Month: February 2022

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CQRS Local will reduce admin time for GPs

Calculating Quality Reporting Service (CQRS) Local is a newly launched web-based payment claim system used by commissioners, GPs and primary care providers to support the management and payment of local incentive schemes. It uses an online payment tool which leads to prompt payments for primary care organisations.

The national CQRS programme is used across the country to collect data from GP practices for a wide range of purposes, including providing GP payments. It is tried and tested system and has been successfully supporting GPs and commissioners to manage payments for several years.

CQRS Local is a one-stop solution for providers and commissioners to claim and manage locally driven schemes that reflect local priorities. The system will make payments without the need for practices to submit invoices, following the approval of a claim.

The key benefits for providers and commissioners are:

* Using CQRS Local, clinical commissioning groups spend less time developing and administering the local payment via spreadsheets, which ensures a standard and consistent approach, due to the automated process
* Through a single, more secure central point of access, commissioners will be able to: track and audit data submissions; view variations in practice/uptake across local providers to inform decision- making; have access to centralised reporting abilities; access external system support teams.

The onboarding process for commissioners, GPs and primary care providers is simple, with ongoing support and training in place for all staff and users.

What users are already saying about CQRS Local:

* It’s easy to use
* We’re not losing things in the process anymore, like we were with email
* We really like working with the CQRS Local team
* The helpdesk is always responsive if you have a question or need support
* Practices complimented how easy and smooth the process was
* CCGs state that it is easier to track and submit claims now there are no spreadsheets.

CQRS Local is led by the CSU Collaborative.

To find out more about CQRS Local, please visit the website: https://welcome.cqrs.nhs.uk/ or to request a product demo email: support@cqrs.co.uk

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Assessing demand for COVID-19 LAMP testing

We helped an integrated care system to evaluate demand and capacity for COVID-19 LAMP testing to ensure labs could meet the need for routine staff testing.

Background

The COVID-19 LAMP testing programme allowed staff across the Lancashire and South Cumbria Integrated Care System (ICS) to be tested routinely. As demand increased from 1,500 to 7,000 tests per week, the Midlands and Lancashire Commissioning Support Unit stepped forward to discuss potential support with analysing data on testing needs.

Predicting future demand for tests could help the national supplier forecast the number of vials required. Lab capacity could also be influenced by a variety of factors and the ICS needed to understand how it could be expanded as demand dictated.

In addition, the ICS needed to identify individual organisations where take-up was higher to highlight which efforts to engage staff with testing were more successful. These approaches could then be transferred to other organisations where uptake was lower to try and replicate their successes.

Action

We worked together with the LAMP programme team to implement the following solutions:

Demand and capacity modelling:

* Gathered data on cohort sizes offered testing and estimates on previous testing trends
* Assessed machinery factors influencing lab capacity, liaising with lab manager
* Created a dynamic model of demand and capacity as factors changed over time.

Measuring staff engagement:

* Measured unique numbers of staff testing within given time periods, and how many were repeat testing (compliance rates)
* Demonstrated how staff engagement was increasing over time and against testing targets.

Impact

The demand and capacity modelling helped the ICS to:

* Have assurance that their lab could cope with demand even if it exceeded projections
* Quickly respond to requests for reporting from the regional team
* Visualise possible demand profiles and understand how actual demand compared to forecasts
* Demonstrate which locations had exceeded minimum regional estimates for testing
* Understand when there was likely to be excess lab capacity that the project could use to respond to emerging new demands for testing.

Reports on staff engagement enabled the project team to:

* Respond to demand from partner organisations for more detailed information on staff testing levels
* Provide information to Covid teams in partner organisations so they could report internally the success of the project and demonstrate where additional resources were needed
* Assess performance of initiatives to improve staff engagement and motivate organisations with lower testing rates to replicate the success achieved by their partners.

The Lancashire LAMP lab has been one of the most successful LAMP labs earning a strong reputation nationally.

Dr Amanda Thornton, LAMP Project Director, Healthier Lancashire & South Cumbria, said:

“Emma Davis [MLCSU Business Intelligence Lead] proved a very intelligent business resource for us – quickly responding to potential risks and challenges. 

“The Lancashire LAMP lab has been one of the most successful LAMP labs earning a strong reputation nationally. Emma’s role made the programme slicker, well-armed with data and very able to show that not only did the programme efficiently deliver to contract – but it excelled – and got the national reputation it deserved.”

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Decision makers can make better use of analysis

Peter Spilsbury, Director of the Strategy Unit at Midlands and Lancashire Commissioning Support Unit, writes about the very essence of the Unit’s mission and how they are defending analysts’ corner in the NHS:

Part of the Strategy Unit mission is to improve the use of analysis in decision making. Current use is, to employ a euphemism, variable.

Our mission takes multiple forms:

* We try to exemplify the behaviour we want to see. We work closely with decision makers; we share models and code alongside results.  
* Though the Midlands Decision Support Network, we run training programmes for Midlands analysts, recognising that certain skills (around leadership for example) are needed.
* And, increasingly, we work with leaders and decision makers to help them understand the value that good analysis can add.

We also advocate. We make the case for analysts in different forums – and we’ve even gone so far as to incite insurrection…

This is why I appeared in the HSJ to argue that the NHS is squandering its analytical talents. The article rehearsed a set of arguments that will be familiar to many: that the NHS has around 10,000 analysts; that they are typically skilled, but not well used; and that the decision maker – analyst relationship is vital and needs attention of the kind it does not currently get.

I also made the case for the Midlands Decision Support Network as a model.

