Tag: primary care

Quality improvement for primary care workshops launch

The West of England Academy are hosting a new series of five free-to-attend interactive online workshops each Friday from 16 April.

Attendees will gain a basic understanding and practical knowledge of applying Quality Improvement (QI) techniques to real-world challenges in primary care.

Modelled on our hugely successful QI Summer and Winter Series, this five-week course, held over 90-minutes each Friday from 12noon can be joined as single sessions or a series.

The workshops have been developed, and will be delivered by, the West of England Academy team alongside guest speakers. Topics include stakeholder mapping, process mapping, data management and the basics for change management.

Attendees can be in any role and/or grade within their organisation, for example from clinical, administration or facilities.

Our academy works hard to welcome attendees from a broad range of backgrounds creating a safe and open environment for learning and sharing ideas.

Find out more about QI for primary care and book here. 

The West of England Academy offers a wide range of free resources to healthcare professionals and innovators across the region. To find out more, visit our Academy pages or email weahsn.academy@nhs.net.

Flu resources launched: People with a learning disability are at greater risk of developing serious illness

The national flu campaign to encourage uptake of the free flu vaccination, particularly amongst at risk groups, has launched.

Individuals with a learning disability are identified as an ‘at risk’ group and are therefore entitled to a free flu vaccine. As are their carers, whether that is a family member or paid support staff who care for the individual day-to-day.

As such, the West of England AHSN and our Learning Disabilities Collaborative will be continuing to share advice and raise awareness of the importance of individuals with a learning disability, their families and carers, getting the flu vaccination throughout winter.

On behalf of the NHS, Misfits Theatre Company have created a great video which tackles the misinformation surrounding the flu vaccination head on and urges people with learning disabilities and their carers (family member or support worker) to not delay in getting their free flu vaccine.

You can watch the video here.

People who have a learning disability can be more susceptible to the effects of flu and are therefore at increased risk of developing complications such as bronchitis or pneumonia. As the NHS emerges from the covid pandemic, anyone with a learning disability is encouraged to get their free vaccination and annual health check to help stay well this winter.

Carers of anyone with a learning disability are also entitled to the free vaccination. All carers (family member or support worker) are urged to ensure they are registered at their local GP practice as a carer of someone with a learning disability. Individuals should also be on their GP Learning Disability Register to access the very best care.

Now is the time that GP practices and community pharmacies are carrying out vaccinations for those at risk. The vaccine offers the best level of protection from the flu virus, and it’s important to have the vaccine every year, especially as the flu virus strain changes every year. Anyone who is defined as being in an ‘at risk’ group should contact their surgery and arrange an appointment to have the vaccine.

Having the vaccine sooner provides the individual with protection over a longer period of time; it also helps reduce the chances of spreading the virus to family and friends.

Watch this NHS England and Improvement video where Camilla, who has a learning disability, talks about getting her flu jab. 

Hannah Little, our Patient Safety Improvement Lead and Senior Project Manager said:

“Flu is a very unpleasant illness. The symptoms can be miserable for many of us, but it can lead to more serious complications for those who fall within certain clinical ‘at risk’ groups. Some people with a learning disability can be more susceptible to flu and can go on to develop more serious complications like pneumonia. Respiratory conditions remain the most significant causes of premature mortality for people with a learning disability where deaths have been reviewed as part of the LeDeR programme.

I’d urge people to make sure they have the vaccination as soon as possible. They should also ask to have their Annual Health Check, which our Learning Disabilities Collaborative discussed at our September 2020 webinar. Carers of anyone with a learning disability should also get the free vaccine from their GP surgery or community pharmacy, the sooner the better to get the best possible protection.”

 

The full pack of winter flu resources for people with learning disabilities and their carers (which includes high resolution resources for social media, communications toolkit and grab pack for professionals) is available on the NHS England and Improvement website.

The flu vaccine is also free for patients in the following at risk groups:
• Those aged 65 years or over (including those becoming age 65 years by 31 March 2021)
• Those aged from 6 months to less than 65 years of age with a serious medical condition such as:
• Chronic (long term) respiratory disease, such as severe asthma, chronic obstructive pulmonary disease (COPD) or bronchitis.
• Chronic heart disease – (such as heart failure).
• Chronic kidney disease (at stages three, four or five).
• Chronic liver disease.
• Chronic neurological disease such as Parkinson’s disease or motor neurone disease
• Diabetes
• Splenic dysfunction
• Reduced immune system due to disease (such as HIV/AIDS) or treatment (such as cancer treatment)
• Morbidly obese (defined as BMI of 40 and above)
• All pregnant women (including those women who become pregnant during the flu season)
• All children aged 2 and 3 years

• All children in school years R through to year 5
• People living in long-stay residential care homes, or other long-stay care facilities where rapid spread is likely to follow the introduction of infection and cause high morbidity and mortality.
• People who are in receipt of a carer’s allowance, or those who are the main carer of an older or disabled person whose welfare may be at risk if the carer falls ill
• Consideration should also be given to the vaccination of household contacts of immunocompromised individuals, specifically individuals who expect to share living accommodation on most days over the winter and therefore for whom continuing close contact is unavoidable

Don’t Wait to Anticoagulate is now award-winning!

