Collated presentation slides - Health Education South London

Report
South London Membership
Council
10 June 2014
Welcome
Aurea Jones
Director of Workforce
Health Education South London
Health Education South
London: Update
Aurea Jones
Director of Workforce
May-June 2014
Beyond Transition
Realising our potential
Health Education England
Realising our potential
•
An organisation that can turn our 5-year strategies and HEE’s
recently published 15-year strategy into reality
•
An operating model to drive quality improvement through the
entire workforce locally and nationally
•
Preserving provider leadership locally and enhancing it nationally
•
Reducing duplication, spreading best practice, increasing
efficiency – ‘One HEE’
•
A sustainable and value-for-money model with good governance
www.hee.nhs.uk
Case for change
• We must create One HEE: one statutory body with a clear vision, purpose,
and culture creating greater alignment between the local and the national
• Our operating model must allow HEE to focus on the transformation of the
whole workforce, the length and breadth of the organisation
• We must ensure HEE meets the standards of governance and process
expected of a single statutory non departmental public body and create
greater alignment with the rest of the system
• We must deliver the DH requirements to reduce running costs by 20%
(-£17m) and the number of senior posts paid over £100k by at least the same
amount
• We must continue to be as efficient as possible in non-staff running costs
to help meet our challenges
www.hee.nhs.uk
One Health Education England
Local functions
National and Nationwide functions
HEE Board and Chairman
Chief Executive
Executive Team including National directors (geography) x4
DEQ x 4 and HoF x 4
13 Local Directors + 13 Chairs + 13 Vice-Chairs + 13 PG Deans
Workforce Planning
Identifying the numbers, skills, values and behaviours to meet current and future patient needs
Attracting and recruiting the right people to the posts we have identified
Using NHS Careers, values based recruitment, Oriel, return to practice and widening participation
Commissioning excellent education and training
Using our financial and contractual levers to ensure that the next generation receive high quality
training that equips them to provide high quality care
Lifelong investment in people
Supporting our staff to be the best they can throughout their careers, including the training and
development of non-professional staff
Enablers – supporting the delivery of our core business functions.
Workforce strategy and transformation
What does this mean for…
HEE local?
• Build on 13 LETBs as local footprint of HEE
• A focus on workforce development and transformation and stakeholder
engagement
• Delegated HEE budgets retained
• Good governance through the independent Chair
• Enhanced provider leadership with Vice-Chair filled by provider CE
• Supported by a Local Director and Postgraduate Dean as part of ‘One
HEE’ to improve alignment between local and national
www.hee.nhs.uk
Key engagement questions
1. What more could be done to strengthen provider and wider system
engagement?
2. What further could be done to fully embed the concept and practice
of One HEE?
3. What further work could be done to develop the proposed model
and ensure the case for change is fully met?
4. What functions, projects or processes should be stopped, started or
kept to ensure the delivery of strategic and mandate priorities?
5. HEE is committed to its staff, what more could be done to support
them and HEE’s aim to be a Top 100 Employer?
www.hee.nhs.uk
How we collect your views
• During staff and stakeholder events
• All comments back to [email protected]
www.hee.nhs.uk
Membership Council Feedback:
Be more
transparent about
future dates
Create a sub group to
enable constituencies
to contribute between
meetings
Membership
Council drive
agenda items
more
Use the Membership
Council to shape
future direction
Set place/venue
to hold meetings
Info/engagement
been a good level,
not too much or too
little
Communicate
actions via Annual
Review
Applications open today
Information & application forms
can be found at:
southlondon.hee.nhs.uk/news
Closing date: 4 August 2014
Health Innovation Network:
Update
Zoe Lelliott
Director of Strategy & Performance
Update for Membership Council
10 June 2014
Zoë Lelliott
Director of Strategy and Performance
Update from the Health Innovation Network
• Looking back on 2013/14
• Brief over-view of the Clinical Themes
Our 2013/14 Annual Report has just been produced
• Our first Annual Report has
been an opportunity for us to
reflect on the achievements of
the Health Innovation Network
over the past year
Highlights from 2013/14 (1/2)
• Established a vibrant AHSN, with a clear strategy and rigorous
approach to service improvement, and effective governance
structures (Board and Membership Council)
• Engaging with stakeholders in our Clinical Themes (prioritised on
local public health needs); initially Diabetes, then in latter half of year,
MSK, Dementia and Alcohol – in order to develop priorities and
specific projects
• Appointed strong leadership teams (led by member CEOs as SRO,
clinical directors, programme managers and patient representatives)
in each of our priority areas; now focusing on delivery of specific
projects and implementation of best practice
Highlights from 2013/14 (2/2)
• Worked with our diverse membership to:
• Ensure that our work programmes are complementary to the
many local initiatives, and build on these strong foundations
• Foster close working with our partner organisations across
South London, including HESL, KHP, the CLAHRC and CRN
• Built collaborative working with industry, including multiple contacts
with relevant businesses in all clinical areas, and some developing
partnerships. Leadership of the SBRI process in Diabetes, and joint
working in Dementia
• Influenced strategy development across the local health and care
system, including involvement in the Mayor’s London Health
Commission and local NHS England 5 year planning process
Looking forward to 2014/15
Strong foundations:
Delivery required in 2014/15
New project management
team in place
Achievement of project
milestones and outcome
measures
New offices, co-locating all
clinical and innovation themes
New challenges:
Reduced NHS England
funding
Requirement to deliver Patient
Safety Collaborative within
resources
Demonstrate relevance to local
commissioners
Facilitate joined up health and
care pathways, and crossboundary working
Increase the focus on
prevention, health promotion and
self-management
Clinical Themes: Musculoskeletal
Project 1 – managing OA in primary care
•Audit of compliance in GP practices, with
benchmarking of performance data
Why MSK?
• A high burden of
chronic disease &
chronic pain,
leading to disability
• High costs &
growing demand
for secondary care
•Developing educational tools with HESL to support
GPs & other primary care practitioners
•Co-design of improvements to patient pathways
Project 2 – implementing NICE approved
intervention for knee pain (ESCAPE)
•implementation of this exercise based programme,
supported by website for professionals and patients
•CCG adoption of ESCAPE
Project 3 – productivity in secondary care
• Adoption of high volume models of elective
care which deliver on quality and cost metrics
Clinical Themes: Dementia
Projects focusing on Patients and Industry Partnerships
Small Business Research
Initiative (SBRI)
• Working with a private
company (IXICO) to develop
an electronic care planning
tool, individually tailored to
support people with
Dementia and their families
• “proof of concept” award for
delivery in 2014
Care homes forum
• Brings together all care home
providers across South
London to innovate and share
best practice
Co-creating Patient Experience
measures
• How to measure what is important to
people with Dementia and carers about
the care they receive?
