New models of care in practice: Cambridgeshire and Peterborough Clinical Commissioning Group | NHS Confederation
A vanguard in Cambridgeshire and Peterborough has focused on helping people who are experiencing mental health crisis and demonstrating how, with the right support, they can get the help they need at home or in the community and avoid a trip to A&E. This is improving patient care as well as providing savings for the local health system.
NHS England has developed a repository of examples and case studies of best practice, which is available via the online Learning Environment.
In March 2016, NHS England introduced a new CCG Improvement and Assessment Framework (CCG IAF). This framework brings together a range of key indicators, enabling NHS England and CCGs to work together to drive improvement for patients.
The CCG IAF framework has indicators for six national clinical priority areas, including dementia. The dementia indicators are:
Estimated diagnosis rate for people with dementia.
Dementia care planning and post-diagnostic support.
NHS England recognises that CCGs will have varying levels of need for support based on their performance against the indicators, and in October 2016 published a support offer to help with this.
To substantiate the support offer, the NHS England Dementia Team has developed the Best Practice Repository on the NHS England Learning Environment website. This repository is currently being developed and case studies will be added to the NHS England Learning Environment website along with links to other resources.
Care planning is crucial in delivering improved care for people living with dementia, and supporting their families and carers | NHS England
he importance of having a high quality care plan that is reviewed regularly is reiterated through its inclusion in the CCG IAF as one of the dementia indicators. It also forms a key part of the forthcoming evidence-based treatment pathway for dementia.
Simply having a care plan, whilst being a good start, is not enough. Any care plan needs to be personalised to the specific needs of each person with dementia and reflect changes in their care needs over time. To support the adoption of high-quality care plans NHS England has developed a guide Dementia: Good Care Planning, with input from people living with dementia, their carers and health and social care professionals.
Responding to domestic abuse: a resource for health professionals | Department of Health
This resource looks at how health professionals can support adults and young people over 16 who are experiencing domestic abuse, and dependent children in their households.
It will help health staff to identify potential victims, initiate sensitive routine enquiry and respond effectively to disclosures of abuse. Commissioners will gain insight into services to support people experiencing domestic violence and abuse, and the importance of joined-up local strategic planning.
The resource draws on the National Institute for Health and Care Excellence multi-agency guidelines on domestic violence and abuse, and provides:
the legal and policy contexts of domestic abuse in England
information for commissioners on effective integrated care pathways
information for service providers on shaping service delivery
what health practitioners need to know and do
information to ensure the right pathway and services are in place locally
This briefing summarises research that analysed data from over 230,000 anonymised patient records for older people aged 62 – 82 years | The Health Foundation
Continuity of care is an aspect of general practice valued by patients and GPs alike. However, it seems to be in decline in England.
Our analysis, published in The BMJ and summarised in this briefing, looks at the link between continuity of care and hospital admissions for older patients in England. We looked specifically at admissions for conditions that could potentially be prevented through effective treatment in primary care.
We found there to be fewer hospital admissions – both elective and emergency – for these conditions for patients who experience higher continuity of care (ie those who see the same GP a greater proportion of the time). Controlling for patient characteristics, we estimate that if patients saw their most frequently seen GP two more times out of every 10 consultations, this would be associated with a 6% decrease in admissions.
To improve continuity for patients, general practices who are not already doing so could set prompts on their booking systems and encourage receptionists to book patients to their usual GP. Patients could also be encouraged to request their usual GP.
Clinical commissioning groups and NHS England Area Teams could work with general practices to support quality improvement initiatives that maintain or improve continuity of care.
Future national initiatives should have a well developed understanding of how and why the policy will impact on continuity in a particular context.
Current ambitions for NHS reform rest on Sustainability and Transformation Plans (STPs). These aim to bring local leaders together to create cohesive systems of care that are proactive, not reactive, with a focus on prevention and care being delivered in the community rather than in hospitals. They also aim for health and social care systems to properly exploit technology. All this will save time and money and deliver better quality care.
In their current form, however, STPs are not going to work. This paper identifies the three key barriers to success and sets out the five changes that need to be made if the plans are to succeed.
STPs should design their own local health outcomes for which every organisation in the STP is accountable.
STPs should take a ‘one-system, one-budget’ approach. NHS, social care and public health budgets should be merged across the STP and commissioned by a single body.
Commissioners need to regularly evaluate whether providers are delivering on outcomes. Where these are consistently not delivered, services should be decommissioned and broken up to allow smaller providers to bid. Contracts should come up for renewal at regular intervals.
NHS Improvement should publish guidance clarifying how current legislation surrounding competition applies in the context of STPs.
STP footprints should have elected leaders who are held to account by the public.
NHS England has updated the indicators for the CCG improvement and assessment framework (CCGIAF).
Every quarter, where more recent data are available, the CCGIAF indicators are refreshed on My NHS. To enable colleagues to undertake further local analysis and view each indicator for all of the CCGs reporting values we have provided the My NHS submission files below for you to view and download, indicator description tabs are included for further information.