Working with the learning disability community to produce our new annual health check videos

The West of England Learning Disabilities Collaborative puts people with a learning disability at the centre of everything we do.

The Misfits Theatre Company, based in Bristol, have previously worked with the AHSN to create videos on topics such as the flu vaccine. In our latest video series, commissioned by NHS South West, we have worked with the Misfits to produce a range of videos that encourage greater uptake of annual health checks for those with a learning disability. The videos cover a range of audiences including health professionals working in primary care, with a second playlist focusing on people with a learning disability and those that care for them.

In this joint blog from members of the Misfits Theatre Company and Rosy Copping, Project Support Officer for the West of England Learning Disabilities Collaborative, we talk about how the video project came to fruition and what it was like to get involved in the filming.

The AHSN perspective from Rosy

Co-creation is the most important factor in our work at the West of England Learning Disabilities Collaborative. It is essential that we gain an insight into the lives of people with a learning disability and their carers, so that we can ensure the needs, concerns and views of the community is reflected through our work.

The video series was created to educate health professionals, carers and people living with learning disabilities on the importance of annual health checks. Annual health checks are so important for people living with learning disabilities as it can help alert them, their carers and their doctors to any underlying medical conditions, and to help manage any current medical conditions that the individual may also be living with, such as epilepsy or diabetes.

We have worked with many experts by experience to produce these videos, namely, the Misfits Theatre Company, Andrew Bright, Head of Development at Thera Trust and Ian Harper, Service Quality Director at Aspire Living. Without their help, the videos may not have spoken to people with learning disabilities in the same way and we might not have been communicating effectively how important it is to get an annual health check. We think it’s vital that when we produce resources, we ensure people from the community who will be using them, get to shape their creation and be directly involved.

We worked with Ian and Andrew on the development of the scripts, and they helped us to ensure that the wording was appropriate for people with learning disabilities to understand, and that the style and tone was friendly and informative. For example, Ian suggested that we change the phrasing of epilepsy to read “seizures”. We then worked with Misfits Theatre Company to film the videos. The Misfits added their own flair to the videos, and we hope they will inspire many others living with learning disabilities to get their annual health checks.

We very much enjoyed working with the Misfits, Andrew and Ian for this piece of work, and we hope that their depictions of why annual health checks are so important, resonate with viewers as much as they did with us.  We certainly could not have achieved this work without their help, so we’d like to say a big thank you!

The Misfits Theatre Company Perspective from Sara Melton

It was fantastic to be part of this very important project.  It is so vital that people with learning disabilities are aware of the importance of having their annual health check and what’s involved in the process.

We asked the actors working on the project to tell us what it meant to them. Here’s what they said:

Rob “I always enjoy helping create different accessible information about the importance of health care.  The fact that the people are willing to get the information out there is wonderful.  I felt the filming went smoothly.  I always have fun doing filming”. 

Beth “It was nice to be involved in the project and feel like I can make a difference by getting the important messages across.  The day was exciting.  I loved using my skills and abilities to educate and inform others”.

Bill “It was brilliant to be involved and I loved being on location filming.  It is so important for people like me to get an annual health check.  The filming went smoothly, and I really enjoyed myself.  The people we worked with were really friendly, which always helps”. 

Penny “The annual health check film went really well.  It helps people with learning disabilities to get their health check.  I really enjoyed being involved in the project.  The film is informative for people like me.  It is rewarding to know I have made a difference for other people with learning disabilities.  I always have fun being involved in films!”

As you can tell from our actors’ comments they really enjoyed being involved in the project.  It is of utmost importance for them to be able to educate others who also have learning disabilities, as well as health care professionals.  Their first-hand experience really enables them to connect and relate with their audience.  The filming also gives them a platform to educate professionals who will be working with people with learning disabilities like them.

We look forward to the next film project!

To find out more about the West of England Learning Disabilities Collaborative, including signing-up to receive newsletters, please visit the collaborative’s webpage.

Spotlight on Inclisiran

October was National Cholesterol Month, and our team have been busy hosting a series of lipid optimisation education sessions; launching the new Child Parent Screening pilot for Familial Hypercholesterolaemia; increasing adoption and spread of lipid optimisation pathways and preparing to roll out Inclisiran to complement current treatments. Read more about our Familial Hypercholesterolaemia (FH) and Lipid Optimisation programme.

In this blog, Clare Evans, Deputy Director of Service and System Transformation at the West of England AHSN, tells us more about Inclisiran and how local systems can get involved….

