QIPP – Sip feeds

1. QIPP – Sip feeds Waltham Forest PCT

2. Summary • Spend and potential savings • Plan implemented in WF • Barriers • Progress so far • Savings for east of England

3. Trend in spending on ONS in WF

4. ONS expenditure in WF

5. Savings in Waltham Forest • Reduce inappropriate prescribing • ONS policy • Scriptswitch • Increase GP awareness (newsletter & meetings) • Complan switch • First line where apporpriate • Starter packs • Educate care homes

6. PoA • Alter policy to promote Complan before other nutritional on hospital discharge and in community • Scriptswitch messages • Complan starter packs in hospital • Dietician to review all patients discharged from hospital on ONS if not referred while in hospital • Audit current practice • Dietician to review patients • Recommendations to GP • GP informs own practice • Better referral levels to dieticians in future

7. Barriers • GP – relationship with PSPs, defensive of current practice • Access to practices – time and computer facilities • Need for dietician to carry out reviews • Insufficient medicines management team support to carry out audit

8. Audit • Top ten spending practices in WF • Patient ID & age, recent BMI, indication, sip feed prescribed and duration, goals recorded, food first advice given, involvement of dietician • Contact details of patients for dietician • Confidential treatment of information

9. Dietician support • Dietician seconded for a year • Sits with dieticians but under MMT • Reviews by telephone, face-to-face or at a clinic • Recommendations to GP • Patient and MMT copied into communications • Weekly excel progress update

10. Progress so far • Early days but encouraging • Discontinued or switched • Informs other dieticians to be vigilant and use Complan first-line • Appointments with patients set-up initially

11. Potential for savings across east of England

12. Thank you for your time 