Clinical Themes: Diabetes
PROJECTS
1. Improving self-management of
insulin therapy
2. Management of unscheduled
care in hypoglycaemia and
hyperglycaemia
OBJECTIVES
• Improving access to and
appropriate use of
technologies
• Improving the integration of
care pathways
3. Improving uptake of Structured
Education
• support for patients to selfmanage their condition
4. Medicines use: investigation of
insulin prescribing
• optimise use of resources
5. Retinopathy / maculopathy (to
be launched 09/14)
• Improve integration of care and
information sharing
Clinical Themes: Alcohol
Common leadership & projects across CLAHRC, HIN, KHP
• Alcohol-related Frequent Attenders (AFAs)
– Reviewing care records of AFAs to determine where early
intervention could make a difference to outcomes
– Developing pathways to identify and treat alcohol issues proactively,
within other clinical settings
• Identification and Brief Advice (IBA)
– Baseline; population survey to determine penetration of tool
– Identifying and addressing process barriers to IBA delivery in key
settings
– Use of technology to expand direct delivery to a wider population
We need your support to make it happen…
In order for the Health Innovation Network and our
Clinical Themes to be really successful, we need:
• Staff in your organisations to get involved in our work
programmes and individual projects, providing expert
advice and guidance
• Your help to indentify leaders of the future, ensuring we
make the right appointments to key roles, such as
Innovation Fellows
• Our member organisations to volunteer as pilot sites to
implement our projects and innovations
Thank you
hin-southlondon.org
[email protected]
0207 188 9805
End of Life Care
Kate Heaps
Chief Executive
Greenwich & Bexley Community Hospice
End of Life Care
Development of an Education and
Training Strategy for South London
Context
• Health services in S London serve a population of
approximately 3 Million people and have an incidence
of approximately 19,000 deaths per annum.
• Approximately 0.6% of GP’s registered population will
die each year
• Main causes of death:
–
–
–
–
Cancer
Organ failure
Dementia/ frailty
Sudden death
• Nationally, the death rate is predicted to increase by
17% by 2030; this is an additional 3,200 deaths per
annum in S London.
Context
• ½ of dying people will die in Hospital, but when people are asked
about their preferred place of care, majority state a preference for
Home or Hospice (Gomes, 2013)
• Nationally, the proportion of deaths in the usual place of residence
continues to increase. 43.7% in 2012, up from 37.9% in 2008
• London has the widest range of values for deaths at home. Sutton
(15.9%) lowest home deaths, City of Westminster (24.9%) second
highest in England
• Implementing Electronic Palliative Care Co-ordination Systems
(EPaCCS) affects place of death, with an extra 90 deaths occurring in
the usual place of residence per 200,000 population each year
above the underlying increase in rates experienced across England
(NHS Improving Quality, 2013)
• People under care of SPC/ hospice more likely to die at home
(GBCH, 53%)
• People over 85 years, those with a non-cancer diagnosis, BAME
community are less likely to access Specialist Palliative Care
Context – Quality and cost issues
• Quality of care variable
• National Survey of Bereaved Relatives
• Londoners who die in hospital following an emergency admission
have a longer length of stay than the National average
• Withdrawal of the Liverpool Care Pathway from hospital
• Social care and hospital costs in the final year of life are estimated
to be £10,130 per person (Georghiou, 2012); this does not include
primary care, community care and prescribing costs.
• There is evidence that implementation of Electronic Palliative Care
Co-ordination Systems like Coordinate My Care could save at least
£538,650 for a 3 Million population each year (NHS Improving
Quality, 2013).
• Significant burden on carers (people who are married are more
likely to be able to achieve a home death if this is their wish
(Gomes, 2013))
What’s happening?
• HIN workstreams:
– Cancer
– Dementia
– Patient Experience
•
•
•
•
•
•
The South London CLARHC End of Life Care theme (outcomes)
London Cancer Alliance – Palliative Care Group
NHS London – End of Life Care CLG
Coordinate My Care ( spread and evaluation)
Advance Care Planning
Health Education South London Training and Education Strategy
(CEPNs and Strategic Investment Funding)
• Which areas are doing good things to improve access to care for
particular groups (early detection and referral, BAME/ non
malignant) how can this good practice be shared and implemented?
• Other ideas?
Outcomes: short term objectives
• An inclusive Palliative and End of Life
Care collaborative across and
beyond South London
• A common set of measures to
capture patient needs and outcomes
• measures which work hard for us
(capture needs, complexity, outcomes
and can deliver quality indicators)
• aligned with other initiatives (Funding
Pilots in England, national MDS,
national outcomes initiative, NICE
Quality Standards, ELCQuA)
IMAGE
Map produced by CLAHRC East Midlands’
Outcomes: medium term objectives
To implement the common set of
measures to capture patient needs and
outcomes
Work towards linked / pooled outcome
data
• to better understand the
population needs and outcomes
• to support evaluation of
interventions
• to support quality improvement
• to enable realistic and
meaningful benchmarking
IMAGE
Map produced by CLAHRC East Midlands’
Outcomes: long term objectives
Regularly map casemix-adjusted
outcomes across South London
Established platforms to evaluate the
complex interventions of palliative and
end of life care
IMAGE
Principles: Inclusivity, patient- and
family-centeredness, bridging evidence
and practice
Map produced by CLAHRC East Midlands’
Coordinate My
Care
London
EoLC
Clinical
Network
Hospices
Primary
Care
London
Cancer
Alliance
GSF
Steering
Group
Social Care
ADaSS
EoLC Group
Care
Homes
CLARHC
HIN
Dementia
Theme
Community
providers
Acute
Care
Strategy Vision – a work in progress
To ensure that the health and social care workforce
in South London have the skills and confidence to
care for the dying regardless of where they are
cared for.
The implementation of the strategy will ensure
incremental improvements and spread of high
quality end of life care to all those who need it,
regardless of patho-physiology, place of care or
other characteristics which may have an impact
on access to care.
Strategy Aims (draft)
• To promote the development of a well trained workforce, leading to
improvements in the quality of EoLC, including increased patient
choice, improved quality of communication and increased levels of
patient & carer satisfaction.
• To contribute to the development of a culture within the health &
social care workforce in which death will not be regarded as a
failure and a good (expected) death is seen as a successful care
outcome.
• Ensure a full range of education and training opportunities related
to the end of life care pathway are available across South London.
• To focus on the education and training of all groups of staff
including non registered staff and volunteers
• To provide opportunities for staff to develop their careers with clear
opportunities for progression into more technical/ skilled and/or
senior roles
Strategy Aims (draft)
• To increase the choices available and improve the experience of care
for dying people and their relatives by having a more competent
workforce across all care settings.
