Working together to achieve better health and wellbeing

Working together to achieve better health and wellbeing

Annual Review - 2015/16

Contents

Managing Director’s Welcome ....................................................... 4

Note from the Chair .......................................................................... 5

Introducing the Team ...................................................................... 6

About SW AHSN ................................................................................. 7

The Regional Footprint .................................................................... 8

2015/16 Strategic Focus ................................................................ 10

2016/17 Business Plan ................................................................... 11

Intelligence Activities ..................................................................... 12

Innovation Activities ...................................................................... 14

Improvement Activities ................................................................. 16

Case Studies ...................................................................................... 18

AppendiCes .................................................................................... 21

The Team ............................................................................................ 22

The Board ........................................................................................... 24

The Members .................................................................................... 26

SW AHSN annual review 2015/2016SW AHSN Annual Review 2015/16

Managing director’s welcome from dr Rosie Benneyworth

The South West Academic Health Science Network (SW AHSN) has now been operational for three years. Our work plans have extended significantly and we have some marvellous achievements and partnership activities to share from 2015/16. This year’s Annual Review has given us a format to reflect and bring some of these projects to broader attention.

Looking at the wider context of our work, the health and social care communities continue to face many challenges, with an ageing population, a rise in people with long term conditions and a difficult economic climate. Within the SW AHSN region, which covers Somerset, Devon and Cornwall and the Isles of Scilly, there is a significantly older population compared to the rest of the UK combined with the challenges relating to delivering services in rural areas.

However, the South West region hosts an extremely active, innovative community; with three Integrated Care Pioneers, two Vanguard sites, the 100,000 Genomes project site undertaken by the NHS Genomic Medical Centre and many other examples of new models of care emerging.

We have been supporting the implementation of NHS England’s Five Year Forward View and now are offering support to the Sustainability and Transformation Plans (STP) across our three regional foot-prints.

The Community Education Provider Networks (CEPN) have been initiated and we are coordinating this for the region. We are supporting both individual organisations and system wide innovation and different funding mechanisms to enable change.

The SW AHSN has made significant progress during 2015/16 with the aim of supporting our members to effect positive change. Our team bring passion and a diverse range of complementary skills to the challenges before us. We strive to build excellent working relationships across the region. We benefit from a wide range of partners, including NHS England, National Institute for Health Research (NIHR) – Peninsula Collaboration for Leadership in Applied Health Research and Care (PenCLAHRC), the Clinical Research Network and Industry to ensure that we are maximising and aligning regional skills to generate the biggest impact. We have also worked to create stronger links with other AHSNs to learn and share from other regions.

I invite you to read some of the highlights of activity from 2015/2016, which are outlined in more detail in the following pages and demonstrate the variety and diversity in our work programme. The partnerships we have fostered and the networks we have facilitated have all played a crucial part in our combined success.

dr Rosie Benneyworth Managing director, sW AHsn

“ The SW AHSN has made significant progress during 2015/16 with the aim of supporting our members to effect positive change. Our team bring passion and a diverse range of complementary skills to the challenges before us. We strive to build excellent working relationships across the region.”

Chairman’s note from dr Alastair Riddell As the new Chairman of the SW AHSN, coming from a medical and life science business background, I have enjoyed getting to grips with the remit of the AHSN and the challenges it faces.

Our licence requires us to:

1. Focus on the needs of patients and local populations

2. Build a culture of partnership and collaboration

3. Speed up adoption of innovation into practice

4. Create wealth

The success of any plan depends upon the quality of those charged with its delivery. There is no doubting the quality, integrity and commitment of the whole team of the SW AHSN and their desire to achieve these aims. The current business plan and the process of its drafting have helped to clarify the business focus and need to organise the AHSN in a way that will deliver on its prime objectives. Our three hubs of Intelligence, Innovation and Improvement, supported by our communications and administrative staff, are covered in more detail elsewhere in this review. Examples of our existing contributions to our licence objectives are also described and we look forward to doing more in the years to come.

As a private company limited by guarantee whose guarantors are predominantly from the NHS, supplemented by two of our local universities, we have to be sensitive to the political decisions that influence their priorities. We must also ensure we deliver on our prime objectives whatever challenges the funding environment engenders. That will be more likely with a dynamic and talented organisation that this report describes.

We hope to be able to extend our role in delivering on the above objectives beyond our current five-year licence. Thus generating a business model that is less dependent on central funding will become increasingly important. Our focus is on delivering innovation and benefits to the NHS and its patients by linking innovators in academia, industry and the voluntary sector with NHS professionals. We at the SW AHSN look forward to demonstrating our utility and indispensability within the healthcare environment in the South West and delivering on our four key objectives.

dr Alastair Riddell Chair, sW AHsn


Page 5

introducing the Team In December 2015 we relocated from our offices in the Innovation Centre, Exeter University to Pynes Hill, an established business park close to exit 30 on the M5 motorway. The distinctive red brick buildings here form a backdrop for our first all staff photograph in the new offices.

