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From the Health Innovation Network this month:
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As Christmas approaches many of us are juggling priorities more than ever! It has continued to feel increasingly busy across the health economy in South London, and I know that for many of you this is an ongoing challenge.
Since our last newsletter we’ve seen the publication of NHS England’s Five year Forward View (FYFV) and the London Health Commission report (LHC) to which the HIN leadership actively contributed. We have spent time as HIN, with KHP, and with the other AHSNs in London looking at our role in implementation and how the messages contained should influence our priorities.
Population health was the central theme of the Commission, with a major focus on obesity, particularly in childhood, and on building mental health resilience. There was a specific recommendation for the development of a Dementia Institute. There was also recognition of the need for better information sharing to improve care and promote research, and a strong emphasis on the role of digital technology and SMEs in the self-management of long term conditions. This area of work was led by Peter Ellingworth, a member of the HIN Board. The London AHSCs will build on their successful collaboration in MedCity to drive this forward, supported by AHSNs.
The HIN obesity strategy provides an opportunity to bring together a preventative approach that crosses our Diabetes and Musculoskeletal themes. There is also a significant element of obesity in the genesis of cancer and dementia, and its comorbidity often in harmful use of alcohol. If we respond to the report by focusing on childhood obesity, this also addresses the omission of children in our original priorities. There are opportunities to bring together commercial partners and children’s public health to increase impact in this arena.
The significant psychological co-morbidity in all our priority long term conditions keeps us focused on the health inequalities related to mental health. The emphasis on building community resilience and using digital platforms as part of the solution is highly compatible with our approach and priorities. The proposed Dementia institute will build on strengths in our network; care delivery, early diagnosis and the development of novel treatments. We already work closely with the Strategic Clinical Network, KHP and the Institute of Psychiatry on Dementia, and are excited by the opportunity to pool London’s wider assets under a single umbrella.
The freedom described in the FYFV to develop novel commissioning models also presents an opportunity for us to work across the system as a neutral facilitator to help the alignment of incentives, reduce costs and improve continuity of patient care.
The final area of alignment between these two reports and the HIN is staff health. The FYFV emphasized the importance of both looking after staff and setting a good example. We are actively exploring a project to promote exercise and healthy eating in staff, aided by digital technology. This crosses our diabetes and MSK themes, helps tackle obesity and has potential overlap in harm reduction from alcohol and the building of mental health resilience.
Whilst the challenges ahead are evident, I am positive about the progress being made across the system, our collaborative relationships with members, and our growing impact. HIN clinical leaders from across our membership are helping us to delivering some really great work, and I look forward to this continuing as we move into 2015.
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ESCAPE-pain Launch
New approaches to treatment of chronic knee pain
Last month, the MSK team showcased the ESCAPE-pain rehabilitation programme for people with knee osteoarthritis and launched a supporting website www.escape-pain.org to an audience of physiotherapists, patients, commissioners, policy advisers, and representatives from NHS England, the Department of Health, leisure centres, and charities. Karen Middleton CBE, Chief Executive of the Chartered Society of Physiotherapists headlined the 'Great ESCAPE' event as the keynote speaker and emphasized the importance of physical activity and self-management and discussed the NICE-endorsed ESCAPE-pain programme.
ESCAPE-pain is a rehabilitation programme for people with chronic joint pain which integrates self-management and coping strategies with a progressive exercise regimen. It helps people understand their condition better and realise that exercise is a safe and effective self-management strategy.
Rigorously evaluated in randomised control trials, ESCAPE-pain has been endorsed by NICE and also cited as a Quality, Innovation, Productivity and Prevention (QIPP) case study. It has been shown to improve clinical outcomes and function, whilst being cost-effective and lowering healthcare utilisation.
One of the opportunities afforded by working as a Network, is the ability to work cross-sector and with Industry. The Health Innovation Network has facilitated the implementation of ESCAPE-pain at 4 Trusts in South London. The ESCAPE-pain website has been developed in partnership with Salaso Health Solutions and support from Health Education South London and Arthritis Research UK, to further help spread the Programme.
The MSK team has now established ESCAPE-pain in a number of South London boroughs and is collecting data on clinical effectiveness in Lewisham; demonstrating clinical benefit, the programme is a great example of the systematically organised adoption of an evidence-based approach. To date, ESCAPE-pain outside of healthcare settings ESCAPE-pain has typically been delivered by physiotherapists but the HIN is now exploring how it can be delivered in a range of community settings. Discussions are underway with local leisure providers and Public Health departments.
