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MSK Clinical leaders Network

MSK Clinical leaders Network. Agenda Welcome and introductions- Rachel Wakefield (AD Planned Care programme) and Geoff Watson (Clinical Director Planned Care Programme) Purpose-

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MSK Clinical leaders Network

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  1. MSKClinical leaders Network Agenda Welcome and introductions- Rachel Wakefield (AD Planned Care programme) and Geoff Watson (Clinical Director Planned Care Programme) Purpose- This meeting is an opportunity to critically review progress, and to identify and agree actions for 2012 that will have the greatest impact on supporting progress and implementation in the following areas:-

  2. Areas of Work:- 1. ICATS 2. StarTBack 3. Pain services 4. Enhanced recovery in orthopaedics 5. Shared decision making/decision aids 6. PLCV

  3. Improvement Indicators • LOS for hips and knees- decreased • Same day admission for hips and knees- increased • GP out-patient referral (all specialities) 5% below 11/12 • Total elective FFCEs- 0.2% below 11/12

  4. ICATS Activities- • Robust model developed by CLN • Adoption across SC of many aspects of above- as demonstrated in following slides:-

  5. Overview of ICATS or Similar Services Integrated Clinical Assessment and Treatment Services or Similar GP NOC, Care UK Bracknell BHFT Assura Southern Health NHS Solent IOW NHS PTC

  6. How do we measure success of an ICATs Service

  7. Have we reduced Outpatient Attendances?

  8. StarTBack – What is it? STarT Back Screening Tool (SBST) • 9 Question screening tool designed for non-specific LBP patients in primary care • Developed, researched and validated by Keele University • The score identifies the level of risk that patients have of developing chronicity out of low, medium and high risk.

  9. 3 or less 4 or more Sub score Q5-9 3 or less 4 or more Low risk Medium risk High risk StarTBack Scoring Flow Chart Total Score

  10. StarTBack Activities- • Presentation at MSK event • Production of DVD • Adoption in many ICATS • Funding for local implementation in primary care

  11. StarTBack- ? Next steps • Commencement of 3 implementation sites • Learning set and virtual interest group • Dissemination of update/progress reports and findings

  12. Pain Services • Activities- • Pain self-management featured in MSK event • Interest across region in developing self-management services- adoption in some ICATS • Innovation Funding to Buckinghamshire & Portsmouth

  13. Pain Services- ? next steps • Conference call with Alf Roberts- colleagues in SC seeking input re self-care pain management • Opportunity to share progress from Portsmouth and Buckinghamshire • Integration of pain service into ICATS (Pain summit 2011) • Pathway development for linking primary and secondary care to improve care for people with knee pain or shoulder pain- COBIC.

  14. Enhanced Recovery in Orthopaedics

  15. Reductions in Length of Stay

  16. Overall Reduction in LOS for Hip Replacements

  17. Overall Reduction in LOS for Knee Replacements

  18. Shared Decision Making/Decision Aids Activities- • Pilots for OA knee- NOC and Solent • SDM/DA feature in many QIPP plan for 12/13 • Cluster team based event on SDM- local plans • Strong links with SE and SW colleagues • Significant interest in Train the Trainer courses

  19. Shared Decision Making & Decision AidsNext Steps • Set up community of interest – HIECs to support development • SHA progress region wide plan • Commission course to train the trainers – based on SW model links to self management programme • Follow-up cluster plans and support • Embed in hip & Knee MSK pathways • Support the development of future decision

  20. Decision Aids- next steps Brief decision Aids (BDAs)- • Request from clinical colleagues in Newcastle to write and comment on BDAs • Designed for primary and specialist settings • Piloting in NE- popular with patients and clinicians • Partnership with EMIS- building on patient information leaflets (PIL)– to form basis of BDA • Have short list of topics to be covered • Seeking- authors to convert PIL to BDA, clinicians and patient to comment

  21. Procedures of Limited Clinical Value Activities- • Promotion and use of Atlas of variation, no national list • Each PCT has a PLCV aspect to QIPP plan for 2011/12, all on target to deliver. • Most moving to a more comprehensive approach- re use of SDM/DA to support work

  22. PLCV- ? next steps • ? Alignment across South Central/Southern cluster • COBIC (Capitated and Outcome-Based Incentivised Contract) project- Oxford • Focus on SDM and DA’s- engagement with option grid development

  23. CLN – Future Discussion CLN- where to focus effort for maximum gain? • StarTBack- adoption across primary care • SDM/DA’s- embedding of tools and way of working in all MSK pathways, ?contribute to BDA development • A comprehensive pain service • Improving Quality programme orthopaedics interface • What else?

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