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Corporate slide master With guidelines for corporate presentations. Early Reflections on Clusters in Wales & Emerging Primary Care Quality Initiatives. Dr Richard Lewis, National Professional Lead for Primary Care. The Wales We Want. Prudent Health Care.
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Corporate slide master With guidelines for corporate presentations Early Reflections on Clusters in Wales & Emerging Primary Care Quality Initiatives Dr Richard Lewis, National Professional Lead for Primary Care
Prudent Health Care • “Prudent healthcare has to be about thinking differently about the services we provide and the relationship between the professional and the individual” • 4 Principles: • Patients and Professionals Equal Partners • Greatest Health Need First • Do Only What’s Needed, Do No Harm • Reduce Inappropriate Variation, Evidence Based • www.prudenthealthcare.org.uk
Children to be given the best start in life from very early years • Thriving communities built on a strong sense of place • Valuing our environment • Investing in growing our local economy • Reducing inequality and a greater value on diversity • A stronger citizen voice and active participation in decision making • Celebrating success, valuing our heritage, culture and language
QOF in Wales 2014-2017 • Removal of QOF clinical indicators • 2014-15 300 points • 2015-17 102 points • Creation of the Cluster Network Development Domain • Support for the use of Clinical Governance Practice Self Assessment Toolkit http://howis.wales.nhs.uk/sitesplus/888/page/37945 • Introduction of National Clinical Priorities
Clinical Governance Practice Self Assessment Tool (CGPSAT) • Maturity matrix- 5 levels http://www.wales.nhs.uk/sitesplus/888/page/44038#A • Based on the Welsh Health and Care Standards ‘encourages practices to bridge the gap between understanding and thinking about their governance systems and completing the actions needed to improve them’
National Clinical Priorities: GP Contract • End of life care • Frailty and polypharmacy • Prevention and early diagnosis of cancer • Lung • Gastrointestinal • Ovarian
Example : Cancer Diagnosis and CareEmerging themes: Adopted Actions • Importance of safety netting • Need to actively manage care pathways/vulnerable groups • Screening- understand/ reasons for failure to attend • Ensure correct interpretation of negative investigations • Continuity in GP to recognise frequent attendance – possible serious underlying concerns • Need for more systematic use of adverse incident reports • Better access to diagnostics • Lower threshold of suspicion • More discriminating about diagnostic tests • Vigilant follow up of results • Proactive about screening • Active response to downgrading • Actively engaging with CPD • Case based discussions in practice • More systematic approach to weight, smoking status etc • Engagement to improve clinical pathways
Blaise Pascal (1623-1662) “People are generally better persuaded by the reasons which they have themselves discovered than by those which have come in to the mind of others.”
Automated software updates Automated aggregated data extract Automated extract – external data transfer utility SAIL, PRISM & NDA The Data Quality System – Simple Schematic Primary Care Aggregate Data Repository Central Repository GP Practice based tool
Audit+ Modules, Projects and Patient Level Data Extractions Supported • QOF 2015-16 • Disease prevalence & incidence • Data quality ‘Tidy Ups’ • Diabetes DES • DRSSW Retinopathy For Public Health Wales • Flu vaccination reporting • Pneumococcal vaccination reporting • Shingles vaccination reporting • Meningitis ACW&Y reporting • Pandemic Disease System • Post viral complications • National Diabetes Audit • HQIP Chronic Kidney Disease Audit • National Chronic COPD Audit • PRISM data extraction module • SAIL data extraction module
Familial Hypercholesterolaemia module Coeliac Disease Audit NDA Practice Support Prescribing Safety Appointment System/Workload data extraction COPD Practice Support GMS Flu module Disease prevalence – co-morbidities Healthchecks+ Support CHD, Diabetes & Stroke Delivery Groups joint initiative Audit+Modules soon to be deployed