If you listen to the radio or read a newspaper it won’t be long before you hear the word ‘Cholesterol’. In my experience as a former nurse cholesterol can be seen as something only some of us have but we all have a level of cholesterol in our bodies. The question is whether each of our levels of cholesterol is ‘good’ or whether it’s high and could be doing us harm and lead to cardiovascular disease (CVD).

CVD is a health equity issue

CVD has been identified in the NHS Long Term Plan as the biggest single area where the NHS can save lives in the next ten years – 150,000 to be exact. Heart disease causes one in four deaths in England, and two in five people in England are thought to have high cholesterol. These stats make sobering reading. We also know that those living in areas of multiple deprivation are more likely to be affected by CVD. If we’re serious about tackling health inequity, CVD and cholesterol is one of the most significant areas to focus on.

Through the AHSN Network’s Lipid Optimisation and Familial Hypercholesterolemia (FH) programme we have been making significant progress in the West of England region. The programme includes working across our region’s three systems to increase the diagnosis and treatment of FH patients, including young people and children. Some of us may be pre-disposed to CVD because of FH – an inherited condition passed down in families. FH can lead to extremely high cholesterol levels. It affects 1 in 250 people in the UK, yet over 90% of cases are still undiagnosed. Our new pilot, also taking place across six other AHSN regions in England, will use a heel-prick test to identify FH in children and subsequently their families.

So where does Inclisiran come in?

Before now if a patient was on the maximum dosage of statins, had been prescribed Rapid Uptake Products such as ezetimibe or PCSK9i and their cholesterol levels were not decreasing, options were limited. But now Inclisiran can support these patients.

Inclisiran injections use a biological process where molecules can shut down protein translation to help the liver remove harmful low density lipoprotein cholesterol (which are often simply referred to as ‘bad cholesterol’) from the blood. Inclisiran can be used with statins or on its own.

In line with NICE guidance, Inclisiran won’t be available to all patients with high cholesterol and can only be prescribed if someone has had a CVD event such as a heart attack or stroke. Inclisiran provides a new option when other treatments are not working – it can reduce cholesterol levels by 50%.

Read more about Inclisiran and the partnership between the NHS and industry to tackle cardiovascular disease.

What’s next?

The Accelerated Access Collaborative are responsible for the implementation of the Inclisiran partnership. Now that Inclisiran is available to NHS patients in England, AHSNs, as the delivery partner, are working to ensure that the new treatment fits seamlessly within the lipids care pathway.

Locally we’ve therefore started conversations to discuss Inclisiran and how it complements the current lipid-optimisation pathway for a specific subset of patients. It’s our job at the AHSN to hear about any local barriers or challenges to Inclisiran uptake and work collaboratively with systems to try and remove these.

Inclisiran remains one part of the lipid optimisation pathway, so we’ll be complementing our ongoing programme, so all of those with CVD see benefits rather than ‘just’ those who will be able to receive Inclisiran.

We’re also working to ensure our systems are fully briefed on the Accelerated Access Collaborative’s revised lipid pathway (which is currently being developed).

How do I get involved?

If your work is related to CVD and lipids optimisation in the West of England region whether that be as an Integrated Care System lead, in a Trust, Primary Care Network, General Practice, pharmacy or as a local lipid specialist, please get in touch with me, clare.evans14@nhs.net or my colleague Rachel Gibbons, rachel.gibbons10@nhs.net so we can discuss how Inclisiran can be adopted by your organisation.

Read more about our Familial Hypercholesterolaemia (FH) and Lipid Optimisation programme.

In addition, there is a comprehensive cholesterol awareness and education campaign targeted at health care professionals involved in lipids management which can be accessed on the Heart UK website.

New e-learning module to support detection of early deterioration of patients with COVID-19

The West of England Academic Health Science Network has worked in partnership with other NHS organisations, Health Education England e-Learning for Healthcare (HEE e-LfH), the Wessex Local Medical Committee and the TEL programme simulation and immersive technology team, to develop two free e-learning resources to support detection of early deterioration of patients with COVID-19.

The new COVID Oximetry @home and COVID Virtual Wards e-learning modules – launched in May 2021 –  aim to support the detection of early deterioration of patients with COVID-19 in primary and community care settings.

The e-learning provides an overview of pulse oximetry for patients and carers and explains how to monitor oxygen levels at home or in a care home setting.