• Enable those responsible for end of life education and training
commissioning to procure training from a full range of local education
providers in a systematic and strategic manner.
• Ensure that those involved in the delivery of end of life care education
and training have the capacity to meet the challenges set out above.
• Develop consistent standards for education training delivery across S
London and to share learning more widely
• Develop networks and relationships with and between specialist
palliative care providers who can provide ongoing guidance & support
for health and social care staff delivering end of life care.
• Support the development of competencies which have recognition and
transferability across health and social care settings
Workforce
Underpinning Principles for End of
Life Care Education and Training
Good end of life care is underpinned by:
• An active and compassionate approach to care that ensures respect for
and dignity of the patient and family
• Partnership in care between the patient, family, health and social care
professionals
• Regular and systematic assessment of patient/carer needs incorporating
patient consent at all times
• Anticipation and management of deterioration in the patient’s state of
health and well-being
• Advance care planning in accordance with patient preferences
• Patient choice about place of care and death
• Sensitivity to personal, cultural and spiritual beliefs and practices
• Effective coordination of care across all teams and providers of care (in
statutory, voluntary and independent sectors) who are involved in the care
of patient and family
What do we need to do?
• Identify and address gaps in workforce capacity
• Determine the current level of education and training provision in
order to inform a gap analysis across the sector
• Address gaps in end of life care education provision
• Develop appropriate education packages to meet the needs of all
staff across all care sectors, including care homes, acute, primary
and voluntary sector service providers
• Promote the development of “core” training packages and
implement innovative methods of delivery
• Provide training in communication skills (at a level appropriate to
the practitioner) for all staff across all sectors
• Ensure that content of courses encompasses all aspects of the end
of life care pathway
Domains of Care
Workforce Groupings
1. Volunteers
2. Health and Social Care Assistants/Non
Registered Workforce
3. Registered/Professional Health/Social Care
Workforce
4. Medical
What’s already in place?
(commissioned)
• Care Homes EoLC Programme
• S London Hospices Collaborative
– QELCA programme
– Volunteers Project
– Certificate in fundamentals of care
– Assistant Practitioner Development
• Southwark CEPN – initial focus on end of life
care
Questions
[email protected]
London Connect
Sam Meikle
Director
South London Membership Council
10 June 2014
Our time together
1. What is London Connect?
2. Our work in Information Governance
3. Your views on our work and potential
links to reduce duplication of effort
Bringing people
and information
together
to improve
care
Online records
Information governance
Benchmarking
The perfect world looks and feels like
1
2
People exist as they are
Often confused, fearful
We aim to increase:
3
4
Awareness
Understanding
5
6
Motivation
7
Action
Commitment
Bringing people
and information
together
to improve
care
Online records
Information governance
Benchmarking
Information Governance
• What does IG mean to you?
• When it works well, it looks like…
• When it doesn’t work well, it looks like…
Information Governance Community
To promote safe and
appropriate sharing
of information to improve
patient experience and
outcomes across London
Top five barriers to information sharing
IG Professionals Survey Responses
1. Lack of understanding of legal technicalities
2. Lack of leadership and vision
3. Inter-organisational working is difficult
4. Can’t do culture
5. Finding resources to implement when facing cuts
Five priorities, as voted by the community
Creating standard
informationsharing
agreements
Securing consent
across integrated
pathways
Good practice:
systems and
technology
Improving IG education and training
Communicating effectively with patients
Four broad themes
1. Raising awareness with
service professionals
2. Raising awareness with the
public
3. Developing new IG tools
and solutions
4. Systems and technology to
facilitate IG
Practical actions
Secure
#CutTheCord2014 (fax to secure email)
Harmonise London IG Passport (unified training standards)
Privacy notices
Standardised Information Sharing Agreements
Common language on consent
Shared awareness materials
Engage
A series of citizen events
Your
views
1. What area(s) will deliver most benefit for you and your team?
2. Are there areas of greater impact we could focus delivery on?
3. Who can we link with to reduce duplication of activity and
isolated implementation?
Information
and technology
are just tools
Questions
Samantha Meikle
Director, London Connect
[email protected]
www.londonconnect.org
Break and refreshments
Health Education South
London: Workforce Planning
Graeme Jeffs
Head of Workforce Development
Workforce Planning
South London Membership Council
Tuesday 10th June 2014
Graeme Jeffs
Head of Workforce Development
Purpose
1. Outline how and why you can get
involved in workforce planning this
year
2. Answer your questions about the
process
3. Gather your views on current
workforce issues
68
68
The process
3
HESL timeline
Directors of Nursing, HRDs
and HEIs meeting
Pre-populate Demand
Projections from previous
years
Apr
May
Jun
HESL Board review
2nd cut workforce
Trusts return demand
projections
Jul
Aug
Sep
Final submission to
HEE
Oct
Nov
Dec
2014
HESL Board
approve Plan
Circulate demand
template to
stakeholders
HEI capacity data gathering
HESL Board
meet to
review
workforce
forecast
First cut LETB
forecast
demand
submissions
to HEE
Bespoke stakeholder and professional
engagement
First cut workforce
investment Plan to
HEE
Workforce Planning Advisory Group designs the overall process, reviews the outputs and
recommendations, provides advice to the Board. Meetings: June, August, and October
HESL Board approves submissions to HEE, takes delivery of the Workforce Planning numbers, and
signs off education commissions. Meetings: June, August, October and December
South London Membership Council discusses workforce planning process, and discusses the overall
priorities for investment.Meetings: June and October
3
Members questions
A cross-section of the Membership Council asked the following questions:
•
What’s changing in terms of workforce planning and will it make a difference?
•
What is the split of commissioning responsibilities across London LETBs?
•
Broadening Foundation – what
will happen in South London?
•
What will the Conference cover
on 8th July?
•
What is the likely impact of
safer staffing and 7 day a week
working?
71
71
London split
LETB
HESL
HENCEL
HENWL
Lead responsibility
Dietetics
Physicians Associates
Occupational Therapy
Operating Department Practitioners
Healthcare Scientists
Speech and Language Therapists
Radiography (Diagnostic and
Therapeutic)
Podiatry
Child and Adolescent
Psychotherapy
Clinical Psychology & IAPT
Physiotherapy
Pharmacy (pre reg and tech)
Dental Care professions
Cytoscreening
Generic responsibility
Community Nursing: Health
Visitors; District Nurses;
Occupational Health; School
Nurses
Adult Nursing
Child Nursing
Mental Health Nursing
Learning Disability Nursing
Midwifery
72
72
Broadening Foundation
Underpinning Principles
73
73
Broadening Foundation
Recommendations
1.
