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Long-Term Conditions Commissioning Plans Overview by Dr. Adrian Mairs - LTCANI Meeting

This document presents the commissioning plans for long-term conditions as discussed by Dr. Adrian Mairs during the LTCANI meeting on August 13, 2012. It outlines the strategic framework for cardiovascular services, diabetes, respiratory conditions, and neurological disorders, emphasizing integrated care, patient education, and the utilization of telehealth and community services. Key targets include enhancing access to life-saving medications and improving patient outcomes through personalized care plans and proactive management strategies. It serves as guidance for local plans and annual commissioning objectives.

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Long-Term Conditions Commissioning Plans Overview by Dr. Adrian Mairs - LTCANI Meeting

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  1. Long Term Conditions Commissioning Plans Dr Adrian Mairs LTCANI Meeting 13th August 2012

  2. LTC Service Team • Reports to Commissioning Programme Board • Sponsor • Joint PHA/HSCB Chair • Linked groups • Cardiovascular Commissioning Group & Network • Stroke Strategy Implementation Group • Respiratory H&W Group • Neurological conditions Sub-group • NIVASC

  3. Remit • Regional commissioning guidance • Framework for local plans • Annual commissioning plan • Review TDPs • Clinical linkages / partnerships • PPI

  4. Scope • Cardiovascular services / Framework • Diabetes • Respiratory services / Framework • Neurological conditions • All ages

  5. Commissioning Drivers • PfG • TYC: integrated care, “shift left”, diagnostics • McKinsey • Quality 2020 Strategy • NICE • Service Frameworks • PPI

  6. Programme for Government (PfG) • Enhance access to life-enhancing drugs for conditions such as rheumatoid arthritis, cancer, inflammatory bowel disease and psoriasis and increase to 10% the proportion of patients with confirmed ischaemic stroke who receive thrombolysis • Identify and evaluate the current baseline of patient education and self management support programmes that are currently in place in each Trust area

  7. TYC - LTC • Self care & prevention – partnership working • Personalised care plans - home based mx. • Named contacts for patients • Use of information systems to support care pathways • Medicines management – community pharmacy • Admissions protocol • Telehealth

  8. McKinsey • Quality & productivity improvements • Better management of LTCs • Reduced LoS • Enhanced /effective home & community services • Shift to lower cost settings

  9. NICE Technology Appraisals (TAs) For each Technology Appraisal, the HSC Board will submit a Commissioning Plan to the Department within 15 weeks • TA 236 - Acute coronary syndromes: Ticagrelo • TA 244 - Chronic obstructive pulmonary disease: Roflumilast • TA 248 - Diabetes (type 2): Exenatide (prolonged-release)

  10. NICE Clinical Guidelines For each Clinical Guideline endorsed by the Department, the HSC Board will submit a Board Response to the Department within no more than 15 weeks • CG 36 - Atrial fibrillation • CG 87 - Type 2 Diabetes – Newer Agents (update of CG66) • CG 101 - Management of chronic obstructive pulmonary disease in adults in primary and secondary care (partial update) • CG 105 - The use of non-invasive ventilation in the management of motor neurone disease • CG 119 - Diabetic foot problems - inpatient management • CG 126 - Stable Angina • CG 130 - Hyperglycaemia in acute coronary syndromes • CG 134 - Anaphylaxs • CG 137 - Epilepsy

  11. Commissioning Context • Programme for Government • Commissioning Plan Direction • Commissioning Plan • TDPs • Population Plans

  12. Commissioning Plan Direction • AAA Screening – June 12 • Thrombolysis: increase to 10% - March 13 • Telemonitoring: 400k monitored pt. days – March 13 • Unplanned admissions:↓ 10% - March 13 • Performance indicators

  13. Unscheduled Care Specification • Proactive Mx of LTCs • 10% ↓ unscheduled hospital admissions • ↓ LoS • Local economies • Practice registers / risk profiling • Regular primary care review • Patient education & self-management • Integrated community teams • Escalation procedures • Medicines management • Tele-monitoring

  14. Commissioning Plan Specific Targets • By March 2013, increase to 10% the proportion of patients with confirmed Ischaemic stroke who receive thrombolysis • By March 2013, achieve 400,000 Monitored Patient Days (equivalent to approximately 2,200 patients) from the provision of remote tele-monitoring services through the Tele-monitoring NI contract.

  15. Commissioning Plan - LTCs Key Deliverables • Implement COPD Integrated Care Pathway • Expand provision of insulin pumps to children & adults with Type 1 diabetes • Identify & evaluate current baseline of patient education & self management programmes in place in each Trust area

  16. Self Management / Patient Education ProgrammesBaseline Audit Wendy Thornton Public Health Agency Monday 13 August 2012

  17. 1. Background • Key commitment (priority 2) in PfG 2011-15

  18. 2. Key characteristics?

  19. 3. Audit scope • Specific programmes only (not support groups) • Programmes for patients only (not carers) • Physical AND mental health programmes • LTCs – key 4 - diabetes, asthma, COPD, heart failure, plus others... • Includes Condition Management Programme (CMP) – DEL/Trust partnership programme • Includes Trust and I.S provided/funded programmes

  20. 4. Methodology • Questionnaire (in form of Excel spreadsheet) • Distribute to Trusts & IS orgs during Autumn • 6 weeks timeframe for completion • Info collated and analysed by PHA/DHSSPS • LTC Regional Implementation Steering Group

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