Transcript Managed Clinical Network for Wales

Managed
Clinical
Network
for Epilepsy
in Wales
Carrie Hammond
Network Coordinator
What is a Managed Clinical
Network?
•
“linked groups of health professionals and
organisations from primary, secondary
and tertiary care, working in a coordinated manner, unconstrained by
existing professional and Health Board
boundaries, to ensure equitable provision
of high quality clinically effective services”
•
WHC (2005) 076
“engines of
improvement”
WHC (2005) 076
Epilepsy
Service Development Directive
• January
2009
• no paediatrics
• no money
Phase 2: Core Service Developments
- For delivery during 2008/09 and
2009/10
Scaffolding already there…
• Clinicians
• Specialist Nurses
• People with epilepsy
£££
•
Initial administration costs for the
Managed Clinical Network have kindly
been made available through the
Association of the British Pharmaceutical
Industry (ABPI) Cymru Wales Neurology
Subgroup.
Basic Ingredients
Experience suggests that developing
an MCN requires at the outset a small team
of people to drive the process forward.
• Coordinator
• Membership
• (>70 members have to
date registered an interest
in the MCN)
Network Aim
• To coordinate and facilitate the work of
epilepsy professionals in Wales,
promoting adherence to national
guidelines, and building efficient and
effective epilepsy care.
Network Objectives
•
The MCN should improve the quality of life for
people with epilepsy by:
•
•
•
•
Capturing the opportunities of the Wales
NHS’s change to integrated care
Encouraging efficient and effective services,
in the most suitable setting
Reducing harm, waste and variation in
epilepsy service delivery
Empowering patients with epilepsy by
equipping them to be full participants in
determining their care
Network Principles
1. Timely and correct diagnosis
2. Timely and correct management
3. Multidisciplinary working
4. Patient empowerment
1. Timely and correct diagnosis
• Specialist in the epilepsies
• 2-week wait (NICE)
Right place, right time
2. Timely and correct management
• Anti-epileptic medication
• Tertiary referral (surgery)
• Holistic approach to care
Right choices, first time
3. Multidisciplinary working
• Neurologists
• Neuropsychiatrists
• GPs
• Epilepsy Nurse
Specialist
• Voluntary Organisation
• Social workers
Working together
4. Patient empowerment
• Question prompt sheets
• Agreed information sheets
• Copying letters to patients
Handing back
Audit
• Promoting adherence to national guidelines
“Epilepsy 12”
Royal College Paediatrics
 Percentage of children with epilepsy with evidence of input by ‘Consultant Paediatrician with expertise in epilepsies’ by 1 year
 Percentage of children with epilepsy with evidence of input by Epilepsy Specialist Nurse by 1 year
 Percentage with evidence of appropriate clinical assessment at first paediatric assessment
 Percentage with no evidence of withdrawal of diagnosis of epilepsy by 1 year
 Percentage diagnosed as epilepsy with evidence of seizure classification by 1 year
 Percentage diagnosed as epilepsy with evidence of epilepsy syndrome or syndromal category classification by 1 year
 Percentage having no evidence of inappropriate EEG
 Percentage with indications for neuroimaging having neuroimaging by 1 year
 Percentage with convulsive seizures having 12 lead ECG by 1 year
 Percentage females >12 years old commenced on epilepsy medication with evidence of discussion regarding pregnancy or contraception
related issues
 Percentage commenced on carbamazepine with absence of contraindications for carbamazepine
 Percentage meeting referral criteria for tertiary involvement with evidence of tertiary care input by 1 yr.
th
28
May
2010
- MCN Launch
•
Now the virtual Network is established,
there is a planned opportunity for
members to determine what the MCN
should
prioritise
as
important
objectives.
Moving forward together
•
•
•
•
•
•
Plan audits
Agree information sheets
Register of rarities
Jointly seek new drug approval
Plan educational activities
Facilitate research
Phase 3: Building Blocks for Long Term
Sustainability –
To be delivered 2010/11
Capturing Opportunity
•
•
The epilepsy MCN is a prime example of
capturing the opportunity of the newly
integrated NHS, in that it brings together
epilepsy clinicians and services in primary,
secondary and tertiary care.
We hope that all Health Boards will support
the Managed Clinical Network in its
endeavours to drive the continuous
improvement of care in line with the SDD.
Capturing Opportunity
•
•
The ability to describe and monitor existing
services is an essential prerequisite to
improvement.
Health Boards can play an important role by
defining their existing designated services
for people with epilepsy, in collaboration
with the MCN. This will allow assessment of
services to ensure they are provided to a
comparable level across Wales.
Capturing Opportunity
•
The MCN should be seen as an integral
part of the local health plan and local
health service delivery, not some
disconnected or isolated development.
How can we ensure that people with
epilepsy can access the right services at
the right time and in the right place?