People at high risk of becoming seriously unwell from COVID-19 are being provided with a pulse oximeter to monitor the oxygen levels in their blood at home for up to 14 days. This includes people who are clinically extremely vulnerable to COVID-19 and people living in care homes.

A pulse oximeter is a small medical device that is put on the tip of the finger. By regularly monitoring oxygen levels it can be easier to spot if COVID-19 symptoms are getting worse and whether people need treatment or support. People with COVID-19 may become very unwell if their oxygen levels fall too far.

The West of England AHSN is supporting the continued roll-out of ‘COVID Oximetry @home’  and ‘COVID virtual wards’ in our region. Our local support offer makes use of our existing expertise, infrastructure and resources.

Click here to find more information about COVID Oximetry @home and COVID virtual wards, including links to relevant resources and webinars.

Dr Alison Tavaré. Clinical Lead NHS@Home South West and West of England AHSN Primary Care Clinical Lead said:

“Many people with COVID-19 were living in residential homes and we realised that carers were being asked to monitor patients with little opportunity to have had any training; therefore this e-learning was co-developed by carers and clinicians. The aim is to provide a quick overview of COVID-19, how to use a pulse oximeter and most importantly give clear information on what to look out for and who to call if a carer is worried”.

This e-learning provides an overview of pulse oximetry for carers, including how to take the measurements and how to tell others if they are worried. It is designed to be used alongside the NHS pulse oximetry guidance.

More information, including access details, is available on the programme page.

By mid-May 2021, over 2000 patients had been supported through COVID Oximetry @ home and virtual ward models in the West of England. Read more about this collaborative programme, including the patient’s journey, here. 

Remote monitoring scheme reaches all eligible patients in England

With support from England’s 15 Patient Safety Collaboratives including here in the West of England, patients at risk from COVID-19 now have access to a national programme designed to provide an early-warning system if their condition worsens.

During the pandemic, reduced oxygen saturation levels have been shown to be a key identifier of deterioration in patients with confirmed or suspected COVID-19. COVID Oximetry @home uses pulse oximeters for patients to safely self-monitor their condition at home, providing an opportunity to detect a decline in their condition that might require hospital review and admission.

The programme is managed by NHS England and NHS Improvement, in partnership with NHSX and NHS Digital.

From a starting point of 20% of Clinical Commissioning Groups in November 2020, 100% of CCGs had established a fully operational COVID Oximetry @home pathway by early February.

By mid-February 2021, over 1,600 patients had been supported through COVID Oximetry @ home and virtual ward models in the West of England. Read more about this collaborative programme, including the patient’s journey, here. 

Patient Safety Collaboratives (hosted by Academic Health Science Networks) supported this rapid spread by working closely with CCGs in their region to offer quality improvement expertise, access to training and resources, data collection and evaluation, and by facilitating a national learning network.

The COVID virtual ward model is a secondary-care-led initiative, using remote pulse oximetry monitoring to support early and safe discharge from hospital (step-down care) for COVID patients. 94% of acute trusts now have access to a COVID virtual ward, an increase of 69% since the beginning of the year.

Natasha Swinscoe, national patient safety lead for the AHSN Network and Chief Executive Officer of the West of England AHSN, said:

‘We have learned so much during this pandemic, and this impressive uptake in the use of pulse oximetry has undoubtedly saved lives. It has also allowed us to ensure, where appropriate, we can provide safe care for vulnerable people shielding at home through simple, remote monitoring.

‘I’m proud of the role Patient Safety Collaboratives have taken, providing support and assistance ‘on the ground’ to establish completely new ways of working in such a short space of time.’

This intensive PSC support to implement these pathways is due to wind down at the end of March 2021, with AHSNs continuing to support systems to embed @home models in the long-term.

Find out more about how we’re supporting our systems with COVID Oximetry @home and virtual wards. 

A year on since the start of the pandemic, Consultant Acute Physician, Matt Inada Kim, reflects on the simple device (a pulse oximeter) that has been a lifeline for thousands of COVID patients & transformed the way the NHS delivers care.

Read Matt’s blog here.

Working collaboratively to improve patient safety during COVID-19

Since mid-November, the West of England AHSN has been supporting our three STP systems with the rapid implementation of the COVID Oximetry @home service (a step up pathway) to help detect the early signs of deterioration in patients with confirmed or suspected COVID-19. More recently, since mid-January, COVID Virtual Wards (‘step-down’ pathways to help enable people in hospital with COVID-related illness to return home safely as soon as possible) are also being rolled out across the region.

