Release 5.0 Preview

1. Release 5.0 Preview Changes affecting Service Definer users 20.09.2010 – Version 1.0

2. Overview of Changes Support for Alternative Care Pathways Copying Clinical Terms Service Lifecycle Management Enquiry Totals

3. Support for Alternative Care Pathways Background Prior to Release 5.0 the only way to restrict access to a service was for the Commissioner to commission the service as not available for initial referral. This function was only available for primary care menu services. The service was then only visible as an onward referral.

4. Support for Alternative Care Pathways Release 5.0 Functionality:- Service Definers for providers of Primary or Secondary Care Menu services will be able to restrict access to their services for clinical reasons or to support Practice Based Commissioning. Providers will be able to set up pathways to the restricted services. These pathways need to be created so that the provider of a restricted service will be able to specify which services, organisations and/or individual clinicians may directly refer to, refer-on to and redirect to their restricted service Primary Care menu services will still need to be commissioned.

5. Support for Alternative Care Pathways The reasons for the change are: • To encourage service providers to put more specialist (tertiary) services onto Choose and Book, because restricted services are protected by identified care pathways. • To enable multiple practices, within the same practice based commissioning consortia, to refer into a specific service which is not available to other referrers. • To identify clear pathways of care for referrers.

6. Support for Alternative Care Pathways If a service is restricted then a clear pathway in will have to be identified. This service will be via one or more of three routes: authorised service, authorised referrer or authorised organisation.

7. Support for Alternative Care Pathways The following slides give examples of when this functionality might be used: • Prior assessment services • Tertiary or specialist secondary care services • Initial Referral (authorised referrers) • Practice Based Commissioning model (authorised organisations)

8. Prior Assessment Model The pathway is via the Newtown MSK Assessment Service. This service is an authorised service. Referrals received into this service are triaged and/or treated. Those referrals that are clinically appropriate can be referred on to the relevant restricted service. GPs wishing to send referrals to the restricted services will be directed to refer via the authorised service. Under local commissioning arrangements, Newtown Hospital provide an Orthotic Service and Village Hospital a specialised Podiatric Service with Surgical Input. Newtown PCT provide a community Physiotherapy service. These services are restricted and do not accept referrals direct from GPs. Newtown Hospital Orthotic Service Restricted Service Authorised Service Authorised Referrer Key Newtown Musculoskeletal Assessment Service Village Hospital Podiatric Surgeon Service Newtown Community Physiotherapy Service

9. Tertiary/Restricted Secondary Care Service Model Newtown Optical Assessment Service Restricted Service Authorised Service Authorised Referrer The National Eye Infirmary offers specialised tertiary services. These services are published on the national DOS as restricted services. The DOS entry lists all available authorised services that referrers can initially refer into. Key Village General Eye Clinic National Eye Removal Service Liverpool General Optical Clinic London Optical Assessment Centre National Optic Nerve Laser Surgery Service Clinicians within the authorised service are able to refer on to the restricted services where clinically appropriate Birmingham General Eye Clinic Bristol Eye Clinic

10. Initial Referral (Authorised Referrers) Newtown PCT Optical Assessment Service Restricted Service Authorised Service Authorised Referrer Key Newtown Hospital General Eye Clinic National Eye Removal Service Dr Smith from Newtown Surgery wants his patient to go to the National Eye Removal Service. He is notan authorised referrerso he cannotmake a direct referral to the National Eye Removal Service. The Authorised Services presented as his pathways are Newtown PCT Optical Assessment Service or Newtown Hospital General Eye Clinic and Village Hospital General Optical Clinic Village Hospital General Optical Clinic Dr Jones Village Community Health Centre Dr Browne Newtown Community Health Centre Mr Green Garden War Memorial Hospital Dr Jones from Village Community Health Centre wants his patient to go to the National Eye Removal Service. Dr Jones is a GPwSI and is an authorised referrerso he can make a direct referral to the National Eye Removal Service.

11. Practice Based Commissioning Model (Authorised Organisations) The service is defined as a restricted service. This particular service has no individual authorised referrers, and it is an initial referral service so there are no authorised services. Instead it is restricted to authorised organisations. In this case all of the practices within the PBC Group (Newtown) are authorised organisations. Both PBC Groups could be in the same PCT. Newtown Practice Based Commissioning Group provide a non-scalpel Vasectomy Service for all practices within the PBC Group. The service is not available to other practices within the PCT Newtown PBC Newtown Group Practice Restricted Service Authorised Service Authorised Organisation Key Newtown Surgery Newtown PBC Non-scalpel Vasectomy Service Dr Sweeting & Partners X Fourways Surgery Oldtown PBC Two Towns Group Practice Village Health Centre New Lane Surgery Village Road Surgery Beech Grove Practice

12. Support for Alternative Care Pathways Requirements for setting up a restricted service: • Service Definer Role • Using the new Service Restriction shrub, a service can be defined as Restricted. • In order to be able to publish a restricted service, one or more Authorised Referrers, Services or Organisations must be added to it. • Commissioning Support • The service should be Commissioned in conjunction with service requirements if on the Primary Care Menu. Once saved the service will be available to Authorised users to refer/refer-on/redirect directly into. Non-authorised users will be able to see but not refer directly into Restricted services.

