Month: June 2023

Posted on

Enhancing elective surgery outcomes

Our expertise in information governance has played a crucial role in improving surgical outcomes through the Surgery Hero project, reducing complications, minimising cancellations, and shortening post-surgery stays.

Background

In response to the increasing need for elective surgery optimisation, the Medical Director, senior information risk owner (SIRO), brought NHS Midlands and Lancashire CSU (MLCSU) on board for a crucial project: Surgery Hero.
This innovative model merged personalised digital guidance with one-to-one remote health coaching, intending to enhance patient preparation preoperatively and bolster their recovery postoperatively.

Action

Given the urgency of the project, we were tasked with completing a Data Protection Impact Assessment (DPIA), Data Sharing Agreement (DSA), and Data Processing Agreement (DPA) that could be utilised across any Integrated Care System (ICS). 
We collaborated with the team to formulate a flexible DPIA, DSA, and DPA, allowing them to be tailored to any ICS requirements. 

Impact

The project has significantly improved surgical outcomes by reducing complications, shortening post-surgery stays, and minimising cancellations. Without this project, patients awaiting surgery would experience deteriorating mental and physical health, resulting in poor surgical outcomes, including longer hospital stays, increased readmissions, and complications.
Surgery Hero, listed in the NHSx perioperative playbook as a best-in-class prehab/rehab solution, has been successfully implemented in multiple NHS projects, consistently demonstrating improved surgical outcomes. The collaboration between MLCSU and Surgery Hero, utilising advanced risk stratification analysis and targeted support, has yielded impressive results, including a notable reduction in post-op chest infections, a decrease in overall complications, a shift towards positive health behaviours, and a remarkable two-day reduction in hospital stays.

Feedback

Working with the CSU on this project has been a rewarding experience. Their proficiency in utilising resources from other NHS regions and projects to expedite the project’s timeline while limiting the need for additional artefacts was particularly commendable. This approach not only guaranteed the project’s success but also highlighted their exceptional expertise and skill set. Their significant contributions have positively impacted the project outcome, and we sincerely thank them for their extraordinary work and commitment to excellence.

Luke Eastwood | Surgery Hero

Our CSU colleagues have brought significant value to this project. Under Chloe Whittle’s guidance, the team has adeptly tackled information governance challenges, unlocking the potential of our collaborative project, and enabling other partners to progress confidently with high standards of IG governance. Their proactive attitude perfectly encapsulates a team that goes above and beyond to ensure information governance and good clinical care align safely, with insight and innovation.

Professor Rowan Pritchard Jones FRCS(Plast)

Posted on

Finalists for three more nominations at HSJ Patient Safety Awards 2023

We are absolutely elated to announce three further nominations for NHS Midlands and Lancashire CSU (MLCSU) at the HSJ Patient Safety Awards in addition to the reducing mortality project shortlisted for HSJ Patient Safety Awards 2023.

Our Medicines Management and Optimisation team has excelled this year, being shortlisted not just for one, but for three projects in the highly esteemed HSJ Patient Safety Awards 2023! This is a testament to the focus and hard work of our staff and the effective and enjoyable joint working with stakeholders. We are passionate about patient care and safety and are pleased to be having an impact across a range of areas.

Out of an astounding 515 entries received this year, MLCSU Medicines Management and Optimisation team has joined the final shortlist of 209 exceptional organisations, projects, and individuals. The sheer volume and exceptional quality of the applications bear testimony to the remarkable commitment and passion for patient care within the UK healthcare networks.

The projects
Let’s delve into the details of our shortlisted projects;

The first project focuses on enhancing inhaler prescribing practice. Through a comprehensive audit of inhaler prescriptions, we discovered that ingredient duplication within the same therapeutic drug class was often overlooked as a potential interaction or cause of side effects. We identified 360 patients with inhaler ingredient duplication errors, and nearly one-third of these errors persisted even during respiratory reviews. Armed with these audit results, we engaged with individual practices and initiated a thorough review of prescribing policies. To prevent future errors, we developed an easy-to-use reference guide for inhaler prescribing and extensively educated staff in primary and secondary care as well as community pharmacy settings.