Educational supervisors should be assigned to foundation doctors for
at least one year, so they can provide supervision for the whole of
Foundation Stage 1 (F1), Foundation Stage 2 (F2), or both years.
2.
Foundation doctors should not rotate through a placement in the
same specialty or specialty grouping more than once, unless this is
required to enable them to meet the outcomes set out in the
Curriculum. Any placements repeated in F2 must include
opportunities to learn outside the traditional hospital setting.
3.
a) At least 80 per cent of foundation doctors should undertake a
community placement or an integrated placement from August 2015.
b) All foundation doctors should undertake a community placement
or an integrated placement from August 2017. It should be noted that
both community and integrated placements are based in a
community setting, and that an acute-based community-facing
placement is not a substitute.
74
74
Broadening Foundation
Recommendations
Community placements
These involved the trainee being based in the community on a
four-month placement. Examples of community placements
included general practice, psychiatry, public health, palliative
care, general practice with public health, community geriatrics
and genito-urinary medicine.
Blended examples, with the trainee still based in the community,
included:
1. split general practice/community specialty, with three days
in general practice and two in another community setting,
such as substance abuse medicine, contraception and
sexual health, palliative care, public health
2. psychiatry, with one month spent in acute medicine and the
following three in psychiatry
3. an eating disorder unit, with some acute work in an
emergency assessment unit.
75
75
Broadening Foundation
Challenges
•
Sufficient community placements with
sufficient clinical content to meet the
Foundation Curriculum
•
Backfill of service provision in acute trusts as
Foundation Doctors move into community or
psychiatry posts
•
Questions remain about the disposition of
medical tariff
•
Developing appropriate supervision
arrangements in new working environments
76
76
Conference
21st Century Care: The People Dimension
8th July
What is the future shape of health and care services in
the medium term?
What are the implications of this on the structure and
skills of the workforce?
How must we change the current workforce planning
and delivery system?
How can this be achieved?
77
77
Safer staffing
The national plan includes indicator
data being published on the NHS
Choices website.
Trusts are expected to have on their own
websites:
•
The full data collection so that
the public can view all wards
in one place for the Trust
•
The 6 monthly Trust Board report
that contains the details regarding the
capacity and capability of wards
•
The monthly Board report relating
to planned versus actual
staffing variances
What impact will
this have on how
Trusts forecast
their demand for
newly qualified
staff?
78
78
Safer staffing
Local Vacancy rates
Local Education and Training
Board
Number FTE vacant
posts
Vacancy Rate
South London
1,325.67
18%
North Central and East
London
1,593.09
14%
East of England
896.5
12%
Yorkshire and Humber
879.76
11%
North West
1883.34
10%
Kent Surrey and Sussex
1243.97
10%
South West
1637.57
9%
West Midlands
1113.58
8%
East Midlands
1360.92
8%
Wessex
282.12
7%
North East
349.72
6%
North West London
No Data provided
No Data provided
Note: based on NHS Employers survey data with low return from South London
– 2/13 trusts
Are these
vacancy
rates
accurate and
if so what
could we do
to support
employers?
79
79
Summary
Issue
Description
Safer staffing levels,
and Broadening
Foundation
• Increased scrutiny on ward level data for each trust
• More community placements needed
Delivering personalised care in out-ofhospital settings
• New skills needed to deliver personalised care in outof-hospital settings
• Need to support culture and behaviour change
towards preventative care and empowering patients
and carers
Challenges in
recruitment and
retention
• High vacancies and turnover
• 'Ticking time bomb' in some professions: age profile
means shortages expected when staff retire
• High cost of living in London
1
2
3
12
Table work
In your tables:
• Take 5 minutes to discuss
and debate what you’ve
heard
• Discuss the 3 key areas you
want us to keep in mind
when making educational
investment decisions
• Any changes you would
propose: ideas to spread
11
Table work
What should HESL response be to
these issues?
1
2
3
Any other issues you would
highlight?
Safer staffing
levels, and
Broadening
Foundation
Delivering
personalised care
in out-of-hospital
settings
What examples of good practice
in London should we spread?
Challenges in
recruitment and
retention
13
Health Innovation Network:
South London Patient Safety
Collaborative bid
Melissa Ream
Special Projects Manager
Patient Safety Collaborative
South London
10 June 2014
@HINSouthLondon
Responding to Francis and Berwick
“Following Don Berwick’s recommendation, NHS
England will establish a new Patient Safety
Collaborative Programme across England to
spread best practice, build skills and capabilities in
patient safety and improvement science, and to
focus on actions that can make the biggest
difference to patients in every part of the country.
They will be supported to systematically tackle the
leading causes of harm to patients. The
programme will start in April 2014.”
The government’s response to Francis,
November 2013
The national patient safety context - NHS
England June 2014 update
• Academic Health Science Network footprint for patient safety
collaboratives has been confirmed
• Chris Streather nominated as National Patient Safety Clinical
Champion
• Revised HIN contract with NHS England includes mandatory
funding allocation of £233K for patient safety (to be ring-fenced
from total HIN budget)
• Additional funding will be available from NHS England amounts and bidding process still to be determined
• Common success measures across national collaboratives
National Guidelines on Success Measures
Excerpts from HIN contract with NHS England
Outputs
Details on the measures for success from the Programme will be co-produced
with AHSNs. They will include the following for the Programme as a whole:
• Establish improvement collaboratives covering the fifteen defined AHSN
geographical areas by the end of 2014/15.
• Ensure every provider and commissioner of NHS-funded care is involved in
collaborative patient safety improvement activity by the end of March 2019.
• Ensure fundamental involvement of patients and carers in the work of the
Collaboratives, including planning of improvement initiatives and
implementation.
• Develop a measurement framework for the Patient Safety Collaborative
programme by the end of 2014/15.
• Ensure NHS staff from board to ward participate in identified development
initiatives that support collaborative improvement activity and improve their
knowledge and skills in the practical application of improvement science.
• Demonstrate measurable reductions in harms that are identified as priorities
for action by the Patient Safety Collaboratives themselves.
