Workforce Modelling for Paediatric Gastroenterology

Paul Fortewww.balanceofcare.com+44 7818 066653

ORAHS 2010, Genoa, Italy, 19-23 July 2010

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

The Balance of Care Model for Paediatric Gastroenterology

PaediatricGastro patients

Cystic Fibrosis

Failure to thrive

Small bowel Crohns

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

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

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

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

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

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