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Strategic Clinical Leadership for PbR Implementation in Healthcare: Lessons from Local Success

This presentation highlights the innovative implementation strategies of Dr. Pratima Singh, a Strategic Clinical Leadership fellow at NHSL. Dr. Singh's work as a clinical lead for PbR at Oxleas NHSFT showcases her expertise in developing evidence-based care packages and improving quality and outcomes in healthcare services. The poster illustrates the cardinal basics of NICE guidelines and the core elements of care at Oxleas NHS Foundation Trust. By emphasizing the importance of accurate cluster allocation and care package development, Dr. Singh's work aims to bridge gaps in care delivery and enhance patient outcomes. Learn from her insights on effective care coordination, monitoring of physical and mental health, and collaborative working with agencies to optimize patient care.

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Strategic Clinical Leadership for PbR Implementation in Healthcare: Lessons from Local Success

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  1. PbR : Ideas from local implementataion Dr Pratima Singh Strategic Clinical Leadership fellow NHSL& Oxleas FT

  2. Background • Clinical lead for PbR in Oxleas NHSFT • London Fellow in Strategic clinical leadership NHSL • Deputy to Dr Strathdee, AMD NHSL and London SHA lead • National input • Regional • Local • Joint working with Devon , Avon, Solent healthcare, CNWL

  3. PbR projects undertaken • MHCT trainer and PbR Lead for Care Package Development • Audit of Current care PbR clusters (n=126)* Poster • Deep dive into understanding variation in lower clusters 1-3 (n=600+) and 11-17 ( n=1000+) • Evidence based care package development for 1-21 based on above with clinical group*

  4. 7 Cardinal Basics of Every NICE Guideline

  5. CLUSTER xyz CARE PACKAGE ELEMENTS IN OXLEAS NHS FOUNDATION TRUST Core Elements of Care: QUALITY AND OUTCOMES GOALS ENTRY TO OXLEAS SERVICES Common referral sources: Assessment: Cluster Description: CRISIS MANAGEMENT CARE COORDINATION MONITORING OF PHYSICAL AND MENTALHEALTH Diagnoses: Risk : Course: Expected Needs Indicative episode of care: Cluster reviews at least every: Step up criteria: Step down: Case Contingent Elements of Care: DISCHARGE CRITERIA (eg) Collaborative Working with agencies to meet

  6. Key findings • Variation of patient profiles wide within each cluster ? • Variation between cluster allocation by clinician and MHCT booklet Clusters 1-3: Upto 57% ,Clusters 11-17: Upto 55% * Importance of getting this first basic step right. • Overlaps and exclusions • Inconsistency of recording clinical information and lack of feedback of information to clinicians • Gaps between actual and proposed care packages- very wide even between clinicians, teams, boroughs

  7. Way Forward • Quality of cluster allocation and Link with a care package • Use existing NICE core interventions as frame work of Care packages that can be audited • Developing common language of beds, interventions to understand care packages • Link MH MDS data to outcomes I- ICD10, accommodation, crisis/acute/rehab/HTT beds • Commission a 1in 10 audit sample to check Cluster appropriation and Care Packages that follow* tool

  8. Thank you

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