By working collaboratively, over 2000 patients (figure updated May 2021) have now been supported by these programmes across the region.

Both of the pathways feature enhanced monitoring for patients with a confirmed COVID case – pulse oximeters are used by the patient to identify ‘silent hypoxia’ (a reduction in oxygen levels in the blood with no other obvious clinical signs). These services built on learning from the first wave of the COVID-19 pandemic and make use of clear escalation pathways based on the person’s oxygen saturation levels in the blood (which are known as sats).

The West of England AHSN has provided a supportive role to our three STP systems, helping drive collaboration within, and across, each region with over 1500 patients having been supported across the step up service (COVID Oximetry @home) and over 100 patients on the step down service (COVID Virtual Ward) thus far.

Crucially for patient safety, these services were demonstrated to reduce mortality, reduce inappropriate hospital admissions (findings also suggest monitoring sats allows patients to be admitted to hospital before they have severely deteriorated), reduce the length of hospital admissions and escalation to intensive care wards.

Both COVID pathways have been fast-paced implementations of new services, largely from a standing start, with most systems in our region rapidly launching the pathways within a few weeks of the publication of national guidance from NHS England.

Hein Le Roux, Joint Clinical Lead for Gloucestershire CO@H, also Clinical Lead West of England AHSN, and GP at Churchdown, said:

“The COVID Oximetry @Home service has had a real impact on my patients who have developed COVID. In Gloucestershire, over 1100 patients have been referred to the service and for the majority it has provided reassurance that they have not developed the potentially fatal silent hypoxia. For the few people who did deteriorate, we were able to identify them early and prioritise their care with steroids and oxygen in the hospital setting.

This has meant they were less unwell prior to receiving treatment and have thus recovered more quickly. It has also shown that by working together as a care system between primary care, the COVID Oximetry @Home service, South Western Ambulance Service NHS Foundation Trust and our acute colleagues, we have improved patient care”.

Michelle Reader, Chief Operating Officer from Medvivo said:

“The Medvivo-provided oximetry monitoring services are a testament to the collaborative and system-wide approach that was taken across BaNES, Swindon and Wiltshire (BSW). Once we’d offered to provide the service for the region we felt really supported by colleagues in commissioning, primary care, secondary care, community services and the AHSN. This allowed these services to be established very quickly, enabling us to provide valuable supportive services to the people of BSW.

The sharing of learning from other areas was really important. I’ve never been part of such a rapid system-wide collaboration, and there was a real ‘can do attitude’ from all involved. It’s been a learning process and we continue to learn and develop the service. The feedback from the patients has been fantastic – this makes all the efforts worthwhile.”

To find out more about COVID Oximetry @home and COVID Virtual Wards, including implementation packs and recorded webinars, please visit our dedicated COVID-19 webpages.

The below case study demonstrates the impact of the COVID Oximetry @home pathway through the story of one patient who we will call John*:

  • Day 1 – John is a 57 year old gentlemen who has developed cough and fever.
  • Day 2 – John takes a COVID test
  • Day 3 – John receives a positive COVID test result. John’s GP contacts him and he is placed in ‘at risk group’ for silent hypoxia & deterioration. John is referred to the COVID Oximetry @Home (step up care pathway) and provided with pulse oximeter.
  • Day 4 – John receives advice on how to use the service for daily monitoring of blood oxygen saturations through a digital monitoring platform. John’s sats are recorded at 95%.
  • Day 7 – John’s sats are now 91% (this is now in the parameter of silent hypoxia). John is contacted by the service provider where he advises he is feeling ‘okay’. John’s advised to call 999 urgently for hospital assessment and possible treatment.
  • Day 7 to 10 – John is admitted to hospital and given dexamethasone and oxygen. John’s sats gradually improve over the next three days.
  • Day 10 – John is discharged home after four days in hospital. John is now monitored on the COVID Virtual Ward (step down pathway).
  • Day 13 – John has made steady progress and is discharged from the COVID Virtual Ward service and sign posted to Long-COVID pathway & given safety netting information.

Without the COVID Oximetry @home service and use of a pulse oximeter, John may not have known he was significantly unwell and could have required more extensive hospital treatment, or potentially even died. These services have not only a positive impact for the patient but the positive impacts are seen across primary and secondary care.

*John is not the patient’s real name.