13. Support for Alternative Care Pathways Service Restriction Shrub A new Service Restriction shrub will appear in the Maintain Services tab.

14. Support for Alternative Care Pathways • The Restricted tick box must be selected to make the service restricted.

15. Support for Alternative Care Pathways • A reason for restricting the service must be chosen. • If ‘Other’ is picked, then the Restriction Comments box becomes mandatory.

16. Support for Alternative Care Pathways Restrictions are applied to this service due to its specialist nature. • The comments in this textbox will be visible in the new Restricted Services Enquiry, which will be available to all users that have an Enquiries tab.

17. When a service is restricted one, or more, of the following must beadded - Authorised Service, Authorised Organisation or Authorised Referrer. • This ensures that a pathway to the service is created. • A restricted service cannot be published without this information.

18. Support for Alternative Care Pathways Add Authorised Services Screen 4358231 Add Service To add an service, find it’s Service ID, which can be internal or external to the current organisation.

19. Support for Alternative Care Pathways Authorised services (which are themselves not restricted) will automatically be ‘Listed’, meaning that they will be visible as part of the recommended alternative pathway to referrers. A service definer may wish to make some services within their organisation ‘authorised’ but not ‘listed’. This means the service is visible within the organisation but not to referrers. This will allow services within the organisation to refer-on to, or redirect to, the restricted service.

20. Support for Alternative Care Pathways Add Authorised Organisation Screen Add Organisation To add an organisation, search by organisation ODS (formerly NACS) code in this field. Remember – where you wish to be able to refer to this service, you will need to add your own organisation.

21. Support for Alternative Care Pathways Add Authorised Referrer Screen To add an referrer, search by surname, organisation or User ID (the 12 digit unique number on a Smartcard).

22. Support for Alternative Care Pathways Completed Service Restriction Shrub Authorised Services and an Authorised Referrer have been added to the service Of the 3 Authorised Services, only 2 have been listed, ie, only 2 will display to referrers.

23. Support for Alternative Care Pathways Restricted Service Enquiry The Restricted Services Enquiry will show which services are restricted and the reason why. The Restriction Date/Time column shows the last time the service was restricted (which is updated each time this action is carried out) and the Restricted Count column shows how many times this has been done. There are also columns showing numbers of authorised services, organisations and referrers associated to the restricted service.

24. Copying Clinical Terms Release 5.0 Functionality:- The maintenance of clinical terms has been enhanced, as follows: • Overwrite Terms It is possible to replace the current terms within a service with the clinical terms of another service. Clinical terms from the imported Service ID will overwrite the current ones. • Copy Terms This functionality allows users to copy clinical terms from one service to another. Existing terms with the service will not be affected. This functionality can be used within and across organisations. As an example, a clinician working across more than one organisation can replicate their selected clinical terms from one DOS entry to another. (The ‘Save As’ functionality can only be used within an organisation).

25. Copying Clinical Terms Clinical Terms Shrub • A new Copy Clinical Terms button will appear in the Clinical Terms shrub. This button will allow you to import clinical terms from another service.

26. Enter the Service ID from which you are copying terms. This can be an internal service, or a service from another organisation. Overwrite Terms This will replace the terms already present, for those from the service you are choosing. Add Terms This will add any terms that are different from the chosen service to the current service.

27. Printing Clinical Terms • The Print Clinical Terms functionality will now display terms in the order that they appear in the Clinical Terms pane. • Where terms are duplicated they will appear on the printout with an asterisk (*).

28. Service Lifecycle Management Prior to Release 5.0: • If is a service is ending, a Service Definer may possibly change the service name or add a ‘Referrer Alert’ to indicate to referrers that the service should not be chosen. • Services can be end-dated but are still available until that date is passed. Once the entered end-date is reached, the service is no longer available to be shortlisted or booked into.

29. Service Lifecycle Management Release 5.0 Functionality: A new ‘transition date’ enables organisations to ‘wind down’ a service. This means that: • When creating a UBRN, or modifying a referral, the referrer will not be able to shortlist this transitioning service - it will no longer be visible. • Any existing UBRNs that have been shortlisted to a transitioning service, can be booked, rebooked or cancelled into this service up until the end date has been reached.

30. Service Details Shrub A new Service Transition Date field will appear in the Service Details shrub. A new Service Transition Date field will appear in the Service Details shrub. A Transition date cannot be entered until an end date is input for the service. A new Service Transition Date field will appear in the Service Details shrub. A Transition date cannot be entered until an end date is input for the service. The maximum period between the Transition and end dates is 180 days.

31. Service Details Pane The 'Service Transition Date' and 'Service End Effective Date' fields will appear in the Service Details screen. If no dates have been set, these fields will display a dash '-'

32. Minor Change Enquiry Total A ‘Results Returned – X’ will now show wherever an enquiry is made.