Our second shortlisted project centres on promoting the Community of Practice Learning Disability and Autism pilot, which aimed to up-skill pharmacists working in primary care networks to conduct holistic structured medication reviews for individuals with a learning disability and/or autism. By providing extensive training and support, the pilot empowered primary care network pharmacists to deliver comprehensive medication reviews that consider the unique needs of these patients. This national project, co-produced with NHS England Health Improvement Pharmacy leads and the NHS Specialist Pharmacy Service, not only identified the learning and development needs of pharmacists but also delivered a model of support and collected data to demonstrate its success. The positive feedback received from participants and users further validated the effectiveness of this model, making it an ideal candidate for wider implementation.

The project team, consisting of NHS England Health Improvement Pharmacy leads, the NHS Specialist Pharmacy Service, and the NHS Midlands & Lancashire Commissioning Support Unit, developed a model of support to up skill pharmacists to undertake structured medication reviews (SMRs) in these patients. Participant and user feedback was positive, recommendations for the wider system were made, and the model is available for wider implementation.

The third project that secured our spot on the shortlist focuses on enhancing the safety of patients prescribed clozapine, a vital medication for managing specific mental health conditions. Working collaboratively with our mental health trust, the team identified that 36% of all patients prescribed clozapine by secondary care did not have this medication documented in their patient medication record in primary care. This created considerable risk in 3 ways: missed drug interactions, missed side effects, and compromised transfer of care. The team reviewed 220 patient records and added clozapine if absent. Working alongside our information technology colleagues, the team created and added a safety protocol on the prescribing system of every local GP practice which alerted clinicians to the potentially fatal complications of clozapine treatment.

The hard work and expertise of our team have been acknowledged by the judging panel, consisting of influential and respected figures within the healthcare community. They recognised our clinical and specialist excellence, as well as our unwavering commitment to enacting organisation-wide change and driving innovation.

Being shortlisted for these prestigious awards is not only an extraordinary honour but also a testament to our relentless dedication and passion for improving patient care. We are truly humbled to have the opportunity to showcase our achievements and contribute to the advancement of patient safety on such a prominent stage.

Jonathan Horgan, Director of Pharmacy Services, said:

“We are really pleased to have been shortlisted for all three of our entries as finalists across two categories for the prestigious HSJ Patient Safety Awards 2023. This is a testament to the staff and the partnership working with wider stakeholders who were part of these entries. The team works incredibly hard and are always focused on improving patient care and safety. As an NHS support organisation which works across wider organisations and borders, we want to have the widest impact and roll out best practice as much as possible. Getting recognition through awards helps us demonstrate the value and innovation we can bring to solve local problems. We are looking forward to the awards ceremony to celebrate the collective efforts and learn about the best examples contributing to patient safety this year.”

Posted on

Patient flow efficiency in five acute and community trusts

We successfully improved patient flow efficiency in five acute and community trusts, achieving zero ambulance delays, reducing handover times, and implementing timely crew shift completions through data-driven strategies and on-site support.

Background
The Northern Ireland National Health Board brought in NHS Midlands and Lancashire CSU’s Nursing and Urgent Care Team (NUCT) to increase patient flow efficiency in five acute and community trusts.

Action
NUCT deployed data and analysis to devise innovative strategies that resulted in tangible improvements. They offered clinical and operational guidance, pinpointed recurring issues, and created cross-pathway solutions to system hurdles. Over three days per trust, they worked with clinical and operational teams, offering real-time information support for crucial decision-making. Senior nurses assumed coaching roles to improve patient flow in emergency departments, wards, and discharge pathways, advocating a uniform approach to demand and capacity management across hospital and community teams.

Impact
The team achieved zero ambulance delays, improved handover times, and timely crew shift completions through on-site presence. They set up hospital operation centres that used data to create an actionable unified view for decision-making.

By increasing early discharges and utilising discharge lounge capacity, hospital flow started three hours earlier daily, resulting in aligning capacity with demand and preventing delays.

Every cooperative action led to enhanced safety and patient outcomes, demonstrating that quality care goes beyond merely meeting targets. NUCT also collaborated with trust staff, recognising the necessary culture shift for the safe and successful implementation of change. They managed out-of-hospital information flows, speeding up hospital discharges and reducing unnecessary stays.

