East of England Region

Heather Ballard

heather.ballard@ltc-team.org.uk

 07506 739665

My background includes working as:

• District Nurse
• Neighbourhood Manager
• Professional Officer for Community and District Nursing Association
• Sue Ryder Care Regional Manager
• Peterborough PCT Strategic Lead for LTC
• And now at the SHA as policy lead for LTCs

Long Term Conditions have been theme throughout my career and I am committed to working in partnership with service users – facilitating the development of supported self care through education, information and personal health planning.  In short, supporting people with long term conditions to live the life they choose rather than the life their condition dictates.

Follow this link to the Long Term Conditions Programme Board where you will find information about the Programme Board, the Personal Health Planning tools, and the LTC Practical Guide.

http://www.eoe.nhs.uk/longtermconditions

East of England Regional Updates:

Working closely with 3^rd sector organisations to support their understanding of the current changes in the NHS following the election of the Coalition Government, in order to help identify new levers and drivers to develop their services and support to their membership and client groups.

Supporting SHA colleagues in driving forward implementation of personalisation and supported self care for people with long term conditions.  This includes a particular focus on evaluating personal health planning; keys to implementation, the impacts not only on the individual and their carers but also on workers and systems.

Two projects with primary care colleagues have completed and plans are being made to publicise the learning widely.  One project has examined the process of implementing personal health planning within one practice and with the registered population of people with neurological conditions – valuable lessons have been learnt which will support implementation across the region.  The other project has been an audit of people with long term conditions registered with one practice, examining the health and social care services they receive, any gaps in support and making recommendations about joint commissioning and working to improve services in this area.

Facilitating the development of a regional neurological network which will give service users, clinicians, commissioners and other stakeholders a forum to benchmark, peer review and drive improvements in equity and quality of care.  The format of this network and its sustainability is a key issue to be resolved in order to provide a legacy for supporting implementation of the Quality Requirements identified in the NSF for long term neurological conditions. 

For previous regional updates, please see previous editions of the LTC team briefing document.

Current projects in east of England

PHP300

This project aims to implement personal health planning with all the registered population who have a long term neurological condition within one general practice, and to use an ‘action research’ approach to identify a range of impacts (personal, staff, system, financial) of this. 

The practice, Central Surgery in Gorleston, Norfolk has a total number of 12,628 people registered with them.  Of those, 4,189 (33%) have a long term condition which is in line with the national average.  Personal health plans were offered to the 271 people with a neurological condition (this is 2% of the registered population and 6% of the people with LTC).

The project will report in early August 2010.

LTC audit

The Joint Improvement Partnership (JIP) for the Eastern region commissioned this audit and identification project of people with a long term condition.  The project was managed by Hertfordshire County Council and the work undertaken by Chells Way Surgery in Stevenage.

There are 13,665 people registered with the practice and the early results of the audit show that 40% of the practice population have a long term condition (5,500). The most common conditions identified are hypertension, asthma,   diabetes, and coronary heart disease.

Key learning points so far

·        Practice does not have information about any health, social care, other support that individuals have and the information had to be gathered through individual questionnaires sent out to the patients

·        It has identified a number of carers who were getting no support

·        Also a number of individuals required immediate referral to other services

·        At least 10 people were called for early GP appointment to review their situation

Analysis is currently being carried out and the report is expected in early June 2010.

Specialist Neurological Rehabilitation Services (SNRS) Review

This is being carried out by the east of England Specialist Commissioning Group (SCG) and supported by the Delivery Support Team and the aims are

·        Prepare map of SNRS available to people from the East of England

• Identify any gaps in SNRS

• Prepare outline of current commissioning arrangements for SNRS

·        Set out the needs of patients and their carers

• Produce care pathways for SNRS including links with the NHS and Local Authorities

• Produce service specifications for SNRS

• Propose commissioning strategy and implementation plan for  SNRS

The project will report in September 2010

Diagnostics in the community

This project is led by Planned Care Programme Board, supported by Acute and Long Term Conditions Boards in east of England.  The purpose to provide guidance to commissioners for the 2011/12 round of contracting.  It is expected that there are some significant QIPP savings to be made in this area. 

The working group is currently agreeing the main areas for focus which are likely to include the generic principles of speed, accuracy and communication, with some specific work around neurological conditions, particularly epilepsy.

The project will complete in September 2010

Links

Past regional events:

- All you ever needed to know about personal health planning - 12 November 2009 CLICK HERE

- Personalisation and Self Care: two sides of the same coin? - 25 June 2009 CLICK HERE

- Levers4Change conference, 4 June 2009 CLICK HERE