1. Participative ICP development
HIV ICP event: Stirling 26th March 2013
Rak Nandwani
Consultant in Sexual Health & HIV Medicine
NHS Greater Glasgow & Clyde

2. Overview of presentation
To provide update on progress in NHS GGC
To show process we are using to develop ICP
To recognise value of engaging teams
To identify where external input is required
Willing to share anything others find helpful

3. Sexual Health & BBV Framework
Builds on HIV QIS standards & Action Plan
ICP direction set by Scottish Government HIV Clinical Leads Group
Also takes account of other national guidance
Framework Outcomes: HIV
1. Fewer newly acquired HIV infections
2. A reduction in health inequalities associated with HIV
3. People affected by HIV live longer, healthier lives
5. A society whereby the attitudes of individuals the public and professionals and the media in Scotland towards HIV are positive, non-stigmatising and supportive

5. Brownlee Clinic numbers 2001-2012

6. Starting point: the patient journey
Show patients what the plan is
Alternative routes tailored to individuals
Patient responsibilities stated
Shared care and sign-off
Engagement of wide range of stakeholders

7. GGC ICP Event 6 Sept 2012 Linked to Health Board ICP workstream
Facilitated by GGC Head of Organisational Development: SIPOC methodology
Key personnel: some meeting for first time
Consider the whole end to end pathway
Review where own part sits in the pathway

8. The Icebreaker.. Consider the presentation and
actions we now need to take
Identify:
One key hope you have for the outcomes
of developing the pathway?
One key concern?
One opportunity you feel this might offer ?
Write these down – one each to a post it page
Take 5 minutes – speak to as many people – one at a time!
– as you can in this time and share the above.
Add to flip chart pages on the wall
Hope
Concern
Opportunities

9. (Linkage Of Processes)
Business
Architecture
(Functional Map)
Level 0
Top Level Block Diagram illustrating the Functional groups and their relationships. Allowing a broad, easily understood picture of the Business as a whole.
L.O.P Map
(Linkage Of Processes)
Detailed Map of all Significant Process Steps captured in Level 1 linking processes together based on their Inputs and Outputs.
Allows personnel to picture where they fit in and where their links are. Displays the actual flow & sequence of events.
Processes are numbered for ease of reference across the Business.
Level 1
SIPOC
Templates
(Suppliers, Inputs,
Process Steps,
Outputs & Customers)
Templates per Functions represented in Level 0 capturing important Inputs to each function , their owners, the function’s significant steps and Outputs from the function.
This gives a general understanding of Functions’ operations and cross functional dependencies & responsibilities inc. Customer focus.
Level 2

10. WHAT is it they provide to our process; Process Output
Process name: Enter Text Here
Process owner: Enter Text Here
Suppliers
WHO provides the inputs to the process
Input
WHAT is it they provide to our process;
Material, equipment, appointments, hardware, software, training, resources, information, data, products
Process
Output
WHAT does the process provide as an output from its activities.
Completed treatment, an appointment schedule, a diagnosis, data, information, referral.
Customers
WHO receives the outputs;
Patient, GP,
Onward referral departments.
Who else has an interest; management teams, committees, agencies.
Finishing Point

11. Outputs from Campanile meeting
Team-building event
Understanding of dependencies of different parts of service
Identified areas of difficulty and where decisions are needed to make improvement
Sufficient outputs to produce draft HIV ICP

12. GGC First 3 months of HIV care ICP
ASSESSMENT OF PATIENT NEEDS AND PRIORITIES FOR CARE Clinical assessment Wider health & well-being Sexual & reproductive health Body metrics Blood tests Urine & other tests SELF-MANAGEMENT SUPPORT PATIENT PARTICIPATION IN DECISION MAKING PHARMACIST ADVICE
NEW HIV+ DIAGNOSIS
(OR TRANSFER)
ENTRY TO HIV CARE
OR ACTION IF DNA
ADVICE ON PARTNER NOTIFICATION AND PREVENTION OF ONWARD TRANSMISSION
REGISTRATION AND COMMUNICATION
INFORMATION GOVERNANCE
CLINICAL DECISION MAKING
AGREEGOALS WITH PATIENT: "CARE PLAN”
CONSIDER ARV THERAPY
DOCUMENATATION
1. List of main issues/summary
can be in form of GP letter or note to file. Offer patient a copy
2. Include actions to be taken and likely timescales to complete
3 MONTH ICP CHECKLIST SIGNED OFF
BY MDT STAFF
EMERGENCY NON-HIV CARE
GP/PRIMARY CARE
HOME DELIVERY

13. NHS GGC draft HIV ICPs
The Excel versions are in early draft form but we are willing to circulate to others once agreed locally.
Please feel free to me if you would like a copy:

14. NHS GGC ICPs Whole pathway visible at once
ICP for first 3 months of care
Identified links to other pathways
Definitions and data to identify variances
Annual review ICP with branches on/off therapy

15. Next steps Further staff event to review draft ICPs
Teams to claim lead responsibilty
What’s missing and what can be removed
Patient & third sector perspectives
What decisions are needed (eg timing of visits)
Documentation without duplication