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Clinical Senates & Networks The Big Picture. The Three R’s. Rationing Revalidation Reconfiguration. NIMROD. Not Including My Relatives Or Dependents. Clinical engagement is critical to getting more for less. Since 2008 over 1000 North East clinicians Have helped develop our
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Clinical Senates & Networks The Big Picture
The Three R’s • Rationing • Revalidation • Reconfiguration
NIMROD • Not • Including • My • Relatives • Or • Dependents
Clinical engagement is critical to getting more for less Since 2008 over 1000 North East clinicians Have helped develop our programme of activity Chairs of the Clinical Innovation Teams and Network Leads meet monthly
We can network Examples: Bill Cunliffe –Planned CareLiz Kendrick- End of Life Care
Having the Choice to Die at HomeFast Focus Session End of Life Clinical Innovation Team Design Document for Discussion
Most people would prefer to die at home. Most die in hospital initiatives • GP Palliative care registers • Liverpool care pathway • Care homes and advanced care planning • “would you be surprised?” • 24/7 community support • Early engagement with 111
Standard care for colon and rectal surgery …… • Two day bowel prep, in hospital • Nasogastric tube until passing flatus • NBM until passing flatus • Compression stockings, no heparin Why did we do this?
Our reasoning was flawed ! Enhanced Recovery ERP planning clinic Preadmission CHO load Gut friendly anaesthetic Eat,drink and move day 1
LaparoscopyEnhanced Recovery Prog. Courtesy Mr Mark Katory, colorectal surgeon 2008 3.5 colorectal surgeons 12 months 129 patients ACPGBI 2009
‘The Clinical Network’ Should we integrate clinical networks? What IS a network? What would the governance look like?
not all problems will respond to NHS Improvement Choice Economy Expectations
Clinical Senates How many? How do they interface with networks, CCGs,HWBs, LA’s and F Ts
Clinical Senates & Networks The Big Picture In the land of the blind, The one eyed man is king