Our staff come from a diverse range of backgrounds including academia, frontline health and social care, research, IT, analytics and NHS support services. This rich skill mix is hugely useful in scoping projects and ensuring that all partner organisations of relevance are considered and involved. The high standards of professionalism and their extensive networks help to build strong and effective partnerships with the health, care and innovation communities across the South West.

A full listing of current staff up to April 2016 is included in Appendix 1.

“ Our staff come from a diverse range of backgrounds including academia, frontline health and social care, research, IT, analytics and NHS support services.”

The SW AHSN is a Company Limited by Guarantee (CLG) and the company and Board have the overarching aims of improving health and creating wealth in the region. The CLG affords us a clear governance structure with strong support and oversight from senior representatives of the healthcare and wealth-creation sectors. A full listing including short biographies of the SW AHSN’s Board of Directors are included in Appendix 2.

About the sW AHsn The SW AHSN is dedicated to improving healthcare and driving innovation acceleration across the region. We are part of a national network of 15 AHSNs that have been set up across the country by the Department of Health to identify, adopt and disseminate innovative healthcare.

The SW AHSN core objectives were articulated in our 2012-2015 Business Plan:

sW AHsn Core Objectives Focus on the needs of patients and local populations:

• Support and work in partnership with commissioners and public health bodies to identify and address unmet medical needs, whilst promoting health equality and best practice.

speed up adoption of innovation into practice to improve clinical outcomes and patient experience:

• Support the identification and more rapid spread of research and innovation at pace and scale to improve patient care and local population health.

Build a culture of partnership and collaboration:

• Promote inclusivity, partnership and collaboration to consider and address local, regional and national priorities.

Create wealth:

• Make use of co-development, testing, evaluation and early adoption and spread of new products and services.

Our Financial position The SW AHSN’s activities are supported financially by both NHS England and also by eighteen of the leading health, care and academic service providers in the South West (see Appendix 3 for full listing).


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Barnstaple

Exeter

Plymouth

Torquay

Truro

Falmouth

Tiverton

Bodmin

Penzance

D E V O N

C O R N WA L L & T H E I S L E S O F S C I L LY

S O M E RS E T

Taunton

Yeovil

Regional Key statistics

1 ONS Subnational Population Projections for Clinical

Commissioning Groups in England

2 Registered population (rather than provider trust)

3 HSCIC epraccur (GP Practices in England and Wales)

SW AHSN RegioN

population total 2,249,056

SW AHSN RegioN NoW 6.4% aged over 80 years

FigUReS FoR eNgLAND NoW4.8% aged over 80 years

SW AHSN RegioN iN 203711.7% aged over 80 years

FigUReS FoR eNgLAND iN 2037 8.4%1 aged over 80 years

2015/16 HoSpitAL emeRgeNcy ADmiSSioNS226,5992

AcUte pRoviDeRS

7 (3 large, 2 medium, 2 small)

NUmbeR oF

gp pRActiceS

3003

meNtAL HeALtH HoSpitALS/SeRviceS

somerset partnership

devon partnership

Cornwall partnership

5%

7%

18%

18% 77%

% that would recommend involvement in / working with the AHSN

All: 75%SW AHSN: 77%

SW AHSN (N=39)

All AHSN (N=976)

75%

Yes

No

Not sure

Upper Middle Lower

Page 9

national AHsn survey In 2015 all 15 AHSNs conducted a YouGov national survey to all of their individual member and stakeholder groups to measure the perception of AHSNs across England. The majority of respondents (75% nationally) said they would recommend working with AHSNs. However, an even higher percentage at 77% of the SW AHSN’s member and stakeholder groups recommended working with us.

5%

7%

18%

18% 77%

% that would recommend involvement in / working with the AHSN

All: 75%SW AHSN: 77%

SW AHSN (N=39)

All AHSN (N=976)

75%

Yes

No

Not sure

Upper Middle Lower


Barnstaple

Exeter

Plymouth

Torquay

Truro

Falmouth

Tiverton

Bodmin

Penzance

D E V O N


S O M E RS E T

Taunton

Yeovil

sW AHsn’s 2015/16 strategic focus

• Focus on the needs of patients and local populations

• Build a culture of partnership and collaboration

• Speed up adoption of innovation into practice

• Create wealth

Five obJectiveS

1. partner of choice - strengthening the membership model

2. Understand the problem - development of Intelligence Hub

3. Accelerate innovations - use of innovation pathways

4. support and Accelerate Quality improvement

- development of Improvement Hub

5. spread - participate in local and national spread and adoption

SW AHSN to be the partner of choice to understand the problem, accelerate innovation and quality

improvement, promoting the spread of these across the South West and beyond.