Together the programme and website will help providers across the country implement an evidence-based treatment for knee osteoarthritis and bring to life the role of AHSNs in spreading evidence-based intervention across NHS and other sectors.
Dr Karen Robb, Regional Rehabilitation Lead – London, NHS England, said: “What’s really important for me is that we promote the adoption of this programme and make sure its dissemination achieves the best possible reach. We need to support commissioners to identify what works for them by bringing all this good work together in a clear way.”
Tim Marshall, Policy Adviser, Department of Health, on the ESCAPE-pain programme: “I’m really keen to promote a holistic approach to patient-centred care, so hearing real examples and experiences from real patients about how it helps them in their daily lives is great. I’m a huge advocate of exercise in maintaining good health.”
For more information about the ESCAPE-pain programme, please visit www.escape-pain.org.
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Our Diabetes Improvement Collaborative was launched on 19 November 2014 with strong attendance and resoundingly positive evaluations from diabetes teams at all Trusts across South London as well as some from North London. The collaborative is a workshop programme supported by an online collaboration portal and a series of facilitated on site visits to aid diabetes service providers across South London in the review and improvement of their insulin pump services.
The collaborative arose from a resounding need that was identified by the HIN diabetes team to bring people and teams together to address some common challenges. Our team conducted an audit early in 2014 that highlighted a number of barriers to the provision of insulin pump technologies to the NICE recommended levels of 15% of Type 1 diabetic adult population, with the South London average just 6%.
The collaborative has begun to tackle these challenges by providing an opportunity for sharing ideas and best practice; bringing together all members of the diabetes service team consultants, nurses and patients alike.
We were excited to not only have representatives from every NHS trust in South London, but to also have colleagues participating from trusts North of the river, demonstrating the viability of this model beyond our geographical scope and supported by a number of carefully selected industry partners.
The second workshop will take place in February 2015, and will feature presentations on innovation in health care more broadly, alongside activities to improve the team’s ability to provide appropriate access to technologies for type 1 diabetic adult patients.
More about the Diabetes Improvement Collaborative.
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October saw the launch of a new Patient Safety Collaborative (PSC) led by the Health Innovation Network that will focus on safety throughout the healthcare system in South London. Its inclusive membership is rapidly growing and already has clinical leadership from Jennie Hall, Chief Nurse at St George's NHS Trust and Adrian Hopper, Quality Improvement and Patient Safety Lead at Guy's and St Thomas'.
Jennie says "by working together with partners across all sectors including frontline staff and management, as well as patients, carers and patient safety academics we can develop patient safety in ways that are simple and practical for all, creating learning environments that promote safety and inspire people, and keeping the focus on safety even improvements are made."
Building on work following the Francis inquiry, and recommendations from the Berwick report on patient safety, a national programme of Patient Safety Collaboratives was also launched in October and will be led by the 15 Academic Health Science Networks in England, who will set their own priorities in line with local needs to continually improve care and reduce risk to patients. They will design, implement and evaluate solutions to improve patient safety across priority areas.The Collaboratives will work with NHS England and NHS Improving Quality to share learnings and co-ordinate work with other PSCs regionally and nationally to maximise the spread and adoption of best practice and innovation.
The Health Innovation Network (HIN) Patient Safety Collaborative for South London has announced it's first area of focus as Catheter Associated UTI's (CAUTIs) and is currently scoping other areas it will cover, including:
- Falls
- Deteriorating Patients
- Medication Safety
- Pressure Ulcers
A South London collaborative event is being considered for early Spring 2015 and more details will be advertised in the new year.
If you would like to get involved in this work around Patient Safety please contact Melissa Ream our programme manager, melissa.ream@nhs.net
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Health Education South London (HESL) and the Health Innovation Network (HIN) have this month announced the winners of funding and support to implement Schwartz Rounds for healthcare across South London.
Point of Care Foundation, an independent charity working to improve patients’ experience of care and increase support for the staff who work with them, will support the winners to embark on their Schwartz Rounds journey, for one year beginning this December; providing training for facilitators and clinical leads, mentoring time and a network of support provided by existing sites.
Schwartz Rounds or ‘Rounds’ offer a forum in which healthcare staff can openly and honestly discuss social and emotional issues that arise in caring for patients. They aim to foster a common culture of compassionate care that puts the needs of the patient first whilst proving enhanced support for staff. Evidence suggests that when staff feel positive about the care they are offering and feel that they are supported in providing that care, this is beneficial for them, the patients, and the organisation as a whole.
