Month: May 2022

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Improving care for people with disabilities

We codesigned and delivered a transformation programme for the improvement of care for people with learning disabilities and/or autism.

Background

NHS England and NHS Improvement set out key priorities for commissioners within the Learning Disability and Autism (LD&A) Programme and the NHS Long Term Plan. These include improving community-based preventative support, transitions into adulthood, and our understanding of best practice models. They also wish to address issues with workforce, funding flows, and the lack of appropriate housing to prevent admission to hospitals, and to facilitate discharges from hospitals. The NHS Midlands and Lancashire Commissioning Support Unit and Shropshire, Telford and Wrekin health system co-created an approach to develop and deliver a robust Transforming Care Programme (TCP) to meets these priorities.

Action

Our TCP Service provides a case management function for NHS funded individuals outside of continuing healthcare (CHC). The service aims to reduce expensive hospital admissions, and improve care outcomes and experiences for individuals with LD&A and complex needs. We provided an ongoing clinical case management service to offer robust support mechanisms for patients.

Deliverables:

* Supporting TCP policy development and stakeholder management to enable robust referral management
* Overseeing, governing, and attending Care, (Education) and Treatment Reviews
* Developing and maintaining a dynamic support register to update an individual’s risk of admission to inpatient or residential units in real time
* Brokering and sourcing care packages to meet individuals’ needs
* Providing clinical case management which includes engaging the individual, assessing, planning, linking with resources, consulting with families and collaborating with clinical and social care partners
* Providing a quality assurance process for referral management
* Attending inpatient discharge review meetings and discharge planning
* Implementing a robust care review process with local authorities where required.

Impact

* Improved person-centred care and individualised packages of support for people with learning disabilities and/or autism
* Brokering care in the most appropriate environment with effective use of resources
* Effective use of expertise, promoting multi-disciplinary team working
* Individuals are active participants in their care process
* Ensuring the role of carers are active participants in the reviewing process
* The responsibilities of partner agencies, ensuring they are active participants in the reviewing process
* Family members or carers feel well supported
* Individual satisfaction (involvement, decision-making, information, respect and dignity)
* Carer satisfaction
* The individual is treated with dignity and respect

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Achieving the best from pharmacy teams

We provided a tailored package of strategic and operational support to a newly formed pharmacy team at a primary care network, helping them increase the rate of structured medication reviews.

Background

When a newly established Primary Care Network (PCN) covering thirteen GP Practices in the Northwest of England approached MLCSU for strategic and clinical support, MLCSU responded by developing a tailored package of year-long support that included clinical supervision, joined-up work planning and strategy development. MLCSU aimed to ensure the PCN achieved its Network Contract Direct Enhanced Services (DES) and Investment & Impact Fund (IIF) targets.

Action

An initial workforce survey highlighted learning needs. We provided senior pharmacist expertise in workforce development, outcome reporting methods, training and clinical supervision:

* Training and clinical supervision – monthly sessions with supported discussions forums to review any clinical issues
* Expert support and peer review – monthly one to one’s with senior MLCSU lead pharmacists and individual development plans with agreed objectives for the next 12 months
* Strategy and workplan development – structured workplan developed in line with DES and IIF requirements
* Operational support – a suite of standardised clinical system searches and tools were shared with the team to help them to identify patients for priority Structured Medication Reviews (SMRs).

Impact

The tailored package of support we developed included training on SMRs, the Community Pharmacy Consultation Service, Antimicrobial Stewardship, Area Prescribing Committees (APCs), Chronic pain, Opioids and medicines related safety. Local speakers were brought in to provide expert advice including the North West regional antimicrobial resistance lead, the local Controlled Drug Accountable Officer and the pan Mersey APC Secretariat.

Clinical supervision sessions provided a safe space for team discussions and interaction with experienced leads for mentorship and support. Group discussions often focussed on how work could be standardised. The team have now successfully implemented a scalable, hub-based model and operate as part of an agreed workplan and wider primary care strategy. Six extended training & clinical supervision sessions were held for the PCN Pharmacy team with a forum for team discussions, with mentorship and expertise provided by experienced MLCSU leads. This was complemented by monthly one to ones for all six clinical staff within the PCN.

Outcomes

* The PCN rated the MLCSU sessions as excellent, delivering improved pharmacist competencies through the use of MLCSU resources to meet their learning needs.
* The PCN progressed from 41 to 437 SMRs during the year with an additional 2,462 medication reviews undertaken.

“I really value [MLCSU’s] input and support. I would definitely like to see them support us for at least the next year.