oNeNAtioNAL NetWoRK

oNe viSioN

3 Roles

CONNECT

CREATE

CATALYST

Health and Wellbeing

Care and Quality

Funding and Efficiency

Barnstaple

Exeter

Plymouth

Torquay

Truro

Falmouth

Tiverton

Bodmin

Penzance

D E V O N


S O M E RS E T

Taunton

Yeovil

Devon

Somerset

Cornwall &The Isles of Scilly

popULAtioN JUSt UNDeR 2.25 miLLioN

FoUR NAtioNAL LiceNce

obJectiveS

FoUR vALUeS

tHReegApS

tHRee HUbS FoR DeLiveRy

COLLAbORATiON

RESpECT

COmmiTmENT

iNTEgRiTY

tHRee coUNtieS

Intelligence

Innovation

Improvement

Page 11

improvement Hub

Improving the quality of care by becoming the ‘go to’ place for improvement expertise, training and coaching

• Patient Safety Collaborative

• Medicines Optimisation

• Improvement Programmes To include Rheumatoid Arthritis Pathways, Calprotectin Audit, Dementia and Mental Health. Supporting the national AHSN spread and adoption agenda by supporting the roll-out of Flo Health

• New Models of Care - Primary care new models, CEPN

• 100,000 Genomes Project

sW AHsn’s Business plan - 2016/17Supporting delivery of the Five Year Forward View ‘Triple Aims’

intelligence HubOffering the best intelligence to inform the planning, commissioning and measuring of service development and create the right environment for information exchange of ideas to accelerate adoption of good practice

• Strategic Organisational and Programme Analysis Support

• Person Centred Co-ordinated Care (PCCC)

• Data capture – populated linked data

• Evaluation (Academic/AHSN and support)

• Regional capacity - Intelligence Hub

• Information Management and Technology (IM&T) - to include Information Governance

• Connecting people virtually and sharing

innovation Hub

Accelerating the development and adoption of innovation into the health and care system

• SW AHSN Innovation Pathway™ connects the NHS and local authority commissioners with industry, academic and community based organisations from the voluntary, community and social enterprise (VCSE) sector

• Innovation Labs ‘hackathons’

• NHS Innovation Engagement Programme

• Industry/VCSE Shadowing Programme

• Industry/VCSE engagement service

• Funding and investment partnerships

• Market access clinics for industry and VCSE innovators

• Broker innovation partnerships: clinical trial, evaluations, adoption and spread

UNDeRStANDiNg pRioRity cHALLeNgeS

expLoRiNg SoLUtioNS AND DeveLopiNg iNNovAtioN

SpReADiNg gooD pRActice AND impRoviNg qUALity

Health and Wellbeing gap

sharing good quality practice and connecting people

Care and Quality gap Funding and efficiency gap


Actionable intelligence from Linked data sets

One of the key programmes has been to help members ‘understand the challenges and opportunities’ through use of good data intelligence and use of innovative visualisation. The SW AHSN team have used existing datasets to produce actionable intelligence information that supports members to focus improvement work.

Increasingly, the emphasis is shifting to build intelligence capacity and capability within the region.

As a result of better understanding of the issues, member organisations have been able to identify relevant groups of patients more readily.

PatientExperience

patientexperience

of pCCC

Is care person centred &

coordinated?

Is care improving self management?

Is care improving health, wellbeing

and loneliness?

Is the model promoting

person centred coordinated care?

Is the model promoting

person centred coordinated care?

To what extent, and for whom, is the model reducing need for care?

PATIENT

QUESTIONNAIRES

QUALITATIVE INTERVIEWS

ANALYTICS

ANALYSIS

A framework for measuring Person Centred Coordinated Care (PCCC) across the system

PRACTITIONERS TEAMS/ORGS ACTIVITY/COST

PatientActivation

patientActivation

Measure (pAM)

Warwick, edinburgh Wellbeing

scale delong Loneliness scale

Patient Health& Wellbeing

PractitionerExperience

practitionerexperience of

delivering pCCC

OrganisationalChange

OrganisationalChange Tool

(OCT)

SystemResource Use

data extraction & Linkage

Who

Wha

tH

ow

neWneW

neW

NIHR CLAHRCSouth West Peninsula

National Institute forHealth Research

INTELLIGENCE

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A good example is the whole system linked dataset, pioneered by the Somerset Clinical Commissioning Group (CCG) and the recognition that patients with more than three long term conditions use more services. The SW AHSN has been working with members to help create similar datasets across Devon and Cornwall.

