‘town planning’: can it help?
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‘Town Planning’: can it help?. Sue Roberts For the Diabetes Team. ‘Then you should say what you mean’ the March Hare went on. ‘I do’ Alice replied ‘at least – I mean what I say…’. What do these mean to you? Do they all mean the same?. Integrated care pathway. Patient pathway - PowerPoint PPT PresentationTRANSCRIPT
‘Town Planning’: can it help?
Sue RobertsFor the Diabetes Team
‘Then you should say what you mean’ the March Hare went on
‘I do’ Alice replied ‘at least – I mean what I say…’
What do these mean to you? Do they all mean the same?
Integrated care pathway. Patient pathway Patient journey Care pathway A ‘pathway approach’
Diabetes Do Once and Share
Planning Levels
Level 1
Level 2
Level 3
Level 4
National & generic
Locally defined
Level 1 : Like a map
DiagnosisInitial
ManagementContinuingCare
PREVENTION
EVENTSEVENTS
Non diabetes admissions
protenuria
heart disease
stroke
ED
Pregnancy
Institutional care
Foot issuesEye
problems
ketoacidosis
Severe hypos
life events
treatment change eg
insulin
new complications
Diabetes NSF
Level 1 : Like a map
Diagnosis
Continuing management
specialist renal advice
Pre RRT treatment and choices
Dialysis and transplantation
End of life care
Renal NSF
Planning Levels
Level 1
Level 2
Level 3
Level 4
National & generic
Locally defined
Level 2: drilling down – the ‘town plan’
Quality criteria
Workforce competencies
NICEGuidance/
HTAs
Do Once and Share
Data items for EHR
Continuing Care
Care planning
Structured education
Psychologicalsupport
Planning Levels :National
Level 1
Level 2
Level 3
Level 4 Locally defined
NSFs,
More definition, Quality criteria, NICE, HTAs competencies etc
Level 3: The local diabetes / renal community: Designing and building
Your model of care
Your workforceDesigning your town
2ry3ry
1ry com
………and commissioning
IC
Planning Levels
Level 1
Level 2
Level 3
Level 4
NSFs,
More definition, Quality criteria, NICE, HTAs competencies etc
Local Model of care – matched to local need
Level 4: ‘Running the show’ How the model works in
practice Who does what / when / In what order Referral pathways What the patient can
expect to happen With knowledge support
Can be presented as algorithms
Should be audited The town council
Care pathways!
Planning Levels
Level 1
Level 2
Level 3
Level 4
NSFs,
More definition, Quality criteria, NICE, HTAs competencies etc
Local Model of care – matched to local need
Care pathways
Responsibilities at each level
Level Responsibility
1 National responsibility, Diabetes / Renal NSF already published
2 National working groups
3 PCT Commissioning: Local diabetes networks need to develop models of care to inform this
4 Providing: Local diabetes networks should develop their local care pathways once model of care has been agreed
What local services like to do!
Level 1
Level 2
Level 3
Level 4
NSFs,
More definition, Quality criteria, NICE, HTAs competencies etc
Local Model of care – matched to local need
Care pathways
Roles for networks on behalf of Local Health Communities (LHCs)
Role Action Level of activity
Commissioning Design, Advise (possibly commission) local models
Level 3
Co-ordination Co-ordinate (possibly manage) local services once model agreed
Level 4
Audit and Monitoring
Audit / monitor to feed into service improvement and future commissioning (and demonstrate contract compliance)
Level 4
Conclusions
The NHS needs clinicians and patients to get involved
The language of levels Explains what needs to be done Clarifies national vs. local Helps people see their roles Enables discussion within /between
disciplines and services So that…
Patients experience high quality services matched to their local need
Thank you!
Level 3: The local diabetes / renal community: Designing and commissioning
Designing your town
2ry3ry
1ry com
IC
Your model of care
Your skill mix
Diagnosis
Continuing management
specialist renal advice
Pre RRT treatment and choices
Dialysis and transplantation
End of life care
Level 2: drilling down
Quality criteria
Workforce competencies Knowledge
Support
Do Once and Share
The EHR
Continuing Care
Care planning
Structured education
Psychologicalsupport
Level 2: drilling down
Quality criteria
Workforce competencies Knowledge
Support
Do Once and Share
The EHR
Continuing Care
Care planning
Structured education
Psychologicalsupport