1. QIPP Projects Update Newbury and District CCG April 2016

2. Transformation Team
In 2015/16 the Transformation and Planning was brought back in house from the CSCU.
Your Transformation Leads are:
Joe Smart – Transformation Lead (Planned Care)
Ruth Horner – Transformation Lead (Long Term Conditions)

3. Planned Care Projects 15/16
IPASS
Arthritis Care

4. Long Term Conditions Projects 15/16
Care Homes Renal

5. QIPPs for 16/17 £17m QIPP requirement £0 implementation plans
The QIPP identified in business cases: £8.2m

6. Roles and responsibilities
All projects rely on Clinical Leads
All projects require implementation plans
Project Managers are there to support you

7. QIPP Projects Overview
Description
Role of Primary Care
Investment £'000
NET Savings £'000
Gynaecology
Review
To reduce clinical variation through DXS, Rollout telephone follow ups and reduce F2F Follow Ups
To support the full use of DXS for gynaecology referrals 71
Dermatology Pathway
Increase the use of tele-Derm; Use DXS for dermatology referrals; Development of See and Treat clinics
The expansion in the use of Tele-Derm, full utilisation of the new clinical referral guidelines through DXS 63
IPASS continuation
To provide an integrated pain and spinal service; Assess and treat patients in the community with a range of strategies;
Reduce the number of referrals to secondary care
Continue to utilise the IPASS service which was set up in 2015 for patients normally referred directly to the pain and spinal service unless clinically contraindicated
515
111
Arthritis Care expansion*
To provide an intervention for all hip and knee patients who would normally be referred direct to secondary care.
Secondary care to reject hip and knee referrals which have not been to Arthritis Care.
So patients have access to shared decision making, lifestyle redesign and dietary & exercise advice.
To refer all hip and knee patients to the Arthritis Care Service prior to referral to Secondary Care.
To clearly indicate on referrals the patients have been to Arthritis Care. 80
717
General MSK
Reduce clinical variation in MSK treatment and Monitor the treatment of MSK in secondary care
Further work with Arthritis Care
To support the reduction in clinical variation in MSK treatment
Use of the proformas in DXS
TBD
TBA

8. QIPP Projects Overview
Description
Role of Primary Care
Investment £'000
Savings £'000
Gastro
The project has 3 work streams which includes: Service Review; Reduce clinical variation through clinical proforma.
The introduction of Telephone Follow ups; Review Meds Management for patients;
To support the reduction in clinical variation in referrals to gastro through the use of the clinical proforma.
Support the patients with self-management and meds education 58
Ophthalmology
To reduce Minor Eye Conditions being treated in secondary care To manage Ocular refinement within the Community Service to reduce false positives being referred to secondary Care
Increase the use of Community Service to support the reduction in minor eye conditions being managed in secondary care. -
300
Telephone follow ups in elective clinics
To work in conjunction with the providers to reduce the number of F2F follow ups and introduce telephone follow ups where possible for elective clinics
To be aware of the change in the management of elective care follow ups
TBD
230
Reducing Variation in Primary Care
To reduce variation in referral activity to secondary care.
Ensure referral data is regularly reviewed at practice level data on referrals and activity rates, review of the data at practice visits and the CCG Council of member practices
500
Diagnostics
To reduce the high levels of variation in the requesting frequency and method for direct access radiology in West Berks CCG’s
Utilisation of ICE better and any good practice 30 75

9. QIPP Projects Overview
Description
Role of Primary Care
Investment £'000
Savings £'000
Safer, Faster, Better implementation
To transform urgent and emergency care
Details to follow once the work programmes have been defined 95
SCAS Falls & Frailty Service
Working with the South Central Ambulance Service to deliver a Falls and Frailty Service, full mobilisation following the 1 year pilot
12.5
120
Resilience investments
Admission avoidance, effective discharge, improved patient flow to support system resilience
Investment was made in 2015/16 continued support in admissions avoidance and supporting effective discharge
investment made in 2015/16 70
Respiratory
Promote the early identification of COPD and asthma, self-management and intervention to improve the wellbeing of patients with respiratory disease. Reduce medical and prescribing costs, reduction in non-elective admissions and out-patient appointments
To support the early detection and self management of patients with COPD and Asthma. To support the upskilling of primary and community care services to maximise the potential support is given to the patient population.
130
long term plan with savings not realised till 17/18
End of Life
To support patients choices once the have been diagnosed as End of Life. Avoid unecessary admissions to hospitals if patients can be cared for in their homes and/or hospice.
Support the patient choices for their End of Life care and support care in the patients homes or hospice if required
438
261

10. QIPP Projects Overview
Description
Role of Primary Care
Investment £'000
Savings £'000
Care Homes
To avoid unnecessary admissions for patients in care homes, reduce delayed discharge of patient to their care home and reduce length of stay for residents during acute illness and hospitalisation
1460
782
Neuro
Implementation of headache care pathways and management guidelines; Support and better aid diagnosis and treatment using clinical decision tools; invest in supporting primary clinicians to manage chronic headache in the community Identify, define and improve pathways for patients with Epilepsy.
To utilise the care pathways and the decision aids to support the management of patients with headaches.
TBC
Diabetes
Increase patient education programmes to meet the level of need. Review the success of the HCP training programme and commission a new service for complex community patient to reduce non-elective repeat admissions 70 31
Obesity
To provide a weight management service for the management of obesity
To refer patients to the for weight management to follow a structured programme prior to referral to secondary care for bariatric services
464
162

11. QIPP Projects Overview
Description
Role of Primary Care
Investment £'000
Savings £'000
Renal/CKD Project
To review the care quality and referral pathways
To utilise DXS for renal referrals
TBC
Fracture Liaison (Falls)
Work with RBFT to provide a liaison for patients >75yrs with fragility fractures, to provide bone density scans for patients <75yrs with fragility hips. Reduce NEL admissions for fractures utilisation of NICE recommendations for the management of bone fragility
Details to follow once the work programmes have been defined
 TBC
TBC 
Leg Ulcer/tissue viability Pathway
Pathway redesign to include all BW CCGs following the pilot in Newbury and District in 15/16, upskilling practice and district nurses
TBD 95