This type of whole system linked dataset supports new models of care to be developed to ensure that these people have person centred care that might help to deliver better outcomes for patients and improved efficiency for the system.

person Centred and Coordinated Care During 2015/16, the SW AHSN supported PenCLAHRC to develop a way of measuring person centred and coordinated care across all parts of the health and social care system. Three new measures have been developed that capture what good looks like from the perspectives of the patient, the practitioner and as an organisation delivering care. These new measures will add to our understanding nationally and internationally about how to deliver care that is centred around the patient and is coordinated across different parts of the system. The measures form part of an Evaluation Framework, also developed with PenCLAHRC, that is supporting the evaluation of new models of care in the South West.

primary Care Workforce The SW AHSN recognises that Primary Care is essential to the future of integrated service delivery. In the Centre for Workforce Intelligence (CfWI) ‘GP in Depth Review’ it was reported 22% GPs intended to retire early. SW AHSN commissioned Exeter University to understand the picture in the South West. This research found 35% of all GPs surveyed intended to retire in next five years whilst 65% of those 50-59 year olds surveyed planned to retire early.

In May 2015 a Primary Care Workforce event hosted by SW AHSN took place to present the regional findings and seek solutions with all key stakeholders. At this pivotal meeting a range of initiatives were identified which have since developed into active and ongoing projects. Progress of these initiatives

is being tracked by the newly established South West Regional Board for Primary Care Workforce Sustainability group which has representation from all key stakeholders across the region.

integrated Care The South West’s population profile shows an aged population which will require a significant health and care service shift during the next 20 years to meet the associated demand for care.

The SW AHSN in collaboration with PenCLAHRC is undertaking an evaluation of patient centred integrated care across the region. Some of the activities under review include:

south West integrated personal Commissioning Collaborative (ipC)integrated Care exeter (iCe)

• Defined population within Exeter

Kernow integrated Care pioneer programme:

• Living Well Pioneer programme

somerset programmes:

• Test and Learn Sites in three localities

• SPQS (Somerset Practice Quality Scheme)

south devon and Torbay integrated Care pioneer:

• Newton Abbot Frailty Hub

• Hele & Watcombe Family Hub

Bed Capacity Modelling The SW AHSN has been working with providers and commissioners on bed capacity modelling using a Queuing Theory model to aid better understanding of current and future bed demand through forecasting. This approach has been adopted by a number of the organisations and ensures that a system thinking approach is used when looking a bed usage and has the additional benefit of introducing a level of rigour to the assessment of impact of admission avoidance and length of stay reduction schemes.

Out of Hospital Nursing

Programme

nHs england

Increased Practice

Placements

HeesW

Before they fail modelling

University of exeter

New models of care portal, characterisation

and capture of emerging new models

sW AHsn

Workforce Sustainability Programme

sW AHsn

Range of projects led by GPs in training

around workforce

deanery

Diabetes Skills and Training

sCn

Workforce Information Architecture programme

HeesW/HsCiC

Primary Care Sustainability

nHs england

Pharmacy in Practice

sW AHsn

PrimaryCare

Workforce Sustainability

Regional programmes across the south West

HEESW – Health Education England, working across the South West HSCIC – Health and Social Care Information Centre SCN – Strategic Clinical Network


supporting innovation in the south West

Our innovation team work across the health and care system to identify and accelerate the development and adoption of innovation.

In 2015/16 we implemented the Innovation Pathway™ developed by North East North Coast AHSN as our framework for supporting innovation.

INNOVATION

Evaluation

Brokering & Adoption

Success

Markets

Finance

Intellectual Property

Culture Ideas

Clinical Trials

£

Page 15

Creating a Culture of Collaboration The SW AHSN launched a shadowing programme, creating the opportunity for senior managers across Industry and the NHS to experience a “day in the life of” their counterparts. In 2015/16 the programme included senior executives from Plymouth Hospitals NHS Trust, Royal Devon and Exeter NHS Foundation Trust, Daiichi Sankyo and Association of the British Pharmaceutical Industry (ABPI).

We supported members and partners in Devon to secure NHS England Healthy New Town programme status for Cranbrook, East Devon.

supporting innovative ideas The SW AHSN has supported 30 companies in the health and life science sector to develop innovations, providing advice and guidance on product development and facilitating partnerships between companies and our member organisations.

We worked in partnership with our member organisations to identify and support over 150 NHS innovators to develop and commercialise their innovations. The first of these innovations will be launched commercially in 2016.

Funding and Finance The SW AHSN has facilitated over £10m of funding and investment into the region to support innovation.

We led the development of the Small Business Research Initiative (SBRI) Healthcare Urgent and Emergency Care Competition in collaboration with Greater Manchester AHSN. This resulted in the identification of 14 products with the potential to significantly impact the increasing pressures on urgent and emergency care. Over £1.4m will be invested through SBRI contracts to develop these innovations, responding to specific challenges identified by SW AHSN members.