Feedback

Their contribution was excellent. Their expert, patient-focused challenge and support enabled the team to reflect on issues differently and to introduce improvements in practices and processes which remain in place today.
Executive Director of Nursing, Midwifery, AHPs and Patient Experience| South Eastern Health and Social Care Trust

Posted on

Reducing mortality project shortlisted for HSJ Patient Safety Award

The NHS Midlands and Lancashire CSU (MLCSU) is thrilled to share that our project to reduce mortality in people with learning disabilities and epilepsy has been shortlisted for Learning Disabilities Initiative of the Year at this year’s HSJ Patient Safety Awards. These awards recognise safety culture and positive experience in patient care, celebrating the worthy finalists on a national scale.

The project

Working on behalf of NHS England Midlands, MLCSU joined forces with national experts at the University of Plymouth, Cornwall Partnership Foundation Trust, SUDEP Action, and Epilepsy Action, among others to spearhead a highly successful regional improvement programme to tackle the pressing issue of premature avoidable death amongst people with learning disabilities and autism living with epilepsy. The partnership worked closely with 11 integrated care systems across the Midlands, supporting them to mobilise partners in a whole-system approach to improvement.

The programme was inspired by the story of Clive Treacey who was an individual with a learning disability and who suffered from complex epilepsy. He spent much of his life moving between care providers and sadly died aged 47. In the resulting review, The Clive Treacey – Independent Review, a breadth of opportunities was identified for learning from Clive’s life, with over fifty recommendations for system-wide improvement at a local, regional and national level.

Through the implementation of a tailored self-assessment tool and guided by lived experience and specialist expertise, MLCSU and its partners helped systems establish a shared understanding of service delivery, workforce capacity, and capability and generated evidence-based improvement plans. The programme works to support a reduction in avoidable deaths, health inequalities, and hospital admissions, providing a framework for ongoing evaluation.

A recent webinar explored the topic further.

The awards

A record-breaking 515 entries were received for the HSJ Patient Safety Awards 2023. The judging panel was made up of a diverse range of highly influential and respected figures within the healthcare community. At this first stage of judging, the shortlist was set against three clear criteria: clinical and specialist excellence, enacting organisation-wide change and service/system innovation.

Following our shortlisting, the official awards ceremony will be held on 18 September in Manchester, as a highlight during the HSJ’s annual two-day Patient Safety Congress.

Hafsha Ali, Managing Consultant at MLCSU Digital Transformation – Transforming Care, said:

“We are hugely proud to have been shortlisted for this award and humbled at the support we have encountered for this improvement programme from all our partners and, of course, Elaine – Clive’s sister.

“The recognition of being finalists at the HSJ Patient Safety Awards 2023 is the awareness boost that this issue requires, and I am thrilled that we have been given this platform to further share our findings and encourage the implementation of more improvement programmes to reduce avoidable deaths, health inequalities, and hospital admissions, across the country.”

In response to the shortlisting Elaine Clarke, sister of Clive Treacey, said:

“We, Clive’s entire family, have the privilege of carrying his love and now a legacy he would be so proud of within our hearts forever. We will forever be grateful and proud for the continuing dedication of so many who have supported and remain committed to Clive’s Way.  We could never have never imagined that Clive would help to galvanise a movement across all health and social care settings in the Midlands and beyond to create capable communities keeping people with learning disabilities and epilepsy safe and living well”.

The full list of finalists for the 2023 HSJ Patient Safety Awards can be found at https://awards.patientsafetycongress.co.uk/shortlist-2023.

Winners will be announced during the awards ceremony at Manchester Central, on 18 September 2023.

Posted on

Proud to announce ISO 27001 and ISO 9001 accreditations

We are delighted to share that our customer finance team has been awarded the globally recognised ISO 27001 and ISO 9001 accreditations, demonstrating their commitment to exceptional quality and robust information security management.

The ISO 27001 certification is the international standard for Information Security Management Systems (ISMS). It provides a framework for managing information security risks, including legal, physical, and technical controls that involve an organisation’s information risk management processes. The team’s achievement of ISO 27001 accreditation testifies to their dedication to ensuring the security and integrity of the confidential data entrusted to them. We understand the importance of robust information security systems, particularly in the healthcare sector, and we are proud to have met these rigorous international standards.