“I enjoy the clinical supervision sessions, and really value the 1:1 support with the team. I hope that our Pharmacy Team relationship with MLCSU can continue as they support the direction of our growing and developing team.”

Pharmacist, St Helens South Primary Care Network

“I would like to say thank you to MLCSU for the service provided to date. I have seen an improvement in the pharmacy team and would like to continue on this trajectory.”

Dr Chibuzo Orjiekwe, St Helens South Primary Care Network

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MLCSU at Health and Care Apprenticeship Awards

This June will see the first ever Lancashire & South Cumbria NHS Health & Care Apprenticeship Awards taking place. The awards recognise the outstanding contribution and achievements of apprentices from across Lancashire and South Cumbria have made over the last year. Those shortlisted must be working towards, or have recently completed an apprenticeship in an NHS, health or social care organisation within the region of Lancashire and South Cumbria.  

Our nominees

We are thrilled to announce that we have been shortlisted for the following awards:

* Above and Beyond Award
* Rising Star Award
* Employer of the Year Award.

We are extremely proud to have been nominated. Our strong track record in workforce resilience is the result of our dedication to developing our employees and offering an exciting place to work. Find out more about human resources and organisational development services in our Workforce Resilience section.

The winners will be announced at the awards ceremony taking place on Friday 17 June at Stanley House Hotel and Spa. A huge congratulations to all nominees and good luck to everyone involved!

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We’re exhibiting at NHS ConfedExpo, 15-16 June

Join us at the NHS Confederation’s annual conference, taking place in Liverpool this summer. Delivered in partnership with NHS England and NHS Improvement, NHS ConfedExpo will bring together leaders from across the health and care profession for a two-day conference and exhibition.

The landmark event will explore the five key themes of People, Quality & clinical improvement, Health Inequalities, Collaboration & partnerships and Driving recovery. Book your pass and hotel accommodation online. It is set to be one of the most significant events in the health care calendar.

Be inspired by our expert speakers, choose relevant sessions that matter to you from over 140 hours of engaging content and meet experts and explore new products on the exhibition floor. 

Bookings are now open and can be secured online. 

https://www.nhsconfedexpo.org/welcome?utm_source=affiliate_exhibitor&utm_medium=organic&utm_campaign=booking_launch

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Discovering efficiencies and service improvements

We helped an NHS trust analyse and visualise data on key performance indicators with the aim of releasing efficiencies and to assess inequalities in service provision on a range of areas.

Background

Leicestershire Partnership NHS Trust (LPT) were planning to take a systematic approach to transforming their services by reviewing a basket of indicators by service line. The aim was to enable efficiencies as part of their three-year financial plan, and to assess inequalities in service provision.

Action

The Midlands and Lancashire Commissioning Support Unit created a comprehensive report for LPT at the end of the 2021/22 financial year. The report provided detailed analysis of each of the indicators in the basket by service line and made recommendations for next steps based on the findings.

Impact

We provided insight on the following indicators:

* Workforce analysis – staffing profile and spend
* Average caseloads
* Travel undertaken
* Estates use, including travel spend
* Clinical activity: commissioned volume versus actual volume by contract type
* Demographic growth (historical and forecasted).

The trust had not analysed data in this way previously, and directors said that the visual representation (by service) is likely to support business cases to move forward much more quickly than previously.

The trust has since implemented new projects to address issues uncovered by the report such as recruitment gaps and reducing reliance on agency spend.

Claire Lacey, Programme Manager, Leicestershire Partnership NHS Trust, said: “The report was very well received by the Transformation Committee who have reviewed the initial findings and recommendations provided by MLCSU.

“The maps and visual representation of our patient journey through Covid, is showing really positive outcomes already, with the speedy implementation of new projects to address areas we uncovered – specifically recruitment gaps and reducing reliance on agency spend.”

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Recovering hospital utility costs

We are helping hospital trusts identify the potential to recover energy costs from telecom devices mounted on the roofs of their buildings.

Background

NHS hospital buildings in England often house mobile telecom operators devices on their roofs. The issue identified is that NHS trusts often do not recover the costs of electricity and power consumption in relation to rooftop communications installations.

The potential rebates can be in the thousands depending on individual trust circumstances. Claims of up to 12 years back can be submitted.

The purpose of this project was to deliver savings for NHS trusts in support of their cost improvement programmes.

Action

* Desk top analysis to confirm the status of the electricity usage by each individual telecommunications tenant.
* Site audit to confirm the supply arrangements and take measurements to determine the usage.
* Determine the lease arrangement relating to electricity recovery of each individual tenant.
* Liaise with the tenants and their agents to confirm the status of their supply and their liability to the NHS.
* Calculate historic recovery sums for either 12 years (for contracts under deed) or 6 years (for standard agreements or to the date last invoiced).
* Determine if any use of the NHS’s electricity and power supply can be recovered.
* Invoice each individual tenant and recover the costs owed.
* Provide a report for each client with recommendations for recovery going forward

Impact

The George Eliot Hospital NHS Trust was able to recoup circa £170k from electricity costs.