The SW AHSN led the development of a partnership project with five local authority partners to explore the opportunity for innovation from the VCSE sector and the potential role of social investment in realising this opportunity. This work will inform the development of a £5m regional social investment fund focused on health and care innovation in the VCSE sector launching in 2016.

We have raised a multi-million pound fund in partnership with regional and national partners to support communities across the South West to identify, develop and scale effective innovations for a healthy and active later life.

Brokering and Adoption We have established partnerships between our member organisations and companies funded through the £2.1m SBRI Healthcare integrated care challenge with an aim of developing and implementing innovative new technology focused on identifying individuals with increasing complexity of need.

We have facilitated the development of three outcome-based commissioning development projects. Funding of £300,000 has been secured to develop the projects and explore new ways of financing outcome-based contracts in partnership with social investors, often referred to as ‘Social Impact Bonds’.

Clinical Trials: strengthening our partnership with the niHR sW CRn We have worked in collaboration with the National Institute for Health Research South West Clinical Research Network (NIHR SW CRN) to facilitate partnerships between small and medium-sized enterprises (SMEs) and member organisations to evaluate innovative technologies supported through the SBRI Healthcare programme.

evidence & evaluation We have secured funding from pharmaceutical partners to support a partnership project with the University of Exeter and Royal Devon & Exeter NHS Foundation Trust to improve the prescribing ability of junior doctors.

“ Our innovation team work across the health and care system to identify and accelerate the development and adoption of innovation.”


south West patient safety Collaborative

Throughout 2015/16 the SW AHSN continued to work with our regional and national partners, building on the foundations of ‘Capability, Collaboration, Culture’ to create a positive environment where continuous improvement in patient safety can flourish.

Capability The SW AHSN aims to increase the capability for quality improvement across the South West by providing leaders and frontline staff with the knowledge, skills and tools required to continuously improve care.

Achievements include:

• Partnering with the Institute for Healthcare Improvement (IHI) in training and supporting 267 staff from across the South West. Training offered includes a four-day Patient Safety Officer level programme and an Executive Leadership programme. Attendees that have completed the training include senior leaders, patients and frontline staff from over 25 health organisations and providers in the region.

• Working in partnership with Somerset CCG in developing a primary care programme of Quality Improvement learning for all 75 GP practices (SPQS), and Quality Improvement training for CCG staff, to be launched in 2016/17.

• Undertaking a mapping of the quality improvement skills and expertise across the South West, as part of a national campaign funded by The Health Foundation to create a quality improvement community, and this is due for completion in the summer of 2016.

• Continuing to support the NHS England South Mental Health Collaborative with the aim of reducing avoidable harm and improving the wellbeing of people with mental health conditions.

Collaboration The SW AHSN supports continual improvement by creating links that bring individuals and organisations together in regional, national and international networks to share learning.


• Development of the LIFE system to help spread best practice and facilitate the success of local quality improvement projects. In partnership with the digital design company ‘See Data Ltd’, SW AHSN created this new web platform to enable front line staff to create and monitor their own quality improvement projects. The tool has been accessed by over 500 staff from across the region, and has been adopted by 10 of the 15 AHSNs nationally.

• Delivery of topic-based workshops that connect with local and national priorities, inclusive of Sepsis, Acute Kidney Injury, medication safety, and transfers of care.

• Working in partnership with patient leaders in developing the capacity of patients and carers in supporting quality improvement. This included providing dedicated Patient and Public Involvement expertise, and the recruitment of a patient leader to support quality improvement throughout the region.

IMPROVEMENT

Page 17

Culture The SW AHSN has supported teams and organisations in their work around culture as a key component of safe care and continuous improvement.


• Delivery of an evidence-based ‘Culture Survey’ tool named SCORE (in collaboration with the US firm Safe and Reliable Healthcare LLC) available for use across healthcare organisations throughout the South West. The tool supports the measurement and development of team cultures, and to date 1475 colleagues within organisations in the South West have been invited to take part across various sectors including acute, primary care, and mental health. The SW AHSN are working with Safe and Reliable Healthcare LLC to measure the impact of completing the surveys, in addition to working with AHSNs nationally in supporting them to adopt the Culture Survey approach. We believe that supporting teams in improving their culture for safety and improvement is a vital cornerstone for the collaborative.

• Working in partnership with Plymouth University in supporting a Department of Health-funded national evaluation of the wider impact of the Patient Safety Collaboratives on safety culture across the UK. The SW AHSN has an advisory role on the evaluation steering group, which forms part of a national commitment by NHS England to measure the overall effectiveness of the Collaboratives since their establishment in 2014.