Developing a Patient Safety Collaborative in South
London – Current Status
•South London collaborative design
being developed based on learning
from Institute for Healthcare
Improvement (IHI)
•Focus on effective planning approach
prior to launch of the programme
•Clinical Lead Jennie Hall appointed
•First engagement events held in May
•Programme initiation document / bid
due July 2014
•Aim is for initial programmes to be
operational by Autumn 2014
Networks
Knowledge
sharing
Change package /
interventions
Consistent measurement
& Evaluation
The collaborative’s overall aim will be to help member organisations
88 period
reduce avoidable harm in priority areas over a three year
Proposed Governance Structure
Patient Safety
Governance
Programme
HIN Governance
Board/ Faculty
of Clinical
Experts
KHP
Joint HESL/HIN
Membership Council
CRN
SRO /
Clinical
Directors
HIN Board
CLAHRC
Industry
Advisory Board
HESL
Executive
Team
INNOVATION THEMES
Alcohol
Education & Training
Cancer
Wealth Creation
Diabetes
Patient Experience
Dementia
London Connect
MSK
Information
Senior
Programme
Manager
Programme
Support /
Contracts
Clinical
Improvement
Work streams
CLINCAL AREAS
Leadership
Workstream
Measurement
Work ream
Organisational
Teams
Priority Areas
Patient Safety
National
Programme
Board
(IHI Breakthrough
Approach)
Engagement /
Patient
Experience
Work stream
CLAHRC is working with HIN to develop a robust
measurement and evaluation workstream
The work will build on existing data sets, e.g.
Patient and Staff Engagement Workstream
The engagement workstream will build on existing South London
networks and seek to lead improvement from the future, which could
draw from a variety of tools
Board Leadership will be a year 1 priority,
supported by Professor Jim Reinertsen
‘Leadership for safety’ masterclass held for
South London Board members in May
Provided leaders with specific horizontal
strategies for leaders
– House-wide daily safety briefings
– Reality rounding
– Edgar Schein’s primary methods by which
leaders change organisational culture
There is strong potential to build these
strategies into the collaborative
programmes, and to provide additional
training and coaching
Early advice from Reinertsen on setting up
the South London Collaborative
Base our
work on
evidence
Focus on a
few
meaningful
things
Transparency
is a force for
improvement
Have a ‘premortem’ – to
ensure
sustainability
Core priorities will be based on national list
Topics to be chosen by providers, based on: interest; current performance;
CQUIN; overlap with HIN, HESL and CLAHRC priorities; Reinertsen list
Topic area
Patient Safety Topic
The
‘essentials’
NHS
Outcomes
Framework
improvement
areas
Other major
sources of
death and
severe harm
Vulnerable
groups for
whom
improving
safety is a
priority
Measurement
Leadership
VTE
Falls
People with
Mental
Health
needs
HCAI
Handover
and
Discharge
People with
Learning
Disabilities
Pressure
Ulcers
Nutrition
and
hydration
Children
Maternity
AKI
Medication
Errors
Deterioration
in adults
Offenders
Sepsis
Acutely ill
older
people
Deterioration in
children
Medical
Device
Errors
Transition
between
paediatric and
adult care
Feedback so far suggests we draw our early
(Year 1&2) priorities from the following areas
Topic area
Patient Safety Topic
The
‘essentials’
NHS
Outcomes
Framework
improvement
areas
Measurement
Leadership
VTE
Other major
sources of
death and
severe harm
Falls
Vulnerable
groups for
whom
improving
safety is a
priority
People
with
Mental
Health
needs
HCAI
(UTIs)
Handover
and
Discharge
People with
Learning
Disabilities
Pressure
Ulcers
Nutrition
and
hydration
Children
AKI
Maternity
Medication
Errors
Deterioration
in adults
Offenders
Sepsis
Acutely ill
older
people
Deterioration in
children
Medical
Device
Errors
Transition
between
paediatric and
adult care
Where possible (highlighted in blue), we would like
focus effort on patient groups with Dementia,
Diabetes and MSK (HIN Clinical Themes)
Topic area
Patient Safety Topic
The
‘essentials’
NHS
Outcomes
Framework
improvement
areas
Measurement
Leadership
VTE
Other major
sources of
death and
severe harm
Falls
Vulnerable
groups for
whom
improving
safety is a
priority
People
with
Mental
Health
needs
HCAI
(UTIs)
Handover
and
Discharge
People with
Learning
Disabilities
Pressure
Ulcers
Nutrition
and
hydration
Children
AKI
Maternity
Medication
Errors
Deterioration
in adults
Offenders
Sepsis
Acutely ill
older
people
Deterioration in
children
Medical
Device
Errors
Transition
between
paediatric and
adult care
Clinical Improvement Workstream IHI
Collaborative Approach:
Helping to make this a success
Clinical improvement workstream approach
will be based on the IHI Breakthrough Model
Institute for Healthcare Improvement BTS model.
Clinical Improvement - Year 1 Plans
•Select 2-3 priority safety areas from the national list
•Establish breakthrough collaborative learning sets in each
area (dependent on funding available)
•Assumptions:
• Two year programme per theme
• Deliver in two phases:
• Year 1 –
• learning sets for up to 5 providers / commissioners (competitive
application / self-selecting, 5 individuals from each provider)
• Establish measurement & evaluation
• Year 2 –
• Continue core learning sets established in year 1
• ‘Sustain and spread’ – enrol additional participants
•Potential to partner with other AHSNs to establish 4-6
collaborative opportunities for London providers to join
Aim of the session – IHI Breakthrough
Collaborative Approach
What are the opportunities for the HIN and its members?
How might a breakthrough collaborative programme benefit
you?
What are the risks? Opportunity costs?
How could you be involved? What could you offer? Eg ideas,
facilitators, support, training, venues, IT,other resources
Making a patient safety IHI breakthrough
collaborative programme work …
Strengths
Weaknesses
How can we enhance this idea
further to make it fit our needs
better? How can we increase
and demonstrate its value?
Think about the weak points –
what can you do about them?
What can we do to improve this
idea?
Opportunities
Threats
How can we test this idea,
learning from this to enhance
implementation? What new
possibilities are opened up by
this idea? How can we
capitalise on them?
What could go wrong when we
try to implement this idea and
how can we avoid this? Who will
raise objections? How can we
modify this idea to reduce this?
Feedback
Working together at your tables,
record your observations on
the template provided
Nominate a person to share your
table’s top 1-2 observations
with the room:
Before you go to lunch...
• Post your template on the wall
• Have a quick read of others over lunch
Summary and Next Steps
Proposed Next Steps (subject to final bid
approval)
June 2014
July – Aug 2014
• Health
• Recruit
Foundation
Faculty /
Bid
Project
• Patient Safety
Resource
Collaborative
• Develop
Bid
frameworks
• Priority Areas
for
Confirmed
improvement,
• Recruit Interim
leadership,
Project
measurement,
Support
engagement
Officer
• Explore joint
work with
other AHSNs
Sept – Dec 2014 Jan 2015
onwards
• Resource in
place
• Launch
leadership
workstream
• Launch
measurement
workstream /
collect
baseline
• Enrol
participants
• Launch
breakthrough
collaborative
groups for
priority areas
Thank you
Health Innovation Network
[email protected]
0207 188 9805
www.hin-southlondon.org
Additional Slides
Institute for Healthcare Improvement BTS model.