Our Don’t Wait to Anticoagulate (DWAC) project won a prestigious Anticoagulation Achievement Award this month for its achievements in stroke prevention.

DWAC won the category ‘The centre best able to demonstrate adherence to NICE quality standards for atrial fibrillation’. The Anticoagulation Achievement Awards celebrate outstanding practice in the management, education and provision of anticoagulation across the UK. Staff from the West of England AHSN attended the award ceremony on Wednesday 11 October at the House of Commons.

The West of England AHSN have been working in collaboration with Gloucestershire Clinical Commissioning Group (CCG) and Bayer Healthcare to prevent strokes amongst patients with atrial fibrillation by improving medicines management in primary care.

Effective anticoagulation has been shown to reduce the risk of stroke for patients with atrial fibrillation; an abnormal heart rhythm. Anticoagulation is the process of hindering the clotting of blood; especially the use of an anticoagulant medicine to prevent the formation of blood clots.

For the DWAC project, the West of England AHSN co-designed resources with a wide range of stakeholders, including NICE, patient representatives and clinical partners. These resources include guidance for clinicians, pharmacists and patients to aid shared decision making and improve take up of anti-coagulant medicines. The resources are supported by quality improvement (QI) and clinical skills training. For more information visit www.dontwaittoanticoagulate.com

During the 36 weeks of phases one, two and three of the project’s roll-out in the westcountry, DWAC has potentially prevented 27 strokes amongst people with atrial fibrillation, representing an estimated saving of over £629,000.

Additionally, feedback from users confirms that the DWAC approach has led to improved patient care, increased confidence in shared decision making, and improved working practices. There has been a strong shift in focus from “Why anticoagulate?” to “Why not anticoagulate?”

This award demonstrates that DWAC is an important part of the national drive to reduce the number of strokes. The project is being adopted across the North West of England, Yorkshire and Humberside, Buckinghamshire and East Berkshire with 85 GP practices involved and many more engaged to start, plus further spread is planned across the West.

“I am really proud that all the hard work in GP practices across Gloucestershire, with the support of the West of England AHSN, has been recognised by winning this award. Furthermore, it is fantastic that the principles and methods developed within the DWAC programme are being rolled out to primary care in other CCG areas across England.”

Dr Jim Moore, GP, Stoke Road Surgery, Cheltenham

The organisers were delighted at the level of interest and applications received for this first year of the Anticoagulation Achievement Awards. The awards are hosted by leading charities, Anticoagulation UK, AF Association, Thrombosis UK, Arrhythmia Alliance and training establishments – Anticoagulation in practice and Thrombus. They invited applications from teams and individuals across secondary, primary and community services who can demonstrate innovation and excellence in delivering anticoagulation services, resources or individual leadership. There were six award categories and DWAC was up against some tough competition.

The winning entries from each category received a £1,000 bursary, which will be used to aid continuous improvement of services.

For the full list of winners, visit the Anticoagulation Achievement Awards website.

 

Photo: Jim Moore, GP at Stoke Road Surgery; Steve Ray, Healthcare Partnership Manager at Bayer; Dave Evans, Quality Improvement Programme Manager at the West of England AHSN; Tasha Swinscoe, Chief Operating Officer at the West of England AHSN; and Tabinda Rashid-Fadel, Circulatory Programme Manager at Gloucestershire Clinical Commissioning Group.

Collaborating for a safety culture in primary care

At the end of May, colleagues from 13 primary care practices from across the West of England, including GPs, practice managers, practice nurses and quality and safety leads, came together for the first meeting of our new Primary Care Collaborative.

The event was opened by our  Patient Safety Programme Director Ann Remmers who spoke about the context for collaboration. Dr Hein Le Roux, GP & Primary Care Lead for Patient Safety for the West of England AHSN, then explained how collaboration was a combination of people and technical skills. He told a cautionary tale of the Choluteca bridge and painted a picture of what better could look like in primary care. He explained how taking a systems approach could tackle some of the challenges through collaboration, and gave an example of a patient in his care where their care could have been better, and shared the learning from that incident.

Stephen Ray, Quality Improvement Programme Manager, expored why things go wrong in a systems context and some of the methods to take a systematic approach to quality improvement to build reliable systems. He explained the clinical microsystems approach, the model for improvement, and case studies from his experience working on improvement with GP practices.

All the presentations from our speakers are available here.

Attendees told us they really valued the time to meet other practices, learn from others and discuss subjects that they don’t normally get time to. There was great feedback about the speakers and group sessions, and the bacon sandwiches first thing were a big hit! They made a list of actions to take away from the day including looking at their existing processes and communications, developing a map of responsibilities, using PDSA and changing their language from “significant event” to “learning event”.