Medicines Optimisation

During 2015/16, the SW AHSN hosted a Medicines Optimisation Roadshow in collaboration with the ABPI and NHS England. Since then, the SW AHSN has built on this event and formed a regional steering group for Medicines Optimisation. The group, which is chaired by a patient representative, includes members from commissioning, acute and mental health trusts, community services, industry and primary care.

Following wide consultation with stakeholders, including a public engagement exercise, the SW AHSN has supported its regional partners in their plans to roll-out an electronic system which refers patients to their community pharmacy following discharge from hospital (‘Medicine Support Service’ project). This is already a well-recognised improvement intervention that aims to improve patient safety and patient understanding of their medicines when changes were made during a hospital admission. In relation to the Medicine Support Service, the SW AHSN has provided project management support, sharing of learning, small grants to support local implementation and support with evaluation.

100,000 Genomes project

SW AHSN has supported the 100,000 Genomes Project since its inception, providing high quality communications and patient and public involvement resource as well as additional project support to the South West NHS Genomic Medicine Centre (SW GMC).

The SW GMC as lead for the project, continued to make good headway towards achieving its aim to sequence 3,457 genomes from 1,629 families by the end of 2017. The first family was recruited in Exeter on April 24th 2015, and since then 100 families with rare diseases have been recruited into the project, which at the end March 2016, represents 129% of the original trajectory for rare disease.

All six Local Development Partners (LDPs) across the South West are involved, with Truro and Plymouth actively recruiting. It is expected that Taunton, Barnstaple, Torbay and Yeovil will be joining in April/May 2016. Once each LDP is active in terms of rare disease recruitment, then setup and planning can begin for cancer patient recruitment in 2016/2017.

AspiC (Analysing implementation in Acute stroke and patient initiated Clinics) During 2015/16, SW AHSN commissioned a review of barriers and facilitators to implementation in two joint projects with PenCLARHC (Acute Stroke and Patient Initiated Clinics). This project provides deep insights into how barriers to spread and adoption to innovation can be overcome. An interim report was received from the lead researcher in December 2015, and SW AHSN have continued to explore with PenCLARHC how joined-up leadership in improvement and implementation science approaches can be provided across the region.

“ Throughout 2015/16 the SW AHSN continued to work with our regional and national partners, building on the foundations of ‘Collaboration, Capability and Culture’ to create a positive environment where continuous improvement in patient safety can flourish.”


impacts/Outcomes

• 181 staff from Intensive Care Units and Emergency Departments have received expert training in the SCORE culture survey methodology from Safe and Reliable Healthcare, LLC.

• Debriefing support has followed to get staff working together to identify improvement projects to address issues raised.

plans for the future

• Discussions are underway to extend the involvement of healthcare teams across the region to include mental health teams, primary care providers, commissioners and the ambulance service.

Case studies Here are five summary case studies to give a flavour of some of the sW AHsn’s 80+ projects from 2015/16.

Case study 1. Better Culture safer Care

The South West Patient Safety Collaborative, working in partnership with the SW AHSN is helping healthcare teams understand their culture and take steps to improve it because of the strong correlation between good culture and the quality of care.

impacts/Outcomes

• It provides a single electronic platform to help create and deliver improvement projects at every level and in every setting.

• Simple to access.

• Provides overview of all QI activity.

• Encourages sharing of learning.

• Over 100 users registered.


• The system, which was originally only available in the South West is now available to all health and care teams in the UK, free of charge.

Case study 2. Rheumatoid Arthritis project

Considerable variation exists in the use of biological therapy for Rheumatoid Arthritis (RA). In the South West, there has been an 18% increase in their use but little understanding about why prescribing patterns vary so greatly, and even less insight into patient outcomes. The SW AHSN developed a project to give clarity and an understanding on the use of these medicines along with the impact that early intervention can have on the local economy.

impacts/Outcomes

• The SW AHSN gained insight into the differing approaches to service delivery and biologic initiation. The initial scoping phase of this appeared to show a correlation between service models, ability to manage demand and the initiation/use of biologic therapies.


• Through a partnership with The Work Foundation we will use the insights gained to explore and quantify a number of scenarios relating to healthcare costs, labour market participation, sickness and productivity losses in the South West region.

Case study 3. Making Quality improvement a way of LiFe

The SW AHSN has created an innovative new software system to support quality improvement (QI) activity at the frontline. The system, called LIFE, provides a platform for individuals, teams, organisations and whole regions to run quality improvement projects whilst being able to share their work and learn from the work of other teams. The system includes an interactive driver diagram tool, full Statistical Process Control (SPC) analysis and reporting capability.

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impacts/Outcomes

• Prototype computer model built and tested.

• Detailed data sets received from four of the seven acute trusts in the South West.

