne Jones ([email protected])


Reducing variation and improving outcomes in maternity services

Reducing still births Early implementation of the National Saving Babies Lives Care Bundle

Maternity providers identified as early implementers by April 2015 Reduced Fetal Movement (RFM): Sticker and leaflet: Implement by April 2015; Evaluation of impact by September 2015; Review and revise (if required) by December 2015; Implement revised version by February 2016. RFM Management Guidelines Develop and agree by May 2015; Implement by June 2015; Evaluation of impact commencing March-Aug 2016 Fetal Monitoring during Labour Review existing competency frameworks by June 2015; Develop/revise framework by March 2016; Implement/evaluate framework during 2016/17.

SANDS Tommy’s Mama Academy Count the Kicks Perinatal Institute Campaign for Safer Births Each Baby Counts (RCOG) Public Health England Local PH Network (CHAMPS)

Maternity, Children & Young People Work Plan








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Development of a business case for a consistent enhanced midwifery service (EMS) for vulnerable women

Review current enhanced midwifery services by December 2015; Identify gaps and variation in provision by February 2016; Develop outline business case by March 2015.

CHAMPS

Optimising the management of acute and chronic conditions in pregnancy

Review and develop appropriate pathways for the management of pregnant women with:-

Kidney disease

Morbid obesity/post bariatric surgery;

Inflammatory bowel disease;

Outpatient management of hyperemesis

Thyroid disease

Kidney Disease Review existing pathways by December 2015; Develop pathway by February 2016; Agree pathway by March 2016; Implement and evaluate impact during 2016/17 Morbid Obesity/Post Bariatric Surgery Review existing pathways by November 2015; Develop pathway by January 2016; Agree pathway by March 2016; Implement and evaluate impact during 2016/17 Inflammatory Bowel Disease Review existing pathway by September 2015; Agree revised pathway by November 2015; Implement revised pathway by December 2015; Evaluate impact 2016/17.

C&M Critical Care Network C&M Neonatal Network

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Outpatient Management of Hyperemesis Review existing pathways by November 2015; Develop pathway by January 2016; Agree pathway by March 2016; Implement and evaluate impact during 2016/17 Thyroid Disease Review existing pathway by April 2015; Revise and agree pathway by June 2015; Implement pathway by December 2015; Evaluation of impact during 2016/17.

Optimising the management of pre-term deliveries

Development of a pathway for intra-uterine transfers

Review existing pathways by October 2015; Develop/revise pathway by December 2015; Agree pathway by March 2016; Implement and evaluate impact during 2016/17.

C&M Critical Care Network C&M Neonatal Network North West Specialised Commissioning

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Improving maternal mental health

Development of a maternal mental health pathway based on NICE Clinical Guidelines 192

Develop pathway by April 2015; Review and agree by June 2015; Implement (by all maternity units) by December 2015; Impact will be evaluated during 2016/17.

CHAMPS Maternal Alliance

Development of a perinatal mental health strategy

Review of current local strategies by September 2015; Agree strategy by January 2016; Implemented by March 2016; Evaluation of impact 2016/17


Reduce variation and improve outcomes in maternity services

Development and implementation of a maternity “dashboard”

Draft dashboard by September 2015; Pilot during October 2015 - March 2016; Evaluate during early 2016/17

North West Neonatal Network C&M Critical Care Network Public Health England Health & Wellbeing Boards

Improving outcomes for children and adolescents

Improving outcomes for children and adolescents with mental health problems

Development of best practice/minimum standards for CYP who self-harm

Review existing standards and best practice by November 2015; Develop key quality standards by February 2016; Agree by March 2016; Implementation and evaluation of impact during 2016/17.

CHAMPS STORM Local Paediatric Urgent Care Network

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Develop recommendations for an Autistic Spectrum Disorder (ASD) pathway

Review pathway by August 2015 Agree by September 2015 Implement by December 2015 Evaluate by March 2016

Schools: Abbots Leigh; Redbridge; Wargrave House and Peters Leigh. Wirral Autistic Society

Development of a quality Dashboard for Child and Adolescent Mental Health Services (CAMHS) Tiers 1 – 4

Review existing dashboards by October 2015; Agree indicators and definitions by March 2016; Implement and evaluate impact during 2016/17.


Support the development of Transformation Plans for children’s mental health including intensive intervention services (Tier 3.5)

National/North of England Learning Event: 10 July 2015; Engagement event with CCGs and HaWBs by October 2015; Transformation plans finalised by March 2016.

Local Authorities

Health and Wellbeing

Boards

North West CYP IAPT

Collaborative Programme

Royal College of Psychiatrists

Improving outcomes for children and adolescents with long term conditions including transition

Review paediatric asthma services against the recommendations from the National Review of Asthma Deaths (NRAD) to identify gaps and variation

Review of services completed by December 2015; Produce report identifying gaps and variation by March 2016.

