– NHS Wirral Map of Medicine Andy Poole – Map of Medicine

Map of Medicine – NHS Wirral
Andy Poole
Project Manager – Map of Medicine
NHS Wirral
17th September 2009
Overview of the Map in Wirral
• The Map is commissioning based but clinically
driven
• It helps to engage local health community (LHC)
staff and clinicians to drive pathway
development
• It is used to review, redesign and find gaps in
existing pathways and services
• Recommendations from pathway development
carried forward
Modernisation Teams
Typical membership of 12-20 people:
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PCT Medical Director (Chair)
Lead Consultant(s)
Programme Manager
Locality GP representatives
Nursing/Midwifery Staff
Patient/Public representative
Other provider representatives
Meet quarterly, with informal task & finish groups set up for pathway
work
Pathway targeted
Robust
Governance
Procedure
Map of Medicine
consulted
Discussed and
agreed by
Modernisation Team
Circulated to GPs
Signed off by
PEC/providers
Pathway published!
Overview of the Map in Wirral
Pathways:
• 44 pathways published
• 3 pathways awaiting PEC
approval
• COPD and AMD
pathways published
before national versions
existed
Users:
620+ Wirral Users
Senior Doctors
11%
Nurses/
Midwives, 19%
GPs, 25%
Management
staff, 15%
Other clinical,
14%
Other clerical,
16%
What we’ve done so far: Some
examples…
Commissioning a service using the Map
Dyspepsia pathway:
• Review of dyspepsia
pathways using Map of
Medicine by cross-sector
team
• Gap identified in current
service (H. pylori testing)
• New pathway adds choice
and convenience
Commissioning a pathway from scratch
• Wet Age-Related Macular
Degeneration (AMD) service
• Rapid redesign of pathway
facilitated by use of the Map
• New pathway publicised on
Wirral view of the Map
• Waiting times cut from 10 weeks
to 10 days
Commissioning a new community service
Low vision assessment pathway
• Drafted by:
• Primary & secondary care
clinicians
• Community optometrists
• Social services
• Voluntary & educational
agencies
• Patient reps
• Next steps:
• Service spec
• Collaboration vs. tender
process
Collaborative Commissioning
Cheshire & Merseyside spinal pain pathways:
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Directors of Commissioning targeted
spinal services due to inappropriate
referrals for expensive interventional
procedures
Cross-region discussions based on
Map spinal pathways, jointly led by
NHS Wirral and NHS Warrington
Standardised care for patients
across the C&M region
Local administrative information able
to be amended for each area
Use in Practice Based Commissioning
Wirral musculoskeletal pathways:
• Musculoskeletal pathways
undergoing review
• Targeting:
◦ Reduction in inappropriate
referrals
◦ Improved patient journey
• MoM used as commissioning/
redesign/ educational tool
Wirral now involved in NHS Institute Rapid
Improvement Programme
• NHS Wirral chosen as one of
ten sites nationally to
participate in children’s
programme
• Selected pathway, ‘Wheezy
child’, will be configured using
the Map as a starting point
Map of Medicine – NHS Wirral
E.
T.
[email protected]
0151 651 0011
Structure & Reporting
Wirral Board
Reporting:
Structure:
Map of Medicine sits
within the Health
Systems Management
Directorate, formerly
Commissioning &
Contracting
Professional
Executive
Committee
Health Systems
Management
Directorate
Programme
Managers
Quality
Team
Map of Medicine
18 Week
Programme
Board
The project reports to the
18 Week Programme
Board and PEC which in
turn reports to the Board
Localised pathways are
signed off directly by PEC
& provider organisation
NHS Wirral
• Population ~ 320,000
• 62 GP practices
• 1 Acute Trust