• Modelling of the data sets completed.


• Using the output from the model to hold facilitated meetings with each trust to explore service changes and improvement that can be made to optimise patient pathways in hospitals.

impacts/Outcomes

• The initial pilot programme was initiated in March 2015 and will run for 8 weeks. Patient consent appears strong and good numbers are opting to have their discharge forms forwarded to their community pharmacist.


• The SW AHSN is also supporting The Royal Cornwall Hospitals NHS Trust and Cornwall LPC to move from their current system of faxing discharge medicines to community pharmacies, to making electronic referrals making the process more efficient and safe.

Case study 4. The Use of High sensitivity TroponinIn collaboration with PenCLAHRC the SW AHSN are investigating the role of High Sensitivity Troponin in the diagnostic pathway for Acute Coronary Syndrome (ACS) in line with NICE Diagnostic Guidance DG15. The project initially aimed to understand the variation in practice across the area using modelling and simulation.

Case study 5. Medicine support service

The referral to community pharmacy project ‘Medicine Support Service’ utilises existing services in community pharmacy to support patients with their medicines following discharge from hospital. It is aimed at improving the transfer of care to help patients better understand their medicines, improve patient outcomes, increase adherence, reduce re-admissions and reduce medicines waste.

The SW AHSN is working with Yeovil District Hospital and Somerset Local Pharmaceutical Committee (LPC) on the initial pilot and implementation of their scheme. We are funding them to help develop an implementation package that can be shared across the South West, and also funding the initial costs around IT licences for the service.

Page 21

Appendices


Appendix 1

The sW AHsn Team Core Team

Anne donnelly

Business Co-ordinator

Bettina Kluettgens

Director of Improvement

Cathy Young

Head of Communications

Chloe Brind

Projects Co-ordinator

Claire Higdon Director of Business Development

dave Baylis Data Analyst

david Thompson IM&T Project Management Lead

david Wright Bid Development Manager

Jennifer Baker Project Research & Delivery Manager Primary Care Workforce Sustainability

Jenny Bethell Bookkeeper

Jo Gajtkowska Programme Manager

Joanna pendray Project Co-ordinator

Jon siddall Director of Innovation

Kim Hannah Communications Co-ordinator

Kurt deFreitas Project Manager - Innovation

Laila pennington Interim Director of Improvement

Laura Hitt Business Administrator

Laura Wheeler Programme Lead – Integrated Care

Louise Witts Director of Integrated Care

Magdalena Wood Regional CEPN Project Manager

naomi Caney

Project Co-ordinator

Richard Blackwell

Information Analysis Manager

Rosie Benneyworth

Managing Director

sarah Linnington

Business Manager

stuart Monk

Programme Manager – Innovation

suzy Taylor

Project Manager – Innovation

Terry Wright

Senior Analyst

William Lilley

Programme Manager – Patient Safety

Consultants

Helen Belben Medicines Optimisation Lead

Helen Morrison Project Manager - Patient Safety Collaborative

Helen parsons Regional Lead - Patient Safety Collaborative

Helen smith Regional Lead - Patient Safety Collaborative

Jo Redgrave Q Asset Mapping Project Lead

Jo Roberts Clinical Advisor

Julie Mills Regional Lead - Patient Safety Collaborative

Kirsten van den Hout Innovation Pathway – Consultant

Mary Ryan Patient Advisor

Matt Hill Regional Lead - Patient Safety Collaborative

Rob Bethune Consultant Surgeon Clinical Advisor Patient Safety Collaborative

sarah Ross Patient and Public Involvement Lead

sue Hook HR Advisor

Zoe Fox Regional Lead - Patient Safety Collaborative


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Appendix 2

The sW AHsn Board dr Alastair RiddellChair

Dr Alastair Riddell joined the SW AHSN as Chairman in January 2016. Dr Riddell has over 30 years’ experience in the pharmaceutical, life science and biotech industries. He began his career as a medical doctor in the Army with six years’ experience in a variety of hospital specialties and in general practice.

Angela pedder OBe

Vice Chair / Chief executive of the Royal devon and exeter nHs Foundation Trust

Angela has been the Chief Executive of the Royal Devon & Exeter (RD&E) NHS Foundation Trust since 1996, making her one of the NHS’s longest-serving chief executives of a trust. In 2004, the RD&E became one of the first foundation trusts in the UK. In 2007, Angela received an Order of the British Empire (OBE) for services to the NHS. She was awarded an Honorary Doctorate by the University of Exeter in July 2011.