Local respiratory networks Asthma UK CHAMPS Royal College of Physicians

Development of quality standards for transition from paediatric to adult services for epilepsy and diabetes

Review current standards by November 2015; Develop/revise quality standards by February 2016; Agree by March 2016; Implement and evaluate during 2016/17

North West Paediatric

Diabetes Network

Diabetes UKEPIC (Epilepsy in Children)

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Development of a pilot for a transition practitioner team model for children with complex needs

Develop model by August 2015; Agree by September 2015; Implement pilot and evaluate during 2016/17

Healthier Liverpool

Programme

Improving acute medical and surgical paediatric care

Review existing paediatric services against the RCPCH Facing the Future: Standards for Acute General Paediatric Services and the new Facing the Future: Together for Child Health Standards

Review services by December 2015; Produce report identifying gaps and variation by March 2016;

Royal College of Paediatrics and Child Health

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Clinical Leads: Sara Finlayson (Mental Health) ([email protected] ); Peter Arthur (Dementia) ([email protected] ); Nick Fletcher (Neurological Conditions) ([email protected])


Quality Improvement Leads: Elaine Owen ([email protected]) Tracie Keats ([email protected]) Mary Jordan ([email protected])


Improving the quality of care and access to mental health and dementia services

Better prevention and increased early access to treatment and crisis care

Support the implementation of the actions from the Mental Health Crisis Care Concordat

Agree an outcome matrix and KPIs to measure delivery by July 2015

Pan Cheshire Mental Health

Strategic Board

Pan Merseyside Mental Health and Social Care Board AQuA

Development and implementation of an early intervention in psychosis pathway which addresses capacity and access issues

Base-line performance of Early Intervention Services by July 2015; Revise and agree pathway by September 2015; Implement best practice pathway by December 2015; Evaluate impact of pathway during 2016/17

EIP Networks AQuA

Development and implementation of a pathway for liaison psychiatry which addresses capacity and access issues

Base-line services by July 2015; Pathways reviewed by September 2015; Pathways revised and agreed by March 2016; Impact evaluated during 2016/17

Liaison Psychiatry Network

Mental Health, Dementia & Neurological Conditions Work Plan







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Development and implementation of a post dementia diagnostic support pathway

Complete capacity & demand of current service by June 2015; Develop new model of care by October 2015; Pilot new model of care in 1 CCG by January 2016; Develop and implement Care Navigator role by December 2015; Impact evaluated during 2016/17

Development and implementation of an integrated depression care pathway

Pathway agreed by August 2015; Implemented by December 2015; Impact evaluation by March 2016

Liverpool John Moores University

Identification of variation in access to psychological therapies and development of best practice models

Best practice models identified by June 2015; Implementation September 2015; Review against new access targets December 2015

IAPT Intensive Support Team

Identification of the baseline and variation for access and waiting times for Eating disorders

Baseline by October 2015; Agree pathways by March 2016; Implementation and evaluation of impact during 2016/17

Talking Eating Disorders (TEDs) Network

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Integration of care to ensure Parity of Esteem

Development of frameworks to ensure that physical health needs of mental health patients are aligned

Review existing Frameworks by July 2015; Agree priorities for inclusion by September 2015; Implement frameworks by March 2016; Evaluate impact during 2016/17

Education and training Support the delivery of a dementia education programme

Ensure training is cascaded by DGHs by July 2015; Agree training package for use within care homes by July 2015; Agree implementation process of GP education package by September 2015

HENW HEIs LETBs C&M Deanery

Improve the management and experience of people with neurological conditions

Reduction of variation in care and treatment

Implementation of a chronic headache pathway

Agree headache pathway by March 2016; Implement and evaluate impact during 2016/17

Implementation of an evaluation tool to determine concordance with the seizure pathway

A baseline of the current use of the referral pathway within trusts will be undertaken by October 2015 (further work will be confirmed)

Development and implementation of a system which ensures timely administration of drugs that are used to treat Parkinson’s disease

A workshop will be held to identify the issues at ward level by July 2015 (further work will be confirmed)

NWC AHSN

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Review of access to acute neurology services

Baseline the current pathways October 2015; Acting on the findings of the review by March 2016

Development and implementation of a pathway for patients with Psychogenic Neurological Symptoms

Baseline the current pathways October 2015; Act on the findings of the review by March 2016

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Strategic Clinical Network Organogram

Venn diagram to show shared work streams

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Cheshire & Merseyside has implemented and retained the recommendations outlined in the Operating Framework for SCNs in relation to structures and grades of staff. Structures continue to mirror those laid down nationally until the outcome of the review is known. In the absence of any agreed national funding allocations in future years, the Cheshire & Merseyside SCNs continue to run with an appropriate pay costs’ ceiling to ensure any future reductions in allocations do not affect staffing levels or compromise job security where programmes of work are up and running. Current plans have indicative budgets as follows:

2015-16

Admin 761

Programme 1056

Total budget with 24% reduction on programme 1817

Core Pay

SCN 456

Senate 62

Programme Costs 856

Clinical leadership 235

Overheads/commission work 208

Senate commission work 0*

1817

*Senate funding to be agreed re regional £250k

Financial Section

cheshire and merseyside strategic clinical networks ...€¦ · evaluate impact 2016/17...

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