The value of this Network is becoming clearer by the day. Whether through networking analysts, evaluators and evidence reviewers; through providing technical training and development; through working with leaders to improve their decision making; or through helping systems create local Decision Support Units.

It provides a model that addresses the requirements for Integrated Care Systems to be intelligence-driven, capable of experimenting and learning. This is a model that other regions are now interested in replicating. I encourage everyone to visit the website – https://www.midlandsdecisionsupport.nhs.uk/ – to find out more and see why.

The Strategy Unit mission will never be complete. Continuing advances in data science mean that analysts will always be capable of adding more value. But the current gap between what can be done and what is done is vast.

This is a gap we are determined to help close.

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Leading a hospital transformation programme

We developed a strategic outline case setting out the ambitions and next steps in one of the NHS’s largest hospital transformation programmes.

Background

The Transformation Unit at Midlands and Lancashire Commissioning Support Unit (MLCSU) supported Shrewsbury and Telford Hospital NHS Trust’s New Hospital Transformation Programme over a 12-month period.

The programme required experienced leadership as well as support for the production of an outline business case.

This is one of the NHS’s largest hospital reconfiguration programmes, with a capital spend of £500 million+.

Action

An initial assessment of the programme status showed that the organisation was not yet at the stage to develop an outline business case and, in fact, required significant support to strengthen the work of the programme and re-write the strategic outline case.

Following the delivery of a readiness assessment, which provided us with an overview of the strengths and weaknesses of the programme, we devised a programme plan, engaged with stakeholders, and commenced work to support the areas requiring improvement.

We guided the client helping them understand the stages of each aspect of the project and engaged with NHSEI to formulate a plan for the strategic outline case submission.

We worked with internal clinical leads, the project team, as well as architects, to finalise a design for the new build and worked in partnership with the Programme Director to produce a robust strategic outline case.

Impact

A comprehensive completed strategic outline case was delivered within the agreed timeframe. This allowed the organisation to plan for the next stage of the programme – development of an outline business case – on a solid platform.

The strategic outline case was reviewed and scrutinised through the programme’s governance and assurance framework.

We continue to provide the trust with support to develop and submit an outline business case.

Additionally, we are supporting the client with other business cases not related to the Hospital Transformation Programme.

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PCNs critical in population health management

Andi Orlowski, director of the Health Economic Unit at Midlands and Lancashire Commissioning Support Unit and senior adviser to NHS England on population health management, casts light on the critical role of primary care networks in population health management.

Selected questions from interview published in Pulse PCN, 1 February 2022.

What’s the current status of population health management (PHM) in England?

The challenge for PHM is using data to identify which interventions are most likely to succeed for an individual based on their wider circumstances and how interventions can be delivered in a way that is most likely to achieve a positive outcome. PCNs and organisations that really understand their populations are best placed to help tailor care to the best effect.

Who is responsible for PHM?

The responsibility lies with all of us. PCNs are critical, not only in the delivery of care but also in providing a deep understanding of local populations. PCNs can shape the care provided by local authorities, NHS providers, public health and beyond. If we are to address ‘health’ and not just healthcare, a wider understanding of what the population needs can only come from a local level. My advice for PCNs is not to wait for the ICS to come knocking but to actively engage with them now. This is the time to act and represent your population.

What is expected of PCNs in terms of PHM?

PCNs should be helping to direct care and support, ensuring the correct interventions are used and addressing unwarranted or harmful variation. PCNs are the engine room of PHM. Their insight and focus on populations will make all the difference.

Are PCNs important for PHM and do you think that is recognised at a system level?

PCNs are critical to successful PHM. Any ICS that does not engage with its PCNs will struggle to have a real understanding of its populations and will miss the key element of tailoring care – after all, how can anyone really understand all the differences in a population of 2-3 million patients? This is not a time to be passive. PCNs must make sure they are heard. If you are in a PCN, do you know who at the ICS you should be contacting? If not, find out.

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Medication reviews offer major patient benefits

Background
The long-term prescribing of anticholinergic drugs, used to treat urinary incontinence, has been associated with an increased risk of cognitive impairment, dementia and mortality.

Clinicians have been advised to consider offering patients ‘drug holidays’ for short periods to assess whether there has been any natural remission of the condition, whether the drugs are still effective and whether there is a continued need for treatment.

Action
Working with Greater Preston and Chorley and South Ribble Clinical Commissioning Groups (CCGs), our Medicines Optimisation team (MOT) created a review tool and templates for the EMIS system to enable a safe and consistent medication review process.

The team worked collaboratively with GP practices to identify patients for whom a four-week ‘drug holiday’ was appropriate.

Patients received an initial telephone consultation offering advice and guidance, followed by a further consultation four weeks later to assess outcomes.

Impact
Across Greater Preston and Chorley and South Ribble CCGs:

* urinary incontinence medication reviews were carried out across 32 GP practices
* 238 patients were identified as being suitable and agreeable to taking a ‘drug holiday’
* after four weeks, 144 patients (61%) did not restart drug treatment and their medication was discontinued
* the total anticholinergic burden score was reduced by 432 points* across the patient cohort
* an estimated annual NHS saving of £29,451 was recorded.

*assigning an ACB score of 3 on ACB calculator for each drug stopped.

Patient feedback:

“I have been taking this drug since 1999 and now I feel much fitter without it.”

“My dry mouth, headache and acid reflux have really improved since I stopped taking the bladder drug. So much so that I threw the oxybutynin tablets on the fire last week!”

“Stopping this medication has made no difference to my urinary symptoms.”

“I have been catheterised for nearly twenty years and wondered why I had to keep on taking this drug – big improvement in my life without it.”