dr Rosie BenneyworthManaging director

Rosie has been with the SW AHSN since March 2015 and was appointed as Managing Director in August. She is an experienced GP, and now works as an Out of Hours GP with Somerset Doctors. Prior to joining the AHSN, Rosie was a member of the Governing Body for Somerset Clinical Commissioning Group and also Chair of their Clinical Operations Group and Vice-Chair of the Somerset Health and Wellbeing Board. Rosie has been a NICE Fellow since 2013 and has recently been appointed to the NICE board as a Non-Executive Director. Nationally for the AHSN Network (all 15 AHSNs), Rosie is the lead for Patient Safety and Long Term Conditions.

dr Jo RobertsClinical Advisor

Jo was a GP for 22 years and is now a clinical lead for South Devon and Torbay Clinical Commissioning Group. He holds the portfolios for innovation and medicines optimisation. He has worked on a host of projects in the region which are all aimed at better integration of healthcare services. Jo continues to sit on local and national committees that evaluate new medicines and technologies, and produce and implement evidence based guidelines.

professor patricia Livseyexecutive dean, Faculty of Health and Human sciences, plymouth University

Professor Livsey is Associate Dean for Post- registration and Postgraduate Studies at Plymouth University. Prior to this Patricia was the Director of Nursing and Allied Health at Liverpool John Moores.

professor stuart Logandirector, national institute for Health Research peninsula Collaboration for Leadership in Applied Health Research & Care (pen CLAHRC)

Stuart is a practising paediatrician but his major role is as a researcher and as Director of The National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula (known as PenCLAHRC) and the Institute of Health Research.

“ The high standard of our staff’s professionalism and their extensive networks help to build strong and effective partnerships with the health, care and innovation communities across the South West.”

dr Tim BurkeChair, northern, eastern and Western devon Clinical Commissioning Group

Tim is the Chair of the Northern, Eastern and Western Devon Clinical Commissioning Group (CCG), responsible for commissioning, or buying, most healthcare services for the local population in North, East and West Devon. It is the largest CCG in England with 124 GP practices serving a population of approximately 900,000 with a commissioning budget of £1.1bn. Tim also practices as a GP in Chulmleigh in Devon.

Ann JamesChief executive, plymouth Hospitals nHs Trust

Ann is the Chief Executive of Plymouth Hospitals NHS Trust in 2012 and before that worked in NHS leadership roles across Plymouth, Cornwall and Torbay, always driving improvements. She joined the NHS as a management trainee in 1989. She is a member of the Plymouth Chamber of Commerce, Plymouth Area Business Council and Plymouth Growth Board.

phil ConfueChief executive, Cornwall partnership nHs Foundation Trust

Phil is the Chief Executive of Cornwall Partnership NHS Foundation Trust, the main provider of mental health, children’s and learning disability services to people living in Cornwall and the Isles of Scilly. As a qualified mental health nurse he has thirty years’ experience working in health care within the public, private and academic sectors.

dr sam Barrell CBe

Chief executive of Taunton and somerset nHs Foundation Trust

Dr Sam Barrell is a clinician by background, training at Charing Cross and Westminster Medical School before working as an anaesthetist in large acute trusts in London and the South East and becoming a GP in 2001. Sam is a member of The King’s Fund General Advisory Council, NHS England’s Innovation, Health and Wealth Implementation Board, and the Institute for Public Policy Research Health Advisory Board. She was awarded a CBE in the Queen’s Birthday Honours in 2014 for her services to clinical commissioning and integrated care.

professor Janice Kay provost University of exeter

Janice is the Provost and Senior Deputy Vice-Chancellor at the University of Exeter and manages the university’s Medical School. She is a Professor of Cognitive Neuropsychology, first appointed to Exeter through a Wellcome Trust University Lectureship.

Richard devereaux-phillipsdirector of external Affairs at Association of British Healthcare industries Ltd (ABHi)

Richard joined the ABHI in June 2015 with over 20 years’ experience in the pharmaceutical and medical devices industries, most recently as Director of Public Policy and Advocacy for North West Europe with Becton Dickinson and Company (BD). In November 2013, Richard was appointed as a non-Executive Director of the SW AHSN. He is also a longstanding member of the Institute of Healthcare Management.


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Appendix 3

Member organisations

Cornwall Partnership NHS Foundation Trust

Devon Partnership NHS Trust

Kernow Clinical Commissioning Group

Northern Eastern and Western Devon Clinical Commissioning Group

Northern Devon Healthcare Trust

Plymouth Hospitals Trust

Royal Cornwall Hospitals NHS Trust

Royal Devon and Exeter NHS Foundation Trust

Somerset Clinical Commissioning Group

Somerset Partnership Foundation Trust

South Devon and Torbay Clinical Commissioning Group

South Western Ambulance NHS Foundation Trust

Taunton and Somerset NHS Foundation Trust

Torbay and South Devon NHS Foundation Trust

Yeovil District Hospital NHS Foundation Trust

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