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Quality information is absolutely mission-central to making healthcare including PBC, work and work well.

Ed Manning Practice Manager

Taking the first steps

Shropshire County PCT covers a broad geographical area and has a correspondingly wide-range of healthcare issues.

Several local healthcare leaders, including Ed Manning, Practice Manager at Ellesmere Medical Practice, Sal Riding, GP at Church Stretton and Health Foundation Leadership Fellow, and Julie Davis, Head of Locality Commissioning at Shropshire County PCT, were meeting regularly to discuss communication and general commissioning issues.

Born out of those meetings, the localities are designed to better manage the care and services available across the PCT. Each locality has elected a chair person and Board and is focusing on PBC.

The locality groups are divided by geography, with one each in the North West, North East, South West, South East and Shrewsbury and Atcham. The chairs of the locality boards meet once a month to discuss local concerns and plans and then take the results to the monthly commissioning group meeting that includes the PCT.

Solution

Still in the infancy of its work, the localities are already making big plans for the future. For example, Ed Manning's practice has a particularly high number of elderly patients, making their work with high-impact patients essential in their long-term management of conditions such as COPD and diabetes.

"Quality information is absolutely mission-central to making healthcare, including PBC, work and work well," said Manning. "We're using the locality groups to better manage resources across the PCT and target potential problems before they happen. The NHS number is absolutely critical to our work in identifying patients and making those important decisions about where care needs to be focused," said Manning.

Each locality group is scheduling training sessions for the Practice and Provider tool. The PCT is focusing on Real Time Monitoring (RTM) in order to best understand the area's overall activity and benchmark the overall potential for involvement in PBC. A data analyst from each locality will be assigned as the information manager for the group and will work closely with the PCT in validating data and managing activity.

Outcome

The commissioning group acknowledges the complexity of service redesign.

"We need to sort out the way information works to the patients' benefit before overhauling complete systems," said Manning. "We're going to start this process by examining patients who have been in hospital more than they should and find a way to treat them before their conditions get to that point."

Each locality board is going to take PBC one step at a time. Over their next meetings, the boards will discuss the plan for each practice to identify top service users and make appropriate care pathway changes. The work will then be evaluated and extended out to other areas of care. The board hopes to be able to have initial assessments and "quick win" improvements by early next year.

After identifying high-impact users, the localities want to delve deeper into the data and examine coding issues.

"As we improve care and methods of working, we're actually increasing our own workload," said Manning. "The more we learn and see in the information, the more we question and want to examine. We're re-organising our team right now and will have three people dedicated to working full-time on data in September across the five localities."

Tool

Practice and Provider Monitor and Real Time Monitoring