Summary of other NHS West Midlands case studies

Stoke Community Health Services

Stoke on Trent Community Health Services has an income of £53M in 2008/09 and employs 1,500 staff.  The organisation is the first community provider to be awarded the national Customer Excellence Award.  The provider services involved include; Community Allied Health professionals and nursing staff (including Out of Hours), Intermediate Care Services, Community Matrons and community hospitals. Key partners included in the project are patients and carers, GP partners, social care and discharge liaison.

Stoke Community Health Service’s key strategic themes are:

• People are at the centre of what we do
• Sustaining and expanding quality services that make a real difference
• Developing partnerships with purpose
• Developing and empowering staff
• Making a real difference – meeting standards for best practice and delivering targets
• Ensuring public money is well spent
  
  Stoke on Trent Community Health Services have commissioned a short-term project with Unipart Expert practices applying the principles of a ‘lean’ methodology with the objective of achieving: ‘A clearly identifiable simple point of access for patients with integrated planning and delivery of care.’
   
  Contacts: Susanne Turner / Helen Birchall Tel: 01782 425235 Susananne.turner@stoke.nhs.uk

Wheelchair lift - South Birmingham PCT

The system, invented by a member of staff from South Birmingham’s Rehabilitation Centre, allows a wheelchair to be lifted easily into the boot of a car, helping elderly users or those with limited mobility.  The lift can be manual or totally automated method of lifting, taking away the strain of lifting and ensuring the lifting procedure is correct and safe. In its automatic mode, the wheelchair is neatly stored in the car boot with minimal user intervention. 

A prototype was built by Coventry University and following a national exhibition in Birmingham,   the wheelchair lift is now being manufactured and will be on the market during 2009. The wheelchair lift is being exhibited at today’s event. 

• Increases independence of elderly patients or those with limited mobility
• Assists carers, particularly the elderly, of users of wheelchairs in supporting the independence of users
• Simple to use, cheap to construct and can be easily fit to any sized car

Contact:  David Gleaves, Chief Executive, MidTECH Tel: 0121 455 0346 david.gleaves@midtech.org.uk

PICS – the Prescribing, Information and Communications System developed and used in University Hospitals Birmingham NHS Foundation Trust (UHBFT).

The PICS system is responsible for the provision of clinical information, drug prescribing, drug administration, order communications and many other functions used in the care of patients within UHBFT.

In any week approximately 2000 staff members access the system, with around 23,000 new prescriptions being written on PICS and 130,000 drug administrations recorded. The system is extensively rules-based in concept, providing real-time decision support in terms of drug interactions, contra-indications, dose limits and in a wide range of other clinical areas, including infection control.

The PICS system was developed by an in-house team and continues to be developed in new areas by the same team.

• Significant reduction in medication errors, alerting staff to around 400 potential errors each day.
• Substantial (50%) reduction in MRSA bacteraemias – enforcing policies for prescribing of decolonisation therapy and reducing time lag for prescriptions for those tested positive from 36 hours to seconds.
• Alerting of potentially dangerous laboratory results to clinicians – available within seconds of reporting.
• Provision, through routine operation, of an extensive database (60Gb) of clinical data and activities, used in clinical and operational audits.

Contacts: Mark Garrick, Head of Medical Director’s Services  Mark.Garrick@uhb.nhs.uk

Tunnelled Jugular Line with observation window drape (Shrewsbury and Telford Hospital NHS Trust)

The Tunnelled Jugular Line with Observation Window Drape will help reduce the chances of dialysis patients developing MRSA.  The product is specifically designed for use during the insertion of tunneled haemodialysis lines.  The current drapes are not specifically designed for the procedure, leading to an increased risk of infection for the patient and feelings of claustrophobia. This specialist drape helps the insertion of tunneled haemodialysis catheters, ensuring that these lines are inserted in a sterile way and with the least discomfort possible for the patient.  The product is being manufactured for distribution, with the aim of launching of November 2009.

• Reduced risk of kidney patients being infected with MRSA
• Improves patient experience by reducing feelings of claustrophobia many patients experience by being covered up
• Increase the efficiency of the drape as an infection control barrier
• Responding to clinical and patient needs.

Contact: Dr Kevin Eardley, Consultant Nephrologist, Shrewsbury and Telford hospital NHS Trust Kevin.eardley@sath.nhs.uk

BENeFIT – Birmingham East and North PCT

BENeFIT is a staff wellness programme which provides telephone lifestyle advice and support to employees of Birmingham East and North Primary Care Trust (BEN PCT). Staff sign up on a voluntary basis, and on joining the programme receive a welcome phone call from a health trainer and a web enabled pedometer. Staff can view their step statistics via a personalised website which gives information on how to improve their health. This is supported by regular calls from the health trainer.

• Healthier staff – better role models
• Health information transferring from staff to patients
• Fewer staff absences meaning better services
• Happier staff leading to a better patient experience.

Contact:  Michelle Abbott, Birmingham East and North PCT Michelle.abbott@benpct.nhs.uk

Eatwell, Shopwell, Cookwell, Slimwell - Sandwell PCT

Eatwell in Sandwell is the Borough’s award-winning healthy eating campaign, funded by the Neighbourhood Renewal Fund.  It aims to make it easier for local people to find healthier food in their local shop. Support is offered to shops in Sandwell that want to stock more fresh fruit and vegetables.