Quality improvement for primary care workshops launch

The West of England Academy are hosting a new series of five free-to-attend interactive online workshops each Friday from 16 April.

Attendees will gain a basic understanding and practical knowledge of applying Quality Improvement (QI) techniques to real-world challenges in primary care.

Modelled on our hugely successful QI Summer and Winter Series, this five-week course, held over 90-minutes each Friday from 12noon can be joined as single sessions or a series.

The workshops have been developed, and will be delivered by, the West of England Academy team alongside guest speakers. Topics include stakeholder mapping, process mapping, data management and the basics for change management.

Attendees can be in any role and/or grade within their organisation, for example from clinical, administration or facilities.

Our academy works hard to welcome attendees from a broad range of backgrounds creating a safe and open environment for learning and sharing ideas.

Find out more about QI for primary care and book here. 

The West of England Academy offers a wide range of free resources to healthcare professionals and innovators across the region. To find out more, visit our Academy pages or email weahsn.academy@nhs.net.

Flu resources launched: People with a learning disability are at greater risk of developing serious illness

The national flu campaign to encourage uptake of the free flu vaccination, particularly amongst at risk groups, has launched.

Individuals with a learning disability are identified as an ‘at risk’ group and are therefore entitled to a free flu vaccine. As are their carers, whether that is a family member or paid support staff who care for the individual day-to-day.

As such, the West of England AHSN and our Learning Disabilities Collaborative will be continuing to share advice and raise awareness of the importance of individuals with a learning disability, their families and carers, getting the flu vaccination throughout winter.

On behalf of the NHS, Misfits Theatre Company have created a great video which tackles the misinformation surrounding the flu vaccination head on and urges people with learning disabilities and their carers (family member or support worker) to not delay in getting their free flu vaccine.

You can watch the video here.

People who have a learning disability can be more susceptible to the effects of flu and are therefore at increased risk of developing complications such as bronchitis or pneumonia. As the NHS emerges from the covid pandemic, anyone with a learning disability is encouraged to get their free vaccination and annual health check to help stay well this winter.

Carers of anyone with a learning disability are also entitled to the free vaccination. All carers (family member or support worker) are urged to ensure they are registered at their local GP practice as a carer of someone with a learning disability. Individuals should also be on their GP Learning Disability Register to access the very best care.

Now is the time that GP practices and community pharmacies are carrying out vaccinations for those at risk. The vaccine offers the best level of protection from the flu virus, and it’s important to have the vaccine every year, especially as the flu virus strain changes every year. Anyone who is defined as being in an ‘at risk’ group should contact their surgery and arrange an appointment to have the vaccine.

Having the vaccine sooner provides the individual with protection over a longer period of time; it also helps reduce the chances of spreading the virus to family and friends.

Watch this NHS England and Improvement video where Camilla, who has a learning disability, talks about getting her flu jab. 

Hannah Little, our Patient Safety Improvement Lead and Senior Project Manager said:

“Flu is a very unpleasant illness. The symptoms can be miserable for many of us, but it can lead to more serious complications for those who fall within certain clinical ‘at risk’ groups. Some people with a learning disability can be more susceptible to flu and can go on to develop more serious complications like pneumonia. Respiratory conditions remain the most significant causes of premature mortality for people with a learning disability where deaths have been reviewed as part of the LeDeR programme.

I’d urge people to make sure they have the vaccination as soon as possible. They should also ask to have their Annual Health Check, which our Learning Disabilities Collaborative discussed at our September 2020 webinar. Carers of anyone with a learning disability should also get the free vaccine from their GP surgery or community pharmacy, the sooner the better to get the best possible protection.”

 

The full pack of winter flu resources for people with learning disabilities and their carers (which includes high resolution resources for social media, communications toolkit and grab pack for professionals) is available on the NHS England and Improvement website.

