Prudent Eye Care: Better Outcomes, Quality, and Value for Patients

1. Corporate slide master With guidelines for corporate presentations Prudent Eye Care Dr Ruth Hussey Chief Medical Officer/ Medical Director

2. What is Prudent Health and care? • Healthcare which is conceived, managed and delivered in a cautious and wise way characterised by forethought, vigilance and careful budgeting which achieves tangible benefits and quality outcomes for patients • Better outcomes • Better quality • Better value http://www.prudenthealthcare.org.uk

3. What are the principles?

4. Applying the principles to eye care • 1. Achieve health and wellbeing with the public, patients and professionals as equal partners through co-production Requires users to be experts in their own circumstances and capable of making decisions, while professionals must move from being fixers to facilitators

5. Applying the principles to eye care • 1. Achieve health and wellbeing with the public, patients and professionals as equal partners through co-production For example • Encouraging people to stop smoking • Encouraging uptake of primary care services e.g. DRSSW

6. Applying the principles to eye care • 1. Achieve health and wellbeing with the public, patients and professionals as equal partners through co-production • The opening question between a clinician and a patient cannot remain “what can I do for you?” It must become “what can we do together to address the problems you are experiencing?” • Using the evidence • Redesigning services

8. Applying the principles to eye care • 2. Care for those with the greatest need first, making the most effective use of all skills and resources • Ophthalmic Planned Care Programme • Redesigning services so that those with highest risk are seen in a timely manner by doctors and others in the team to manage those in lower risk categories • Ophthalmic Diagnostic and Treatment Centres for glaucoma management • Nurse injectors in wet AMD clinics • Technology developments for self care

9. Applying the principles to eye care • 3. Do only what is needed, no more, no less; and do no harm Quality and patient safety at the heart of all services Choosing Wisely Cymru NICE do not dos

10. Applying the principles to eye care • 3. Do only what is needed, no more, no less and do no harm “You can think of the NHS as an escalator, on which we are always pushing people up the levels of intervention and somehow the higher up you go, the more prestigious it becomes and the more you feel you’ve gotten something good out of the health service. Prudent medicine is all about reversing that escalator. Professor Mark Drakeford, Minister for Health and Social Service

11. Applying the principles to eye care • 3. Do only what is needed, no more, no less; and do no harm • Many good examples in eye care in Wales: • EHEW accredited optometrists managing more cases in primary care • BetsiCadwaladr University Health Board found that a large proportion of patients didn’t need to be referred to secondary care and many being followed up in the hospital didn’t need to be • Aneurin Bevan discharge cataract patients at day zero

12. Applying the principles to eye care • 3. Do only what is needed, no more, no less; and do no harm “If we are serious about the principles of prudent medicine, then primary care is the single most important place where can start to make this happen.” Dr Mark Drakeford, Minister for Health and Social Services

13. Applying the principles to eye care • 4. Reduce inappropriate variation using evidence based practices consistently and transparently

14. Applying the principles to eye care • 4. Reduce inappropriate variation using evidence based practices consistently and transparently

15. Prudent Health and care is an approach which must permeate all facets of the health and care system - a cultural shift in mind-set so that we have prudent patients, prudent professionals and prudent services. http://www.prudenthealthcare.org.uk