CAPÍTULO IV DESARROLLO DEL PROYECTO ARQUITECTONICO
Anexo 01: Diagnóstico general de los tres Distritos Tarapoto, Morales y Banda de
Community and home based nursing care
Trafford residents will enjoy high standards of home and community based nursing care which will be easy to access and
offer a high quality alternative to hospital treatment. This will enable us to make significant reductions follow up appointments in secondary care, reduce length of stay and improve the patient experience of care in the community.
Work will commence on reviewing this service in 2014 with the implementation of improvements in 2016.
Community Cardiology
We will be investing in services which deliver community based rehabilitation and assessment services for heart related problems. Ideas for consideration include community outreach
clinics, access to ECG assessment for Primary Care. We will be focusing on the design and development of these services in 2014 with implementation in 2015-2016.
Our commitment
Our investments in community and primary care provision will deliver:
Reduced first appointments in secondary care
Reduced emergency admissions for heart failure
Increased ability to self manage conditions such
as angina
Improved patient experience of care
Community Cardiology Programme will deliver:
2.5% reduction in elective care
from 2015-2019
1.6% reduction in outpatients
Diagnostics
Between 2014 and 2016 we will develop a service which will allow for accurate diagnosis of IHD in a community setting,
reducing referrals to secondary care.
Trafford has an existing open access diagnostic service to GPs for investigation of suspected arrhythmias. A review of referrals in 2013/14 with primary care has identified patients who have been referred to secondary care that could have been managed by this service. Work is being carried out with primary care to localise the map of medicine for tachyarrythmias.
Respiratory
Trafford CCG as part of the respiratory work programme has established a steering group who will have oversight of the work
programme that seeks to improve and/or redesign respiratory pathways for COPD and Asthma in line with clinical evidence based practice and the principles of integrated care. The group will ensure delivery of projects and ensure a reduction in unscheduled care admissions and the achievement of National Quality Premiums, CCG QPs and GP QP indicators.
There are a number of schemes which will deliver change, deliver service improvements with measurable benefits across Trafford.
There is no single diagnostic test for COPD, diagnosis relies on a combination of
The benefits of developing this service:
Reduced referrals into secondary
care
Improved access to diagnostics and
reporting to GPs
The benefits and goals of the Respiratory Programme are:
A reduction in unplanned activity
into secondary care by 1.8 from 2015-2019
To relieve symptoms
Ensure alleviation
Improve exercise tolerance
Prevent and treat complications
including exacerbations
PATIENT VOICE
Do you want to be
involved in reviewing
this service? Contact us
on
[email protected]
or 0161 873 6008
history, physical examination and confirmation of airflow obstruction using spirometry. Currently the CCG are seeking to invest in spirometry educational programmes within primary care establishing an expert workforce responsible for both the performance and interpretation of spirometry, ensuring that the primary diagnosis is both accurate and appropriately treated.
The CCG has already commissioned an oxygen assessment and review service who will clinically manage all long-term oxygen patients within a community setting. Additionally, in order to meet the goals of the programme the steering group will redesign the current pulmonary rehabilitation service specification in-line with clinical best practice and national guidance ensuring appropriate outcomes and increased independence and quality of life for Trafford residents.
PATIENT VOICE
Do you want to be
involved in reviewing
this service? Contact us
on
[email protected]
Minor Eye Conditions Service
We will be assessing the appropriateness of a service to use the skills of optometrists in primary care to manage, assess and prioritise patients and to deliver increased levels of treatment in primary care.
We will be undertaking the initial design and development of this service during 2014 and a cost provision of circa £50,000 has been advised by
our Local Ophthalmic
Committee.
Integrated Diabetes Care
Trafford CCG is establishing a Diabetes Network to develop a Diabetes Strategy for Trafford covering the period 2014-2017. The Network will be chaired by Diabetes UK and involve key stakeholders from across the diabetes care pathway to include general practitioners, acute sector providers, medicines management, public health and patient representatives.
Procurement to ensure Value for Money
Macular services – Intra-ocular injections
Due to increasing demand, new conditions requiring this treatment and current costs of this service, a decision has been made to review the current service and pathway provided by the Royal Manchester Eye Hospital.
We believe we can both improve accessibility to this service, ensure its quality and achieve financial savings, all of which are critical for us over the next 5 years.
This will be a value for money review with accessibility for Trafford patients a key aspect.
The Ophthalmology Programme will:
Improved clinical outcomes
for patients
Increased patient
satisfaction
Improved efficiency and
reduced costs
Reduce elective care by
1% from 2015- 2019
Reduction in outpatient
appointments by 3% from 2015-2019
Diabetes Strategy outcomes:
To increase the percentage of
people receiving all 8 care process by 15% by 2018/19
To increase the percentage of
people achieving all diabetes treatment targets by 2.5% by 2018/19
To reduce the average diabetes
outpatient follow up per first attends from 11.48 (2013/14) to 6 by 2018/19
Increase the provision and uptake
of a patient/carer satisfaction survey
A reduction in outpatients by 1%
The Network will work towards enhancing the quality of care and improve service provision relating to the prevention and early diagnosis of Type 2 diabetes, and the appropriate management of Type 1 and Type 2. Implementation of the strategy will ensure that future service provision is provided in a timely and universal manner throughout the health economy.
Community Dermatology
Trafford CCG will be working closely with its neighbouring CCG’s in Central & South Manchester to procure a community based dermatology service in 2015
This service will enable increased, timely and appropriate interventions (assessment, diagnosis and treatment) in the community to ensure only those patients who really need secondary care treatment are referred to hospit al.
MSK Integrated Care
Musculoskeletal (MSK) - Community Physiotherapy
We will invest £230,000 in Community based physiotherapy. This will contribute to reducing patient waiting times for treatment.
Community based dermatology will deliver;
Additional years of life as a result of
better management of skin cancers
Reduced referrals for hospital treatment
and savings on the current expenditure of £1.1M
Improved patient experience
A reduction in outpatient appointments
by 0.5% from 2015-2019
Community based physiotherapy services will deliver;
Treatment for urgent cases within 2
weeks, and routine treatment within 4.
Increase in the number of patients
completing treatment
Improved patient experience and
satisfaction
A reduction in elective care by 0.8%
from 2014-2019
A reduction in outpatient appointments
by 0.9% from 2015-2019
MSK – Review of hospital based Physiotherapy
To ensure we deliver the desired benefits from our Community based Physiotherapy services we will review the services being delivered by both CMFT & UHSM.
We will be commencing with this review in 2014
with a sustainable revised level of referrals expected to be delivered by 2017.
Community Pain Management & Education
For clinically eligible patients who have been in pain for upto 3 years we will be developing a community pain management and education service. We are targeting an investment of £12,500 per annum based on 140
referrals and aiming to test, assess & implement this initiative during 2014
MSK – Review of hospital based physiotherapy services will deliver:
Improved quality and appropriateness
of referrals for hospital based treatment
Improved patient experience and
satisfaction
Benefits of a community based pain management and education service include:
Improved patient clinical outcomes
Increased positive patient experience
KEY ENABLER