The flu vaccine is also free for patients in the following at risk groups:
• Those aged 65 years or over (including those becoming age 65 years by 31 March 2021)
• Those aged from 6 months to less than 65 years of age with a serious medical condition such as:
• Chronic (long term) respiratory disease, such as severe asthma, chronic obstructive pulmonary disease (COPD) or bronchitis.
• Chronic heart disease – (such as heart failure).
• Chronic kidney disease (at stages three, four or five).
• Chronic liver disease.
• Chronic neurological disease such as Parkinson’s disease or motor neurone disease
• Diabetes
• Splenic dysfunction
• Reduced immune system due to disease (such as HIV/AIDS) or treatment (such as cancer treatment)
• Morbidly obese (defined as BMI of 40 and above)
• All pregnant women (including those women who become pregnant during the flu season)
• All children aged 2 and 3 years

• All children in school years R through to year 5
• People living in long-stay residential care homes, or other long-stay care facilities where rapid spread is likely to follow the introduction of infection and cause high morbidity and mortality.
• People who are in receipt of a carer’s allowance, or those who are the main carer of an older or disabled person whose welfare may be at risk if the carer falls ill
• Consideration should also be given to the vaccination of household contacts of immunocompromised individuals, specifically individuals who expect to share living accommodation on most days over the winter and therefore for whom continuing close contact is unavoidable

Don’t Wait to Anticoagulate is now award-winning!

Our Don’t Wait to Anticoagulate (DWAC) project won a prestigious Anticoagulation Achievement Award this month for its achievements in stroke prevention.

DWAC won the category ‘The centre best able to demonstrate adherence to NICE quality standards for atrial fibrillation’. The Anticoagulation Achievement Awards celebrate outstanding practice in the management, education and provision of anticoagulation across the UK. Staff from the West of England AHSN attended the award ceremony on Wednesday 11 October at the House of Commons.

The West of England AHSN have been working in collaboration with Gloucestershire Clinical Commissioning Group (CCG) and Bayer Healthcare to prevent strokes amongst patients with atrial fibrillation by improving medicines management in primary care.

Effective anticoagulation has been shown to reduce the risk of stroke for patients with atrial fibrillation; an abnormal heart rhythm. Anticoagulation is the process of hindering the clotting of blood; especially the use of an anticoagulant medicine to prevent the formation of blood clots.

For the DWAC project, the West of England AHSN co-designed resources with a wide range of stakeholders, including NICE, patient representatives and clinical partners. These resources include guidance for clinicians, pharmacists and patients to aid shared decision making and improve take up of anti-coagulant medicines. The resources are supported by quality improvement (QI) and clinical skills training. For more information visit www.dontwaittoanticoagulate.com

During the 36 weeks of phases one, two and three of the project’s roll-out in the westcountry, DWAC has potentially prevented 27 strokes amongst people with atrial fibrillation, representing an estimated saving of over £629,000.

Additionally, feedback from users confirms that the DWAC approach has led to improved patient care, increased confidence in shared decision making, and improved working practices. There has been a strong shift in focus from “Why anticoagulate?” to “Why not anticoagulate?”

This award demonstrates that DWAC is an important part of the national drive to reduce the number of strokes. The project is being adopted across the North West of England, Yorkshire and Humberside, Buckinghamshire and East Berkshire with 85 GP practices involved and many more engaged to start, plus further spread is planned across the West.

“I am really proud that all the hard work in GP practices across Gloucestershire, with the support of the West of England AHSN, has been recognised by winning this award. Furthermore, it is fantastic that the principles and methods developed within the DWAC programme are being rolled out to primary care in other CCG areas across England.”

Dr Jim Moore, GP, Stoke Road Surgery, Cheltenham

The organisers were delighted at the level of interest and applications received for this first year of the Anticoagulation Achievement Awards. The awards are hosted by leading charities, Anticoagulation UK, AF Association, Thrombosis UK, Arrhythmia Alliance and training establishments – Anticoagulation in practice and Thrombus. They invited applications from teams and individuals across secondary, primary and community services who can demonstrate innovation and excellence in delivering anticoagulation services, resources or individual leadership. There were six award categories and DWAC was up against some tough competition.

The winning entries from each category received a £1,000 bursary, which will be used to aid continuous improvement of services.

For the full list of winners, visit the Anticoagulation Achievement Awards website.

 

Photo: Jim Moore, GP at Stoke Road Surgery; Steve Ray, Healthcare Partnership Manager at Bayer; Dave Evans, Quality Improvement Programme Manager at the West of England AHSN; Tasha Swinscoe, Chief Operating Officer at the West of England AHSN; and Tabinda Rashid-Fadel, Circulatory Programme Manager at Gloucestershire Clinical Commissioning Group.

Collaborating for a safety culture in primary care

At the end of May, colleagues from 13 primary care practices from across the West of England, including GPs, practice managers, practice nurses and quality and safety leads, came together for the first meeting of our new Primary Care Collaborative.

