Establishing the Information Requirements of a new GP Commissioning Practice

1. Establishing the Information Requirements of a new GP Commissioning Practice GPs are motivated by: Making their patients better Having more personal time Running a successful Practice Therefore an information system must address these motivators and reward the Practice accordingly Making patients better: Besides job satisfaction a better patient is no longer a burden on the healthcare system. Having more personal time: No doctor is going to thank me if my “brilliant” system can only reach its full potential if he has to work to 10pm every night. A successful Practice: is a Job well done and is contributing to the better health of the community.Making patients better: Besides job satisfaction a better patient is no longer a burden on the healthcare system. Having more personal time: No doctor is going to thank me if my “brilliant” system can only reach its full potential if he has to work to 10pm every night. A successful Practice: is a Job well done and is contributing to the better health of the community.

2. The Challenges The information requirements: Reducing NHS bill by £5 Billion each year (equates to cutting £2500 every day per practice) Patient-level detail that GPs are familiar with whilst commissioning for the whole Community Engagement so that GPs rather than managers can analyse effectively and make decisions Reducing NHS bill: This is a reality check on the current climate and in line with the July 2010 Government White Paper “Equity and Excellence: Liberating the NHS”. We need to unleash the “bean counter” in all of us. This is only going to be achievable by “moving outside the box” and using a system that can triangulate primary and secondary care services. Patient-level detail: The system needs to cater for both the patient-centric instincts of the GP and also show the aggregation of healthcare plans for all the Practice’s patients. Engagement: The requirement is that the system is ergonomic and GP-friendly. The GPs are now be called on to provide a service that they were never intended to do so we need to help them.Reducing NHS bill: This is a reality check on the current climate and in line with the July 2010 Government White Paper “Equity and Excellence: Liberating the NHS”. We need to unleash the “bean counter” in all of us. This is only going to be achievable by “moving outside the box” and using a system that can triangulate primary and secondary care services. Patient-level detail: The system needs to cater for both the patient-centric instincts of the GP and also show the aggregation of healthcare plans for all the Practice’s patients. Engagement: The requirement is that the system is ergonomic and GP-friendly. The GPs are now be called on to provide a service that they were never intended to do so we need to help them.

3. Information Systems can reduce healthcare costs by promoting the following: Set up clinics for chronic conditions like Asthma, COPD and Diabetes. Encourage more patient self-management Proactive medicine for vulnerable groups to minimise avoidable emergency admissions Longer Practice opening hours: opening evenings and weekends to reduce A&E attendances These are the quick wins. We design the system so it pushes inherently towards a healthier population, and lowers costs. The Quality, Innovation, Productivity and Prevention (QIPP) process is a natural forum in the NHS for the best and brightest ideas for efficiency savings but here are some more examples: Set up clinics: I did some research at Mid-Staffs to find reasons to limit the South Staffs’ PCT’s excessive capping of outpatient follow ups. I observed that some specialist areas like post operative trauma & orthopaedics treatment must be carried out in an acute setting. However other treatments can be safely transferred away from the hospital-based consultant-led appointments to the cheaper nurse-led appointments in the community. There is strong empirical evidence that Patient self management works. Patients educated on how to manage their condition require less treatment. Proactive Medicine: Use the system to flag up vulnerable groups and treat them before further complications set in. In response to established facts about the patient, the system can advocate: 13 year old girl: due for HPV vaccine. Attended A&E 18 times in last year: frequent flyer: set up an advanced care plan. Elderly with urinary tract problems: Send community matrons to their houses to check catheters etc. The condition can be managed and there is less likelihood of emergency admission. Longer practice opening hours: There is a strong correlation between poor accessibility to primary health care and high A&E attendances, often leading to admissions. Within reason the opening hours of the Practice needs to match the requirements of the community.These are the quick wins. We design the system so it pushes inherently towards a healthier population, and lowers costs. The Quality, Innovation, Productivity and Prevention (QIPP) process is a natural forum in the NHS for the best and brightest ideas for efficiency savings but here are some more examples: Set up clinics: I did some research at Mid-Staffs to find reasons to limit the South Staffs’ PCT’s excessive capping of outpatient follow ups. I observed that some specialist areas like post operative trauma & orthopaedics treatment must be carried out in an acute setting. However other treatments can be safely transferred away from the hospital-based consultant-led appointments to the cheaper nurse-led appointments in the community. There is strong empirical evidence that Patient self management works. Patients educated on how to manage their condition require less treatment. Proactive Medicine: Use the system to flag up vulnerable groups and treat them before further complications set in. In response to established facts about the patient, the system can advocate: 13 year old girl: due for HPV vaccine. Attended A&E 18 times in last year: frequent flyer: set up an advanced care plan. Elderly with urinary tract problems: Send community matrons to their houses to check catheters etc. The condition can be managed and there is less likelihood of emergency admission. Longer practice opening hours: There is a strong correlation between poor accessibility to primary health care and high A&E attendances, often leading to admissions. Within reason the opening hours of the Practice needs to match the requirements of the community.