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Librarians and Commissioners

Librarians and Commissioners. Mike Roddham Head of Library & Knowledge Services. Why?. Ensuring local people get the best quality health services by Ensuring services are commissioned according to the best available evidence. What?. The importance of language

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Librarians and Commissioners

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  1. Librarians and Commissioners Mike Roddham Head of Library & Knowledge Services

  2. Why? Ensuring local people get the best quality health services by Ensuring services are commissioned according to the best available evidence

  3. What? The importance of language Where do we fit in the commissioning cycle? What they want and what they don’t The service model & how it will change us The importance of relationships Challenges and Gains But not necessarily in that order

  4. http://www.commissioningboard.nhs.uk/2012/02/03/commissioning-intelligence-report/http://www.commissioningboard.nhs.uk/2012/02/03/commissioning-intelligence-report/

  5. 1. How healthy? 8. What are our future plans? 7. What difference have we made? 2. What’s really happening in this system? Whatquestionsdo we need toanswer? 6. How could things be better? 3. How much? 4. How do we compare? 5. Are my providers delivering what they agreed?

  6. 4. How do we compare? Q4.01: Where is there clinical / activity / cost / outcome variation vs local, national, international, best practice? Q4.02: Are we delivering national standards of care for patient experience, quality and outcomes? Q4.04: Do current pathways reflect evidence-based good practice? Q4.05: How do we compare for value for money, outcomes and productivity against similar areas / best practice over time?

  7. Data Types of service & tools S4.01: Practice-level, regional and national bench- marking of disease prevalence, activity, productivity and costs D4.01: Age-sex deprivation standardised comparative data at practice level for commissioned activity D4.02: Primary care data extracts providing integrated analysis of with acute activity e.g. prevalence rates vs admissions / screenings S4.02: Analysis and presentation of productivity indicators by programme / project D4.03: Comparative benchmarking data (e.g. QOF Data sets, NCHOD, NHS Comparators, NHS Atlas of Variation, Better Care Better Value indicators S4.03: Clinical pathway mapping and modelling and cost comparators D4.05: Benchmarked GP referrals analysis S4.04: Providing evidence and information on comparative health outcomes D4.06: Practice profiles (needing national standards) S4.05: Statistical analysis of variation and correlations e.g. Statistical Process Control D4.07: National guidance, PROMs, utilization reviews

  8. Look at the model. Which areas do you think we can contribute to?

  9. Targeting There are areas where we can contribute effectively, e.g.service redesign, pathways, individual funding requests There are areas where we can’t, e.g, contract compliance Be realistic Target your message

  10. Targeting Be specific, don’t generalise Concentrate your fire on target areas but don’t miss an opportunity. • Use examples from • Commissioning Handbook, • knowledge4commissioning

  11. Wordsmithing Understand their mindset Know their world Talk their language Read up – HSJ, reports, DH stuff, NHS Commissioning website

  12. Wordsmithing Literature searching • Finding evidence • Create the evidence base • Identify national & international best practice • Horizon-scanning • Knowledge management • Decision support Literature searching Training Literature searching Loans Literature searching Books & journals Current awareness Library Organising information Literature searching & reviewing

  13. Wordsmithing Watch for changed meanings Data analysis Intelligence Evidence Knowledge management Analysts and commissioners believe in Safety in Numbers

  14. Wordsmithing Don’t describe the services you offer Present the benefits that the commmissioners gain Talk outcomes, not processes i.e. not literature searches but “confidence in their decisions”

  15. They Don’t Want Piles of photocopies Reference lists To have to come to the library Bureacracy and form-filling

  16. Don’t offer training! They don’t want it, they won’t use it. Our unique selling point – “we find it for you.” We have professional skills they can exploit to save money and improve patient services

  17. What Do They Want Information on what works Information on how others are coping (we can offer not just UK, but international) Information on what doesn’t work Reviews, summaries, time-savers

  18. What Do They Want? • Information they can rely on • Information they can base decisions on • Evidence they can hide behind • Information that enhances what they already have DATA DATA DATA DATA DATA What do they have? DATA DATA DATA DATA DATA DATA DATA DATA DATA DATA DATA

  19. DATA • Always Historical • Somewhat predictive of activity • Says ‘what happened,’ ‘when,’ ‘how many,’ ‘how often’ • Doesn’t say ‘why,’ ‘what else,’ ‘how do we change’ • Not always reliable

  20. Major Change Get them thinking beyond the data Examples, stories, vignettes are really important

  21. Relationships • Develop them • Exploit them • Use champions Work through people you know to reach those you don’t

  22. Likely Prospects Business intelligence leads/ directorsdon’t talk to the analysts IFR / PIN leadsUnderstand need to justify expenditure Public healthstill need library support. GP members, education committees, clinical effectiveness & research committees

  23. CCG or CSU?

  24. What You Could Do You might need to loss-lead to show them the benefits Set it up as a project with option to make permanent Work together across services if you aren’t co-terminous with a CCG. Use their borders, not yours. Also looks better to customers

  25. Challenges • Work out of the library– physically and mentally! • Change your mindset– think like the customer • Sell your skills not your resources

  26. More Challenges • Summarising and reviewing Needs better service monitoring Gathering feedback on service impact & activity • Learn to sell yourselves – exhibitions, marketing materials, publicity, Facebook

  27. More Challenges –A Different Sort of Enquiry Risk stratification for Long Term Conditions; which risk stratification tools work best; any local examples; within the last year; review articles within the last 3 yrs Innovative community ENT services; national examples/best practice; primary care based/community-led Best Practice initiatives to reduce inappropriate GP referrals in planned care: Cardiology, Gastroenterology, Neurology, General Surgery - Upper GI, Colorectal, Breast, Vascular • Health Visitor involvement in early interventions for improving children's language development & early communication skills. Is peanut allergy in children more prevalent in the UK? If so, why? The Troubled Families Initiative - any information? On intervention strategies in particular.. Is there any new evidence to support revision of the local referral guidelines on hip pain, knee pain and low back pain? Impact of weight management services (Tier 3/4); does engaging in them lead to e.g. reduction in incidence of diabetes, hip/knee replacements, etc. GP direct access to head CT scanning - any protocols, reasons why if not

  28. Gains Understanding Secures services Respect Non-MADEL income Feel good Champions New skills New user groups Direct contribution to improving local health

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