Review of other trusts’ cost is currently ongoing, and we expect we could deliver similar savings for potential clients.

Sean Grant, Waste and Sustainability Manager, George Eliot Hospital NHS Trust, said: “Thanks to NHS Midlands and Lancashire CSU (MLCSU) for engaging George Eliot Hospital NHS Trust in the potential recovery of energy costs generated by mobile masts. We successfully backdated 10 years’ energy costs, which have contributed towards cost improvement programmes at the Trust. 

“The whole process from start to finish was made easy with clear engagement from MLCSU to ensure the project was successful. We fully recommend the service you provided in energy cost recovery from mobile masts. Thank you!”

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Vaccine safety at PCN vaccination centres

We ensured that vaccination centres functioned with safety at the highest level by training staff and providing ongoing senior pharmaceutical support.

Background

When the COVID-19 vaccination programme began, our Medicines Optimisation team offered support to all eight Primary Care Network (PCN) vaccine centres across Chorley and South Ribble and Greater Preston.

Action

The team completed 10 hours of training provided by the local Hospital Trust and Health Education England. This ensured each member of the team could competently dilute the vaccine using aseptic technique and had the required knowledge to confidently respond to queries. We then supported the vaccination centres with:

* Dilution of Pfizer/BioNTech vaccine
* Training other staff how to competently dilute the vaccine
* Escalating queries from PCNs and vaccination centre staff to the local System Vaccination Operating Centre (SVOC)
* Storing vaccines appropriately and maintaining the cold chain
* Reporting defective or damaged vials via the Yellow Card Scheme and returning to the manufacturer.

We also provided senior pharmaceutical support including:

* Clinical assurance of vaccination centres
* Development and ratification of local policies
* Clinical support to the CCG vaccination programme lead
* Key information on legal and pharmaceutical issues
* Readily available advice to clinicians.

Impact

Seven PCN vaccination centres across Chorley and South Ribble and Greater Preston were supported by the MLCSU Medicines Optimisation team.

Senior pharmaceutical input enabled effective and efficient delivery of the vaccination programme including policy changes, clinical guidance, legal matters and cold change management.

We ensured the vaccine vials were stored and diluted safely by training many healthcare professionals across the vaccine centres.

New paperwork was created to ensure the processes of storage, dilution and administration of the vaccine followed standard operating procedure and that they were auditable and translatable across all sites.

Fridges were regularly reviewed and assessed for breaks in the cold chain to ensure minimal vaccine wastage.

We helped the operation of the vaccination bus during ‘Phase Two’ of the vaccine roll out. The bus delivered the vaccine to the heart of areas of Preston and Chorley where uptake had been poor.

Support was provided 7am-8pm, seven days a week, through flexible working and shift patterns to ensure there is cover during all PCN vaccination centres operating hours.

Andrea Trafford – PCN Non-Clinical Vaccine Lead, Chorley Central PCN, said: “The guidance and support that the team have provided has been invaluable in our journey in mobilising the COVID vaccination programme. Their expertise has ensured that our vaccination centre has functioned with safety at the highest level and the team are always happy to support and provide cover when asked.  As a Primary Care Network, we could not have asked for better support, the whole team should be commended, without them, our delivery programme may not have been as successful as it is. Thank you to you all, you have been outstanding and unwavering in your support to us all.”  

Gillian Stubbs – Practice Manager, Leyland PCN, said: “Fantastic support and thank you to all the team, you are amazing.” 

Tara Oxby – Pharmacy Technician, Chorley East PCN, said: “I just wanted to say a personal thank you to all the team that has helped us out at the COVID-19 vaccination centre, it has been an absolute pleasure working with each and every one of you, you have all been amazing! We really wouldn’t have been able to run the Pfizer clinics without your help.”

Brian Hann – PCN Non-Clinical Vaccine Lead, Chorley and South Ribble Health Network, said: “The amazing turnaround response to our request was testament to the teamwork approach I think we should all be proud of. On the days the Medicines Optimisation team are on site – everyone is great and works seamlessly as part of the wider delivery team.  Even when – unfortunately due to the nature of it – they are often left to themselves in the other end of the building!! In summary – I’d like to say the support has been and continues to be invaluable and I think it’s just one example of how Central Lancashire has worked so well together on this programme and other pandemic services.”