At our next meeting in September, the Collaborative agreed to focus more on sharing learning from particular examples from practices, with in-depth support on a topic chosen by attendees. Suggestions included:

  • Engaging and motivating staff to make changes
  • Putting changes into practice
  • How to engage all staff to make real change
  • Motivating staff and changing culture
  • Bringing on board difficult characters – what impact can individuals have on instigating change?

About the Primary Care Collaborative

The Collaborative has been set up to promote a safety culture in the primary care setting through the use of incident reporting, whilst giving the practices involved tools and training in quality improvement methodology. It will also help practices to undertake their own improvement journeys and network with other practices in the region to share learning and facilitate collaboration.

Benefits for the practices involved in the new Primary Care Collaborative include helping their practice in its next Care Quality Commission inspection and will contribute to the revalidation and appraisal processes for all staff. Staff are receiving quality improvement methodology training and resources throughout. Being a part of the collaborative will also increase awareness amongst practice teams of the patient safety agenda, while promoting an open and honest culture.

Patient safety is high on the public agenda, and practice’s involvement in the scheme will improve assurance that their practice has an open and transparent approach towards patient safety, in addition to improving the overall patient experience. Patient representatives for each practice have also been invited to take part as members of the practice core team.

Future events

  • Swindon| Hilton Swindon, Wednesday, 7 September 2016 from 08:00 to 12:30
  • Gloucestershire | Stonehouse Court Hotel, Wednesday, 30 November 2016 from 08:00 to 12:30
  • Bath | Royal United Hospital, Wednesday, 1 March 2017 from 08:00 to 12:30

Contact

For more information on the Primary Care Collaborative, please contact Kevin Hunter at kevin.hunter@weahsn.net.

The Leadership Series – Commissioning Musculo-Skeletal Care

The concept of the Leadership Series is to bring specific senior commissioners together from across the seven CCGs to focus on areas of common challenge, facilitate learning, spread knowledge across the patch and identify further areas to explore collaboratively.

Five Leadership Series meetings have been scheduled to date: three in 2016, covering the topics of ‘Primary Care Demand and Flow’, ‘Commissioning Musculo-skeletal care’ and ‘Commissioning Diabetes Care’, and two of which were held in 2015 on ‘Using Evidence & Evaluation in Commissioning’ (February 2015) and ‘Exploring different approaches to CCG prioritising and de-prioritising strategic initiatives’ (May 2015).

The Musculo Skeletal Care event was held on 19 April with 17 attendees from all seven WEAHSN member CCGs and two UWE researchers.  Feedback from the meeting from delegates was very positive, with a request to meet again in early September, in advance of the CCG business planning timetable.

Feedback after the event included:

“An excellent opportunity to share work in a supportive environment.  I have a far better understanding of what is happening locally and who is involved.” GP Clinical Lead

“Between us we can transform MSK; we need to coordinate much better.” Elective Care Lead

“Very helpful to see what is happening on the patch.  Good to combine clinical perspective with management transformation.” GP & Clinical lead for Planned Care

“We are all grappling with similar issues and it feels a less lonely place now!  There is a collective motivation to embed transformation.”  Service Improvement & Development Manager.

“Useful to collaborate.  We are all trying to do similar things.”  GP Clinical Evidence Fellow

There was also agreement that a musculo-skeletal ‘community of practice’ would be helpful to electronically enable attendees to stay in touch.

Measuring demand in general practice – new report published

A new study has been published exploring how demand is measured and managed by GP practices in the West of England.

The West of England AHSN commissioned the study, in partnership with NIHR CLAHRC West, as part of its Commissioning Evidence Informed Care programme, which is led by Dr Peter Brindle.

Demand for Primary Care services exceeds capacity available. With increasing cost pressures, increase in patient expectation and advances in medicine, more people are visiting their GP than ever before. With no new monies available to significantly increase GP numbers, the West of England AHSN is advocating an evidence-based approach to measuring and managing demand.

There were three main aims to this research:

  1. To review existing literature and to scan regional and national projects that aim to measure
    and manage demand.
  2. To understand how GP practices currently measure and manage demand and how they use
    routinely collected data to predict demand and strengthen capacity planning.
  3. To gain an overview of the three Prime Minister Challenge Fund sites in the region and to determine their approach to measuring and managing demand.

The study highlights a lack of research in this area and a lack of continuity in national projects aimed
at supporting GP practices to understand demand. It therefore provided strong evidence supporting the need for a study of this kind and for further investigation of this area.

Work with GP practices revealed no definitive or widespread approach to measuring demand in primary care. However it confirmed that practices and clinical commissioning groups (CCGs) were struggling to cope with apparently increasing demand and were very keen to engage in further activities that might help understand and manage it better.

Download a copy of the full report here for a full analysis of the findings and recommendations for next steps.