American Diabetes Association et al. Diabetes Spectr
2004;17:97-101
Copyright © 2011 American Diabetes Association, Inc.
Reality Rounds: A Leadership Practice to Improve
Implementation of “Vertical’ Processes
1. Pick a major safety practice critical to your aims for this year
2. Develop a scripted set of questions designed to expose
operational barriers to implementation of that practice, and to
drive positive feedback to staff who know and implement the
practice
3. Commit the leadership team to round
–
–
–
CE 1 hour per month
Director 1 hour per week
Unit manager 1 hour per day
4. Fix the operational problems you learn about
5. Pick another safety practice, and repeat
An example script:
Hi, I’m ____, the Medical Director for Surgery. Do you have a
minute to chat about the hospital’s work in infection control?
I see this patient has a urinary catheter. Could you tell me the
elements of the “bundle” for preventing infections in this
patient?
Great job! So here’s a question. Which of the elements of the
bundle is hardest for you and the other nurses to implement?
Thanks. Let’s move beyond bundles: are there any other things
that worry you about patients getting infections in our
hospital?
As long as we’re chatting, do you have any other concerns about
safety, either of the patients, or of the staff?
109
Thanks!
House-wide Daily Safety Briefings: A Leadership
Practice to Build “Sensitivity to Operations”
15 minute daily meeting of key operational leaders, led by
Chief Executive
Agenda:
– Quick report on housewide safety status: “It’s been X days since our
last Serious Safety Event and Y Days since last employee lost work
day event.”
– Brief scripted report on any safety issues from each manager,
including security, facilities, bio-med…
– Brief follow-up on any previously identified urgent safety issues
Note: Generally works best around 830 or 9 am, allows managers to have their
own “pre-huddles” with their teams.
Note: Don’t skip Saturday and Sunday!
Note: Don’t ignore nights!
110
RAND Patient Safety Strategies Ready for
Adoption: Strongly Encouraged
1. Preoperative checklists and anesthesia checklists to prevent operative and
postoperative events
2. Bundles that include checklists to prevent central line–associated bloodstream
infections
3. Interventions to reduce urinary catheter use, including catheter reminders, stop
orders, or nurse-initiated removal protocols
4. Bundles that include head-of-bed elevation, sedation vacations, oral care with
chlorhexidine, and subglottic suctioning endotracheal tubes to prevent
ventilator-associated pneumonia
5. Hand hygiene
6. The do-not-use list for hazardous abbreviations
7. Multicomponent interventions to reduce pressure ulcers
8. Barrier precautions to prevent health care–associated infections
9. Use of real-time ultrasonography for central line placement
10. Interventions to improve prophylaxis for venous thromboembolisms
http://archive.ahrq.gov/clinic/ptsafety
Patient Safety Strategies Ready for
Adoption: Encouraged
1. Multicomponent interventions to reduce falls
2. Use of clinical pharmacists to reduce adverse drug events Documentation
of patient preferences for life-sustaining treatment Obtaining informed
consent to improve patients’ understanding of the potential risks of
procedures
3. Team training
4. Medication reconciliation
5. Practices to reduce radiation exposure from fluoroscopy and CT
6. The use of surgical outcome measurements and report cards, such as those
from ACS NSQIP
7. Rapid-response systems
8. Use of complementary methods for detecting adverse events or medical
errors to monitor for patient safety problems
9. Computerized provider order entry
10. Use of simulation exercises in patient safety efforts
http://archive.ahrq.gov/clinic/ptsafety
Lunch
@HINSouthLondon
@HealthEdSL
Welcome Back
Richard Sumray
Chair
Health Education South London
Barbara’s Story
Eileen Sills
Chief Nurse & Director of Patient
Experience
Guy’s & St Thomas’ NHS Foundation Trust
Barbara’s Story
Eileen Sills, CBE
Chief Nurse & Director of Patient Experience
June 2014
Background
•
As a trust we pride ourselves on the standard of care we give, but feedback
told us we don’t always get it right, we don’t focus on the small things, and
we don’t always put ourselves into the shoes of a patient
•
Our CQUIN expected us to raise the level of awareness around dementia
•
Therefore in April 2012 we set ourselves a challenge – to train 13,200 of
our staff in a year on the needs of older people and those with a dementia.
•
But how? Through a power point presentation? Through briefings? Putting
a patient in front of 13,000 staff…. NO
You create a film, so simple but so powerful - you create a drama,
which pricks the conscience of the workforce
Barbara’s Story
•
•
•
•
•
•
September 2012 we launched Barbara’s Story, making it mandatory for all
staff to attend
The 12 minute film which turned out to be episode one is shown and then
pulled apart and debated by staff.
Delivered only by the Chief Nurse and the Safe Guarding team to ensure
consistency
Within 6 months 10,000 staff had seen the film, word of mouth spread and
other organisations wanted it.
With the support of the Burdett Trust episode one was turned into a training
package free for distribution, and in addition 5 further episodes were filmed
tracking her journey as her health changes. All episodes are available in a
training package from the end of March.
To date 13,500 of our own staff have been trained, 900 copies of Barbara’s
story have been distributed and the team have trained many staff externally
The initial impact
•
Due to its simplicity many found themselves becoming very emotional
•
The whole organisation just began to talk about Barbara's Story
•
Barbara has become the most well known person in the Trust – even more
then Florence Nightingale
•
Everybody wanted to be part of it, we didn't have to chase staff to attend,
Barbara’s story pricked the heart of the organisation, giving staff permission
to talk about kindness alongside hard metrics
•
We identified staff who needed help in their personal lives
Formal Evaluation
•
Formal evaluation led by London South Bank University
•
1240 staff sent written comments & 67 staff participated in 10 focus groups
•
6 themes emerged from the written comments
– Personal reflections on the film
– What I will do in my personal life
– What I will do in my professional life
– What the organisation should do (general comments and training)
– What others should do
– Other comments
•
Most comments related to what staff would do in their professional lives
Findings
•
Raised awareness of the needs of older people and those with a dementia
•
Evidence of staff doing things differently
•
Prompted staff to think more broadly rather then just in their own silo
•
Evidence of a culture change, making the Trust values real
•
Evidence that staff felt more able to give more time and supported to give
more time
•
Specific examples of how to do things differently and suggestions for the
future
Key Messages
•
•
•
•
•
•
•
When we launched the film on the 21st September 2012, we never expected
the impact that this film would have
It has been an emotional journey, one which has been very humbling, but at
no time was it difficult
Its given our staff permission and supported our staff to always put the
patients first, but its also making us focus on the well being of our staff
It is entirely possible to train 13,000 staff in a year face to face in addition to
doing the day job
It has to be led by the top of the organisation
Keeping it simple made a difference
Giving it away free to anybody who wanted it made a difference
Next steps for us…
•
•
•
•
•
We showed episode 6 for the final time in a public showing on the 28th
March
All episodes have been produced into a comprehensive training package
and is free to anybody who wants it.