The event was opened by our  Patient Safety Programme Director Ann Remmers who spoke about the context for collaboration. Dr Hein Le Roux, GP & Primary Care Lead for Patient Safety for the West of England AHSN, then explained how collaboration was a combination of people and technical skills. He told a cautionary tale of the Choluteca bridge and painted a picture of what better could look like in primary care. He explained how taking a systems approach could tackle some of the challenges through collaboration, and gave an example of a patient in his care where their care could have been better, and shared the learning from that incident.

Stephen Ray, Quality Improvement Programme Manager, expored why things go wrong in a systems context and some of the methods to take a systematic approach to quality improvement to build reliable systems. He explained the clinical microsystems approach, the model for improvement, and case studies from his experience working on improvement with GP practices.

All the presentations from our speakers are available here.

Attendees told us they really valued the time to meet other practices, learn from others and discuss subjects that they don’t normally get time to. There was great feedback about the speakers and group sessions, and the bacon sandwiches first thing were a big hit! They made a list of actions to take away from the day including looking at their existing processes and communications, developing a map of responsibilities, using PDSA and changing their language from “significant event” to “learning event”.

At our next meeting in September, the Collaborative agreed to focus more on sharing learning from particular examples from practices, with in-depth support on a topic chosen by attendees. Suggestions included:

  • Engaging and motivating staff to make changes
  • Putting changes into practice
  • How to engage all staff to make real change
  • Motivating staff and changing culture
  • Bringing on board difficult characters – what impact can individuals have on instigating change?

About the Primary Care Collaborative

The Collaborative has been set up to promote a safety culture in the primary care setting through the use of incident reporting, whilst giving the practices involved tools and training in quality improvement methodology. It will also help practices to undertake their own improvement journeys and network with other practices in the region to share learning and facilitate collaboration.

Benefits for the practices involved in the new Primary Care Collaborative include helping their practice in its next Care Quality Commission inspection and will contribute to the revalidation and appraisal processes for all staff. Staff are receiving quality improvement methodology training and resources throughout. Being a part of the collaborative will also increase awareness amongst practice teams of the patient safety agenda, while promoting an open and honest culture.

Patient safety is high on the public agenda, and practice’s involvement in the scheme will improve assurance that their practice has an open and transparent approach towards patient safety, in addition to improving the overall patient experience. Patient representatives for each practice have also been invited to take part as members of the practice core team.

Future events

  • Swindon| Hilton Swindon, Wednesday, 7 September 2016 from 08:00 to 12:30
  • Gloucestershire | Stonehouse Court Hotel, Wednesday, 30 November 2016 from 08:00 to 12:30
  • Bath | Royal United Hospital, Wednesday, 1 March 2017 from 08:00 to 12:30

Contact

For more information on the Primary Care Collaborative, please contact Kevin Hunter at kevin.hunter@weahsn.net.

The Leadership Series – Commissioning Musculo-Skeletal Care

The concept of the Leadership Series is to bring specific senior commissioners together from across the seven CCGs to focus on areas of common challenge, facilitate learning, spread knowledge across the patch and identify further areas to explore collaboratively.

Five Leadership Series meetings have been scheduled to date: three in 2016, covering the topics of ‘Primary Care Demand and Flow’, ‘Commissioning Musculo-skeletal care’ and ‘Commissioning Diabetes Care’, and two of which were held in 2015 on ‘Using Evidence & Evaluation in Commissioning’ (February 2015) and ‘Exploring different approaches to CCG prioritising and de-prioritising strategic initiatives’ (May 2015).

The Musculo Skeletal Care event was held on 19 April with 17 attendees from all seven WEAHSN member CCGs and two UWE researchers.  Feedback from the meeting from delegates was very positive, with a request to meet again in early September, in advance of the CCG business planning timetable.

Feedback after the event included:

“An excellent opportunity to share work in a supportive environment.  I have a far better understanding of what is happening locally and who is involved.” GP Clinical Lead

“Between us we can transform MSK; we need to coordinate much better.” Elective Care Lead

“Very helpful to see what is happening on the patch.  Good to combine clinical perspective with management transformation.” GP & Clinical lead for Planned Care

“We are all grappling with similar issues and it feels a less lonely place now!  There is a collective motivation to embed transformation.”  Service Improvement & Development Manager.

“Useful to collaborate.  We are all trying to do similar things.”  GP Clinical Evidence Fellow

There was also agreement that a musculo-skeletal ‘community of practice’ would be helpful to electronically enable attendees to stay in touch.