Schwartz Rounds are now held in over 300 organisations in the USA, and over 50 in the UK. Evaluation of Schwartz Rounds shows that they have a unique and profound impact on participants and on their host institutions. The methodology of the Schwartz Rounds is well tested and highly regarded. Staff who have attended Rounds have reported that their ability to provide compassionate care has improved and that relationships between staff/team working have improved.
Uptake of Rounds in the UK has been primarily in hospital settings, the aim of the HESL and HIN initiative is to extend them in the community, in primary care and in mental health services.
Following a competitive selection process, that saw invitations to organisations across South London asking them to submit applications followed by an event for applicants to participate in a Round, meet facilitators from other London sites and learn about Schwartz from the CEO of the Point of Care Foundation, Jocelyn Cornwell, five organisations have been chosen in South London to implement Schwartz Rounds:
- Greenwich & Bexley Community Hospice.
- South London and Maudsley NHS Foundation Trust.
- South West London & St George’s Mental Health NHS Trust.
- The Royal Hospital for Neuro-disability.
- Your Healthcare CIC.
We’ll be following the progress of the winning teams over the coming months and sharing their news across South London.
For more information about the awards see www.pointofcarefoundation.org.uk
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My Brain Book is an innovation from the HIN Dementia programme, working in partnership with IXICO, to tackle the challenge of independence and adequate care planning for people with Dementia. The online tool provides people with Dementia and their carers the opportunity to reflect on what matters to that individual, to create a store of memory stimuli and to plan for the immediate future and for the possible challenges of the long term. My Brain Book is now in phase two of its development, having previously been tested by pairs of people with dementia and their family, friends or carers; and receiving constructive and overwhelmingly positive feedback.
In October we presented our bid for phase 2 development funding of My Brain Book with IXICO to the Small Business Research Initiative for Healthcare (SBRI Healthcare) ‘Dragon’s Den’. Although we weren't successful on this occasion, IXICO and the HIN are still very committed to developing My Brain Book further, as the feedback has been extremely encouraging, and we believe that My Brain Book could truly transform the experience of people living with dementia. We have been showcasing My Brain Book at several events in London including Mindtech and SPARK.
For more information about the My Brain Book Project see our website.
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The Health Innovation Network and King’s Health Partners are hosting a free conference to look at how public and third sector employers can better promote and protect the physical and mental health and wellbeing of their staff.
Across South London we have a large public sector workforce, and with a combined effort we can work together to tackle the health and wellness issues we and our colleagues face. This event will showcase innovative and exemplar practice, highlight up-to-date policy perspectives and provide a platform to build a collaborative effort to drive forward this agenda across the region, at all levels of our organisations.
The event is on Tuesday 10 February 2015 at The Oval and has an exciting agenda with keynote speakers including Dame Carol Black, Expert Adviser on Health and Wellbeing at work for the Department of Health and the Rt Hon Earl Howe.
Additionally, presentations from Public Health England, NHS Employers, Health Innovation Network, King’s Health Partners, our member and affiliated organisations will provide valuable input to ensure it is an inspiring, energetic and valuable day.
If you would like to book yourself a place on this event, please get in touch with Eric Barratt, ericbarratt@nhs.net who will add you to the guest list.
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NHS England announces wave two application process now open
NHS England has announced a new £50 million Prime Ministers' Challenge Fund to help improve access to general practice and stimulate innovative ways of providing primary care services. On 30 September 2014, a new second wave of access pilots was announced, with further funding of £100m for 2015/16.
The pilots will explore a number of ways to improve access. There is particular interest in this second wave of pilots in the use of technology to provide alternatives to face-to-face consultations, e.g. via phone, email, webcam and instant messaging; the use of patient online services; and the use of telecare and healthy living apps to help people manage their health.
NHS England states 'we would welcome applications from practices or more likely, groups of practices that wish to test new models for providing general practice services, with potential benefits not only for patients accessing general practice, but also with benefits to the wider NHS.'
You can find more information on the wave two pilot application process here, and on the Challenge Fund more generally here.
The Health Innovation Network is committed to supporting GPs in South London, and we would be interested to hear from any practices that are planning to submit a Challenge Fund bid.
If you feel there are ways in which the HIN could assist your bid, please let us know by contacting Tim Burdsey, Project Manager at the Health Innovation Network at tim.burdsey@nhs.net
Please note: the deadline for submission of applications for wave two is 17.00 on Friday 16 January 2015
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Southwark and Lambeth Integrated Care is the partnership that has brought the health and social care organisations and citizens of Southwark and Lambeth together, so that local people can lead healthier and happier lives.
The December edition of their Older People’s programme newsletter explores how staff working within their partner organisations are preventing unnecessary hospital admissions, making interventions and improving care pathways. Read it here.
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