A 30 minute version of all episodes have been produced into a film which
will be put onto You tube this month
We have to embed the learning from the films and this will be undertaken at
individual team level
Barbara’s story has challenged us to think creatively on how we train our
staff in the future
We are all very different people for doing this
Health Education South London:
Team Up
Andrew Frankel, Postgraduate Dean
Anna Eastgate, Senior Strategic Project
Manager
Team Up
Re-launch 2014
Anna Eastgate
Andrew Frankel
Team Up
Relaunch 2014
Connecting Health and Voluntary sectors to enhance
education and training through health and well-being
projects in local communities
The History of ‘Team Up’
Click to edit Master text styles
• Originally created as an Olympic legacy project to sustain
health and well-being in local communities
Second leve
• Team Up facilitated the partnering of doctors in training with
Third level
voluntary organisations to promote
health and wellbeing
Fourth level
• Doctors in training formed teams and became involved in
Fifth level
short term volunteering projects that delivered sustainable
benefits to local communities through health promotion
programmes
• The health teams were supported by Public Health Registrars
who supported the teams with their projects
www.hee.nhs.uk
www.southlondon.hee.nhs.uk
@teamuplondon
Previous Projects
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• Eighty-four trainees
Second leve
Third level
• Working with 20 community
organisations
Fourth
level
Fifth level
• Teams completed 22 health improvement projects
within the 20 organisations.
www.hee.nhs.uk
www.southlondon.hee.nhs.uk
@teamuplondon
Benefits of ‘Team Up’ for
trainees and students
• Develop multi professional team working skills across
boundaries
Click to edit Master text styles
Second leve
• Develops advanced organisational, teaching and leadership
skills
Third level
Fourth
• Opportunity to make a difference
bylevel
working with local
Fifth level
community organisations on projects
which improve the
health and wellbeing of local communities in London
• Enhances professional development portfolio.
• Raise self esteem and confidence
www.hee.nhs.uk
www.southlondon.hee.nhs.uk
@teamuplondon
Benefits of ‘Team Up’
for Organisations
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• Teams of skilled and enthusiastic health trainees dedicated to
improving health & wellbeing
in leve
London communities
Second
levelof volunteers
• Stronger and more diverseThird
network
Fourth level
• Promotion of partner organisations and projects
Fifth level
• Presence of health professionals embedded within local
community settings
• Sustainable projects for organisations to continue in the
future
www.hee.nhs.uk
www.southlondon.hee.nhs.uk
@teamuplondon
Benefits of ‘Team Up’ to
the wider community
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• Working in alignment with the objectives of the HEE mandate
and the NHS constitution
Second leve
• Increase trust between health
professionals
and vulnerable
Third
level
communities
Fourth level
• Enhance quality, reduce inequalities
and improve outcomes
Fifth level
in health, public health and social care
• Engage ‘hard to reach’ communities with health and well
being projects
• Increase patient safety through multi-disciplinary team
working
www.hee.nhs.uk
www.southlondon.hee.nhs.uk
@teamuplondon
Positive feedback
“Learned new teaching skills and ways of communicating with children … and
learning to work with peers from different specialities. Feel I am making an
impact to local vulnerable populations”
Click to edit Master text styles
“A
Second leve
chance to have contact with socially excluded members of society and to gain
better appreciation of the challenges they face that may serve as obstacles
to maintaining/accessing dental health.”
Third level
level
has been valuable working as part Fourth
of a team
and learning from registrar
colleagues. It has given us the opportunity
to level
be autonomous in our work
Fifth
and decision-making, which we do not normally have as much opportunity to
have in our training.”
“It
“Participating in a team has been inspiring. Work with the third sector is so
pivotal to the future of the NHS and the GP role in commissioning that this
has given me valuable experience of engaging and working with a 3rd sector
organisation.”
Source: learning outcomes survey
www.hee.nhs.uk
www.southlondon.hee.nhs.uk
@teamuplondon
Team Up 2013/14
Mental Health Community Champions
Dr Nathan Lawrence
Dr Kathy Liu
Amani Fairak
The Theory
• “Mental Health Literacy”
The Theory
• “Mental Health Literacy”
• 1000 ways to try and improve this
Project Outline
• 1. Initial meeting with community leaders
• 2. Baseline questionnaire
• 3. Workshop A
• 4. Workshop B
• 5. End point questionnaire
• 6. Further workshops to help train/assist leaders in
disseminating these ideas around community themselves
Project Outline
• 1. Initial meeting with community leaders
• 2. Baseline questionnaire
• 3. Workshop A
• 4. Workshop B
• 5. End point questionnaire
• 6. Further workshops to help train/assist leaders in
disseminating these ideas around community themselves
The workshop
Was it useful?
Statement
Average pre workshop
scores (/7)
Average post workshop
scores (/7)
I feel I have a basic understanding of
depression
4.6
6
...of treatment options for depression
4.8
6
...of the services in Brent that can help
with mental illness
5
6.7
I feel there is a need for increased
mental health awareness in my
community
6.8
7
Conclusion
• Lessons learnt
• Awareness of need
•
1. Initial meeting with community leaders to identify something of the way they
approach mental health and the cultural context in which they operate.
•
2.Baseline questionnaire to assess current knowledge of/attitudes to mental
health problems (specifically depression, bipolar disorder and schizophrenia).
•
3.Workshop A with these leaders to impart knowledge and interest in depression
both for their own awareness and as a potential model for how to convey this to
their communities.
•
4.Workshop B with these leaders to impart knowledge of bipolar disorder and
schizophrenia and launch discussion of how knowledge of these ideas could be
effectively disseminated in their community.
End point questionnaire to assess leaders’ post-intervention knowledge/attitudes
around mental health problems.
Further workshops to help train/assist leaders in disseminating these ideas around
community themselves (e.g. teach them to deliver workshops A&B, help organise a
community mental health day etc).
•
•
Bowel Cancer Screening Programme: The Impact of Local
Teaching Sessions by Health Care Professionals in South
London
Dr Cheh Kuan Tai, Miss Phoebe Leung, Dr Wen Ling Woo,
Dr Samantha Goh, Dr Yooyun Chung, Dr Roderick Prawiradiradja
NHS
Health Education
North Central and
East London
North West London
South London
INTRODUCTION
METHOD
DISCUSSION
Bowel cancer is the 4th commonest cancer in the UK [1]. 5 year survival
from bowel cancer is 90% when detected early [2]. Faecal occult blood
(FOB) detection has been found to reduce bowel cancer mortality by up to
27% [3].
