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Putting the Long Term Plan into action

The NHS Long Term Plan, launched at the start of 2019 has been heralded as the blueprint to make the NHS fit for the future. It highlights investment in latest technology, digital health and cutting edge treatments, coupled with early detection and a renewed focus on prevention to stop an estimated 85,000 premature deaths every year.

It also lays out plans for a more integrated, person-centred service, where health organisations come together across primary, community and mental health to provide better, joined-up care in partnership with local government. There is a lot in the plan that highlights work already being planned and undertaken by the West of England AHSN. Here some of our medical leads highlight how our work is helping our member organisations respond to the Long Term Plan.

The role of innovation

Anne Pullyblank – Chief Medical Officer

The Long Term Plan sets out a simpler, clearer innovation system with a key role for AHSNs. The aim is to speed up the development pipeline in the NHS, so that proven and affordable innovations get to patients faster. This is one of our key roles.

Our Innovation Exchange (see page 20) will help innovators locate funding and resources in our region, and connect them with other innovators. Our business advisers provide support to innovators from development to adoption and spread. They can signpost companies to clinicians who can help refine products, and they run brilliant free ‘bootcamps’ to develop business ideas (see HIP page 14).

Making innovation work for the health service is not just about developing products; it’s also about helping to define the need. We work with our members to develop challenges that stimulate innovation in the areas where it is most needed. Recent examples include our calls on the topics of ‘keeping people healthy at home’ and ‘young people’s mental health’.

We know we don’t have a monopoly on good ideas so a core part of our role is also encouraging the spread and adoption of products and solutions developed and tested elsewhere. However, we want to ensure that innovation remains at the heart of healthcare in the West of England so we are developing our Academy to help healthcare professionals across the region understand the role and potential of innovation. Learning from our work in developing a vibrant and exciting quality improvement culture in our region, we will foster the growth of our innovation ecosystem.


 Supporting mothers and babies

Ann Remmers – Maternal and Neonatal Clinical Lead

We’ve made great strides in the West of England in supporting safer care for mothers and babies and we are fully focused on supporting the continuous improvement work that has been at the heart of our success. Responding to the Long Term Plan, and meeting the ambitious targets of reducing still births, brain injury and maternal deaths by 50% over the next 10 years will require continued system-level learning.

I’ve been so impressed with the collaborative, supportive approach in the Maternal and Neonatal Health Safety Collaborative. They have embraced a quality improvement approach and supported learning both within organisations and across the region as whole.

Our focus on evidence-based care and improvement led to the development of PReCePT. This is now rolling out to all maternity units across the country and is embedded in the new Saving Babies’ Lives Care Bundle, which includes guidance to administer magnesium sulphate to women in very pre-term labour to prevent their babies developing cerebral palsy.

PReCePT is a fantastic example of how we can put evidence into practice using QI methodology to test and refine it, before spreading a proven approach nationally. I look forward to working with our members to continue improving care for mothers and babies.

Managing end-of-life

Hein Le Roux – Primary Care GP Lead

The theme of individualised care in the form of ‘what matters to me’ rather than the traditional medical approach of ‘what’s the matter with you’ runs throughout the LTP. For people approaching the end of their lives, there are two pieces of work that can support people’s wishes, advance care planning and treatment escalation plans.

The West of England AHSN is spreading the ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) form and process across our region. In the community there can be a lack of information about a patient’s condition and when a deterioration occurs, the family may be panicked and the professionals (out of hours clinicians and ambulance crews) may not know the patient. This can lead to reactive care where the patient’s wishes are not fulfilled.

ReSPECT aims to remedy this by encouraging a conversation with the patient and their loved ones to ascertain what the medical issues are and how these fit with the patient’s preferences. It leads the professional to have a sensitive discussion with the patient and their loved ones about what the end might look like and what is important to the patient. Having a standardised way of communicating with patients, which is then recognised across the chain of care will hopefully lead to an improvement in the care we deliver for patients.

Optimising medication

Mark Gregory – Lead Pharmacist

In the West of England we have an active Medicines Safety and Optimisation work programme. This addresses themes in the LTP such as the research quoted that shows as many as 50% of patients are not taking their medicines as intended. One of the underlying issues here is the increasing number of medicines people are being prescribed as they live longer with multiple medical conditions.

Our PINCER (Pharmacist-led Information technology intervention for reducing Clinically important ERrors) programme allows GPs to review patient records and identify patients who are being prescribed medicines that are commonly and consistently associated with medication errors. Where possible, they will simplify the regime, in line with the NHS England initiative on ‘overprescribing’, to help patients cope with their daily medication taking. Our Transfers of Care Around Medicines (TCAM) programme is helping to ensure that when a patient leaves hospital, they have access to support so they understand the medicines they have been prescribed.

The Long Term Plan also includes supporting patients to reduce the use of short acting bronchodilator inhalers. We’re developing a Medicines Safety Dashboard with a feature on identifying and addressing the suboptimal use of inhalers. The dashboard also includes a focus on minimising side effects, in line with the new medicines safety programmes envisaged in the Long Term Plan.

Read more in our Innovating Together magazine – a look back at the work of the West of England AHSN in the year 2018-19, and a look ahead to some the work we have planned.Download it here as a PDF or read it below via Issuu.