It includes:

• Shopwell providing shoppers with good quality, affordable fresh fruit and vegetables at their local store
• Cookwell courses – a six week cooking course to find out more about healthy eating, try new foods, learn how to cook healthy, cheap meals
• Slimwell sessions for people who want to lose weight (see more info below)
• Eatwell Awards rewarding cafes with healthier options on the menu
• Ready Steady Grow, a community allotment, linking healthy eating and exercise for school children at Salop Drive market gardens (see more info below)
• Lunchbox programme helping parents and pupils put together healthier packed lunches.

Eatwell  enables the residents of Sandwell, perhaps for the first time, to access quality, fresh food accessible locally.  Through its Ready, Steady Grow scheme, residents can also access cookery lessons and tasting sessions through its related Cookwell scheme, whilst its community allotment offers the opportunity to grow your own food, and teach schools pupils about healthier diets, have tasting sessions and learn where food comes from and keep food diaries.  Fresh produce can yield a 30-40% margin and experience has shown that the average local shop may be able to increase its profit by 10% by adding fresh fruit and vegetables to their stock. They sell to their existing customers and possibly get some new customers as well.

Contact: Angela Blair, Food Policy Worker, Sandwell PCT angela.blair@sandwell-pct.nhs.uk

Hook-on – Wolverhamton City PCT

Hook-on promises to revolutionise the way intravenous drugs and fluids are given to patients in their own homes. A portable lightweight drip stand that enables bags of intravenous drugs or fluids and monitoring equipment to be securely attached so nursing staff can safely administer treatment. Staff identified a need for a portable stand  to enable them to safely and effectively administer intravenous drugs and fluids to patients at home.  The Hook-on stand can also be used in hospital wards and incident scenes.  The Intermediate Care Team have worked with Medical Device Technology International (MDTi) to design, test and evaluate the stand.

Hook-on was designed to work with the hook-it IV portable drip hook that was created by a theatre nurse at New Cross Hospital in Wolverhampton.  A training DVD has been produced which is being used to market the invention. 

Contact: MDTi, tel 01902 778380 or visit http://www.mdti.co.uk

Hollier Simulation Centre, Heart of England NHS Foundation Trust

A pilot simulation centre since September 2008 offering a comprehensive training programme of acute medical scenarios for junior doctors across Birmingham.  In the centre, clinical areas are mocked up and medical scenarios are run from a control room  using animated dummies as patients, medical teams are then trained to respond correctly to a variety of situations recreated in a realistic patient-free environment. It is planned that the pilot will be rolled out across the West Midlands to train doctors, dentists, AHPs, nurses and multi-disciplinary teams n a dedicated simulation centre to be open by 2010.

Every scenario is recording using high-tech digital video.  In an interactive debriefing session, the scenario is then replayed and lessons learnt are explored and discussed. The region’s universities, the royal college of surgeons and the Ministry of Defence have all expressed an interest in working with the centre and future plans include the setting up of mobile simulation centres across the West Midlands.

 Contact: Dr Hannah Harris, Project Manager, Heart of England NHS FT, tel: 0121 424 2973 or email simulation.centre@heartofengland.nhs.uk

Transforming patient care utilising the Year of Care approach – NHS Telford and Wrekin (Telford & Wrekin PCT)

The service aims to improve the health and wellbeing of people with Long Term Conditions by properly supporting and empowering them so they are confident about managing their own condition on a day-to-day basis.  The project will enhance and promote further development of the recently set up of the ‘personalised care plan’ steering group across the PCT.  This is a whole community approach to delivering personalised care with membership from, patients, social care, health professionals and voluntary groups, ambulance service, local council.

By using the year of care approach and the learning opportunities that can be derived from the experiences of the pilot Year of Cares, the aim is to establish that care planning is right at the centre of the clinical consultation to ensure that patients have:

• a complete involvement in planning their care
• the respect for and recognition of their ability to self manage
• a choice to tailor support for those who wish to take on a greater role
• consistency and greater continuity of care
• a central role in service planning and influencing what local should look like
• information and signposting to local support services care

The expected achievements/issues that will be addressed will be to:

• Fully engage patients by agreeing goals and priorities in their care to improve their outcomes.
• Provide a ‘stimulus’ to the whole care community to redesign services for people with Long term conditions, enabling the PCT to deliver the right care in the right place a the right time by people with the right skills, with the right resources.
• Provision of a proactive approach to addressing the urgent care agenda by having a direct impact on reducing unnecessary hospital admissions.
• Enable commissioning to be informed by ‘real’ patient data. It will provide the real information needed to commission services that people need and clinicians value.
• To develop ‘true integrated care pathways’ using real patient experience.
• Provide good evidence for Practice Based Commissioners to identify the needs of their practice populations and on the basis of this evidence how they develop services to meet these needs.
• Develop a multidisciplinary training programme to embed the philosophy of care planning and self-care into everyday working. This programme needs to embrace the ‘shift’ towards patient centred care, rather than ‘systems driven care.

Contact: Cath Molineux, Nurse Consultant & LTC Clinical Lead, 01952 217400, catherine.molineux@telfordpct.nhs.uk