6 junior doctors worked with the Bowel Cancer UK charity to deliver
teaching sessions over a 3 month period.
Our audience has been of the appropriate age group with majority being
over 50 years old. Educating people early can have the added benefit of
inciting health related behavioural change such as reducing risk and
preparing people for BCSP when they are of eligible age at 60 years.
The National Health Service (NHS) Bowel Cancer Screening Programme
(BCSP):
•
Open to all aged 60-74 years
•
Aims to identify asymptomatic individuals
•
Uses a FOB test kit with step-by-step instructions
•
Participants with abnormal results are referred for further investigation,
usually in the form of colonoscopy, or imaging
In the first 2 years of screening implementation, response to offer of
screening was at 54.5% [4] with lower uptake of screening among lower
socioeconomic and ethnic minority groups [5][6].
Factors for non-uptake include:
•
Fear of the consequences of positive results
•
Belief that healthy individuals do not require screening
•
Embarrassment from open discussion
•
Test kit viewed as an invasion of privacy; disgusting or unhygienic.
(People from areas of higher deprivation index were more likely to
consider the test to be disgusting [7].)
Therefore, there is a need for further education on bowel cancer and the
benefits of BCSP in the lower socioeconomic and ethnic minority groups as
early detection of bowel cancer greatly improves survival [8].
Faecal Occult Blood test Kit.
Two small samples from the
‘head’ and the ‘tail’ end of the
same stool smeared onto the kit in
order to maximise yield.
AIMS
•Develop a health awareness programme lead by health care professionals
(HCP), targeting communities in South London to increase awareness and
improve uptake of BCSP
•Evaluate the impact of the sessions through surveying the target group’s
understanding and willingness to participate in screening before and after the
sessions.
Target area: Lambeth and Southwark Boroughs
•
Known to have low uptake of BCSP and high levels of social
deprivation
Target population: British/Irish and ethnic minorities eg. Chinese
Session Content:
•
Information regarding bowel cancer and the importance of screening
•
Demonstration of the bowel cancer screening test kit
•
Pre-session and post session questionnaires given to assess level of
awareness of bowel cancer and willingness to participate in BCSP.
RESULTS
Number of people attended: Male:Female 9:27
Age 31-49: 1(<3%); 50-69: 20(56%); >70: 15 (42%)
Ethnicity: Chinese 19 (53%); Vietnamese 1(<3%); Irish 15 (44%)
Pre-session questionnaires showed that 19% of the target population were
aware of symptoms and risk factors of bowel cancer. Post-session, this figure
increased to 95% and 100% of participants showed willingness to discuss
concerns about bowel cancer with their GP. Despite the improvement in
understanding of bowel cancer and risk factors, only 23-42% expressed
willingness to change lifestyle factors such as smoking cessation.
Implementing lifestyle change is difficult in any area of health promotion.
In order to optimise chances of change, further education campaigns by
providing further information may be beneficial as after these sessions, our
audience showed increased knowledge and willingness to participate in
BCSP. Further evaluation to assess retention of knowledge and long term
health related behavioural change to reduce risk of developing cancer will
need to be conducted. This could be followed up in a further evaluation 3
months after these sessions are completed.
HCP-led sessions have a significant impact on increasing awareness and
willingness to participate in screening. Our results support the recruitment
of more HCPs to continue this programme.
CONCLUSION
1. Our HCP led health awareness programme showed marked improvement
in willingness to participate in screening as well as knowledge on risk
factors and symptoms of bowel cancer.
2. Further research is required to see if these changes are sustained and
whether actual uptake of FOB increases in these areas of social deprivation.
ACKNOWLEDGEMENT
Pre-session, only 39% of our audience expressed willingness to participate in
BCSP due to lack of knowledge on how to perform the FOB test and the test
being perceived as too complicated. This increased to 95% post session.
100
80
60
40
20
0
We would like to thank Gail Curry, Kathryn Nichols, Fiona Giles and Jo
Ireland from South East London Bowel Screening for all their support and
help during this project.
REFERENCES
Symptoms and risk
factors
Pre-session
Willingness to
participate in
BCSP
Post-session
1.http://www.ons.gov.uk/ons/dcp171778_259504.pdf
2.Smith R A et al. American cancer society guidelines for the early detection of cancer.
CA: A cancer journal for clinicians (2009) Vol51(1)
3.Wagner C V et al. Inequalities in participation in an organized national colorectal cancer
screening programme: results from the first 2.6million invitations in England. Int J
Epidemiology (2011) Vol40 (3)
4.Scholefield J H et al. Effect of faecal occult blood screening on mortality from
colorectal cancer: results from a randomised controlled trial. Gut (2002) Vol50 (6)
5.Wardle J et al. Socioeconomic differences in cancer screening participation: comparing
cognitive and psychosocial explanations. Soc Sci Med (2004) Vol59
6.Mansouri D et al. The impact of age, sex and socioeconomic deprivation on outcomes in
a colorectal cancer screening programme. PLOS (2013)
7.Keighley, M R B et al. Public awareness of risk factors and screening for colorectal
cancer in Europe. European Journal of Cancer Prevention (2004) Vol13(4)
8.http://www.cancerscreening.nhs.uk/bowel/finalreport.pdf
Re-launch of Team Up 2014
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• Multi-Professional
• Students and doctors inSecond
training will
leveform health teams
• Over 100 charities engaged Third level
Fourth level
• Team Up project team will attend universities and speciality
Fifth level
school forums to gain volunteers
• Launch date in the summer
• Projects will go ‘live’ at the end of October/beginning
November, duration of projects will be 3-6 months
www.hee.nhs.uk
www.southlondon.hee.nhs.uk
@teamuplondon
Making Team Up work for you…..
How can Team Up work
with your organisation?
How can your
organisation support
Team Up?
What communication
methods could we utilise
within your organisation
or partner
organisations?
Click to edit Master text styles
Second leve
Third level
Fourth level
Fifth level
www.hee.nhs.uk
www.southlondon.hee.nhs.uk
@teamuplondon
How to Click
keep
datetext
with
Team Up
to up
editto
Master
styles
Second leve
Follow us on Twitter @teamuplondon
Third level
Fourth level
http://www.londondeanery.ac.uk/specialty-schools/publicFifth level
health/teamup
Email: [email protected]
www.hee.nhs.uk
www.southlondon.hee.nhs.uk
@teamuplondon
Closing remarks
Dr Richard Barker
Chair
Health Innovation Network
Next Meeting:
8th October 2014

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