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Workforce Modelling for Paediatric Gastroenterology
Paul Fortewww.balanceofcare.com+44 7818 066653
ORAHS 2010, Genoa, Italy, 19-23 July 2010
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Important issues…
• Need to make best use of an expensive resource: efficiency and effectiveness
• Quality of patient care – enabling ‘care close to home’
• Managing care across organisational and professional boundaries
• Development of clinical networks and information flows
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The Balance of Care Model for Paediatric Gastroenterology
PaediatricGastro patients
Cystic Fibrosis
Failure to thrive
Small bowel Crohns
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The Balance of Care Model for Paediatric Gastroenterology
PaediatricGastro patients
Cystic Fibrosis
Failure to thrive
Small bowelCrohns
Specialist nurse
Paediatric nurse
Voluntary &Private sector
Health Service
Municipality
Dietitian
Social worker
Care worker
Play specialist
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The Balance of Care Model for Paediatric Gastroenterology
PaediatricGastro patients
Cystic Fibrosis
Failure to thrive
Small bowelCrohns
Specialist nurse
Paediatric nurse
Voluntary &Private sector
Health Service
Municipality
Dietitian
Social worker
Care worker
Play specialist
Option 1
Option 2
Option 3
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P1 - Small bowel Crohn's disease No. of Patients: 40Unit Cost: £2,355 £1,223 £932 £ £ £ Totals
Allocation: 15% 5% 80% 100%Allocated Patients: 6 2 32 0 0 0 40
Code Service Description Nutritional Steroids Yr 2: stable Opt 4 Opt 5 Opt 6 CostS1 Specialist nurse/ community nurse (hrs pa) 8 2 £2,128S2 P aediatric surgeon (hrs pa) 1 1 £1,862
S3 Dietitian (hrs pa) 20 1 5 £6,204S4 SALT (hrs pa) £S5 P hysio & OT (hrs pa) £S6 P aediatric psychologist (hrs pa) 4 2 2 £1,840S7 Health Visitor (hrs pa) £S8 P aed Nurse (ward) (hrs pa) 10 2 2 £1,920S9 P lay specialist (hrs pa) 6 2 4 £2,016S10 P aed Gastroenterologist (hrs pa) 8 8 4 £9,408S11 General P aediatrician/ Comm paed (hrs pa) 1 1 1 £1,960S12 SP R (hrs pa) 4 4 4 £4,800S13 Social worker (hrs pa) 2 2 1 £912S14 Care worker (neurodisability) (hrs pa) £S15 Feed company personnel (hrs pa) 8 2 £1,120S16 School meals co-ordinator (hrs pa) 0.5 0.5 £190S17 Specialist paed gastro nurse (hrs pa) 20 10 4 £5,896S18 School nurse (hrs pa) 10 10 5 £4,560S19 P athologist (hrs pa) 2 2 0.5 £1,568S20 GP (hrs pa) £
Total Cost: £14,130 £2,446 £29,808 £ £ £ £46,384Quality Score: 0.0%
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Example Care Options
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Current and projected WTE for selected workforce
0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0
Specialist nurse/ community nurse
Dietitian
SALT
Paed Gastroenterologist
Paediatric psychologist
WTEs
Current Projected
An Example Scenario
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Pilot Project Results
• Successful methodology for working with clinicians
• Description of patient categories• Specification of workforce inputs• Some initial quantification of demand and
supply• Local health economy focus• Highlighting of data issues
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Value of the Balance of Care Approach
• A workable ‘whole system’ approach for clinicians
• It is patient-focused: a view of the patient journey across organisational and professional boundaries
• Supports development of a local joint vision and strategy for service
• Communication and involvement of stakeholders - it enables meaningful dialogue