On the other hand, ISO 9001 is the international standard for a quality management system. This accreditation affirms that the team is committed to providing a high level of quality in their services and are continually seeking ways to improve. Our quality management systems comply with the stringent criteria set out in the ISO 9001 standard, providing a clear demonstration of our commitment to customer satisfaction and continuous improvement.

We believe these certifications are not just recognitions but also responsibilities that reaffirm our commitment to maintaining the highest standards of service delivery and information security. We would like to express our sincere gratitude to our dedicated customer finance team whose hard work and commitment to quality and information security have made these achievements possible. We also want to thank our clients for their trust and assurance in our services.

We will continue to strive for service excellence and improve our processes, always putting our clients and their information security at the heart of what we do.

At NHS Midlands and Lancashire CSU, we take pride in delivering the highest quality services to our clients while ensuring robust information security. These ISO accreditations represent a significant milestone in our continuous journey of excellence and improvement.

Jules Harrhy, Deputy Director of Finance AT NHS Midlands and Lancashire CSU said:

“Securing the ISO 27001 and ISO 9001 certifications is a significant achievement for my customer finance team. These accreditations are a clear testament to the commitment we have towards delivering exceptional quality of services while ensuring the utmost security and confidentiality of information. As the Deputy Director of Finance, I’m proud of our collective efforts and perseverance. This success sends a strong signal that we are dedicated to continuous improvement, thereby instilling greater confidence in our stakeholders. As we move forward, we remain committed to maintaining these high standards and working tirelessly to offer our services still wider to serve our local population.”

Posted on

Increasing patient referrals to the National Diabetes Prevention Programme

By implementing effective strategies, we increased patient referrals to the National Diabetes Prevention Programme. The number of primary care referrals more than doubled, with 42 GP practices actively participating in the initiative. Through our efforts, we engaged with 3,680 patients and referred 2,130 individuals to the program.

Background

Between June 2021 and March 2023, NHS Midlands and Lancashire CSU (MLCSU) were commissioned by the Black Country and West Birmingham CCG (subsequently the Black Country ICS) to support GP practices to increase referrals to the National Diabetes Prevention Programme (NDPP). The Black Country ICB has one of the highest diabetes prevalence rates in England. The NDPP is designed to support adults who are at a high risk of developing type 2 Diabetes Mellitus. Participants are referred to a structured educational programme and attend a series of group sessions to empower them to make sustainable lifestyle changes to reduce their risk of developing type 2 Diabetes Mellitus.

Action

To help practices increase referrals to the NDPP, we worked collaboratively with local NDPP providers and primary care commissioning leads to maximise GP practice engagement. With the appropriate information governance, we carried out an early implementation test at Thornley Street GP Practice to test processes prior to at-scale rollout across the Integrated Care System (ICS) footprint. We provided practices with:
* A dedicated secure NHS mail inbox for queries and transfer of data from primary care
* Pathway documents to provide practical information to support practice engagement and implementation of NDPP
* Clinical system searches to identify all eligible patients for referral within a practice
* Direct discussions with eligible patients to encourage referral to NDPP
* Electronic transfer documents including clinical library codes to inform practices of the outcomes of patient discussions.

Impact

In the first year of our support, referrals from primary care more than doubled (799) compared to the previous year (364).
In total, during this programme of support, we have:
– Engaged with 42 GP practices in the Black Country and West Birmingham
– Contacted 3,680 patients and referred 2,130 to the NDPP programme

In February 2023, a personalised video test of the concept was trialled across 5 practices. The video was personalised with the patient’s first name, GP practice, postcode, gender and blood sugar level result. 279 videos were generated with 61% of patients who had opened the video choosing to be referred or requesting more information. Results showed high levels of engagement and high levels of action taken by patients.
This project has shown that the at-scale approach employed by MLCSU for referrals is an effective means to increase diabetes prevention and support GP practice primary care capacity.

Feedback

Thank you very much for all your support and assistance. Clearly, this exercise has been very useful. I will share the results with our team. Ikbir Kaur | Practice Manager, Hilltop Medical Centre