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Long Term Conditions Commissioning Plans

Long Term Conditions Commissioning Plans. Dr Adrian Mairs LTCANI Meeting 13 th August 2012. LTC Service Team. Reports to Commissioning Programme Board Sponsor Joint PHA/HSCB Chair Linked groups Cardiovascular Commissioning Group & Network Stroke Strategy Implementation Group

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Long Term Conditions Commissioning Plans

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  1. Long Term Conditions Commissioning Plans Dr Adrian Mairs LTCANI Meeting 13th August 2012

  2. LTC Service Team • Reports to Commissioning Programme Board • Sponsor • Joint PHA/HSCB Chair • Linked groups • Cardiovascular Commissioning Group & Network • Stroke Strategy Implementation Group • Respiratory H&W Group • Neurological conditions Sub-group • NIVASC

  3. Remit • Regional commissioning guidance • Framework for local plans • Annual commissioning plan • Review TDPs • Clinical linkages / partnerships • PPI

  4. Scope • Cardiovascular services / Framework • Diabetes • Respiratory services / Framework • Neurological conditions • All ages

  5. Commissioning Drivers • PfG • TYC: integrated care, “shift left”, diagnostics • McKinsey • Quality 2020 Strategy • NICE • Service Frameworks • PPI

  6. Programme for Government (PfG) • Enhance access to life-enhancing drugs for conditions such as rheumatoid arthritis, cancer, inflammatory bowel disease and psoriasis and increase to 10% the proportion of patients with confirmed ischaemic stroke who receive thrombolysis • Identify and evaluate the current baseline of patient education and self management support programmes that are currently in place in each Trust area

  7. TYC - LTC • Self care & prevention – partnership working • Personalised care plans - home based mx. • Named contacts for patients • Use of information systems to support care pathways • Medicines management – community pharmacy • Admissions protocol • Telehealth

  8. McKinsey • Quality & productivity improvements • Better management of LTCs • Reduced LoS • Enhanced /effective home & community services • Shift to lower cost settings

  9. NICE Technology Appraisals (TAs) For each Technology Appraisal, the HSC Board will submit a Commissioning Plan to the Department within 15 weeks • TA 236 - Acute coronary syndromes: Ticagrelo • TA 244 - Chronic obstructive pulmonary disease: Roflumilast • TA 248 - Diabetes (type 2): Exenatide (prolonged-release)

  10. NICE Clinical Guidelines For each Clinical Guideline endorsed by the Department, the HSC Board will submit a Board Response to the Department within no more than 15 weeks • CG 36 - Atrial fibrillation • CG 87 - Type 2 Diabetes – Newer Agents (update of CG66) • CG 101 - Management of chronic obstructive pulmonary disease in adults in primary and secondary care (partial update) • CG 105 - The use of non-invasive ventilation in the management of motor neurone disease • CG 119 - Diabetic foot problems - inpatient management • CG 126 - Stable Angina • CG 130 - Hyperglycaemia in acute coronary syndromes • CG 134 - Anaphylaxs • CG 137 - Epilepsy

  11. Commissioning Context • Programme for Government • Commissioning Plan Direction • Commissioning Plan • TDPs • Population Plans

  12. Commissioning Plan Direction • AAA Screening – June 12 • Thrombolysis: increase to 10% - March 13 • Telemonitoring: 400k monitored pt. days – March 13 • Unplanned admissions:↓ 10% - March 13 • Performance indicators

  13. Unscheduled Care Specification • Proactive Mx of LTCs • 10% ↓ unscheduled hospital admissions • ↓ LoS • Local economies • Practice registers / risk profiling • Regular primary care review • Patient education & self-management • Integrated community teams • Escalation procedures • Medicines management • Tele-monitoring

  14. Commissioning Plan Specific Targets • By March 2013, increase to 10% the proportion of patients with confirmed Ischaemic stroke who receive thrombolysis • By March 2013, achieve 400,000 Monitored Patient Days (equivalent to approximately 2,200 patients) from the provision of remote tele-monitoring services through the Tele-monitoring NI contract.

  15. Commissioning Plan - LTCs Key Deliverables • Implement COPD Integrated Care Pathway • Expand provision of insulin pumps to children & adults with Type 1 diabetes • Identify & evaluate current baseline of patient education & self management programmes in place in each Trust area

  16. Self Management / Patient Education ProgrammesBaseline Audit Wendy Thornton Public Health Agency Monday 13 August 2012

  17. 1. Background • Key commitment (priority 2) in PfG 2011-15

  18. 2. Key characteristics?

  19. 3. Audit scope • Specific programmes only (not support groups) • Programmes for patients only (not carers) • Physical AND mental health programmes • LTCs – key 4 - diabetes, asthma, COPD, heart failure, plus others... • Includes Condition Management Programme (CMP) – DEL/Trust partnership programme • Includes Trust and I.S provided/funded programmes

  20. 4. Methodology • Questionnaire (in form of Excel spreadsheet) • Distribute to Trusts & IS orgs during Autumn • 6 weeks timeframe for completion • Info collated and analysed by PHA/DHSSPS • LTC Regional Implementation Steering Group

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