1. MUNROS is funded by the European Commission FP7 programme www.abdn.ac.uk/munroswww.abdn.ac.uk/munros Leads: Christine Bond and Bob Elliott University of Aberdeen MUNROS AIM: – To describe the contribution of new health care professionals and new professional roles to the delivery of care – To assess clinical and cost effectiveness of new roles – To inform future workforce planning Health Care Reform: The iMpact on practice, oUtcomes and cost of New ROles for health profeSsionals (MUNROS), funded under European Community’s Seventh Framework Programme (FP7 HEALTH-2012-INNOVATION-1) grant agreement number HEALTH-F3-2012-305467EC

2. MUNROS is funded by the European Commission FP7 programme www.abdn.ac.uk/munroswww.abdn.ac.uk/munros Early findings: Experiences and satisfaction of patients with CHD Demography o 66% male; age 61 years (28- 88) o 2 post acute event, 10 in rehab and 25 in long term follow up o Care is provided by >20 different professionals o Most see a regular GP o Most 30/39 are being regularly monitored o WTP for an ideal visit £110 Low involvement in care? Less than half say they never or rarely: o Contribute to treatment plans (18/39); o Are given choices (17/39) o Are asked about problems (11/39); o Are asked about goals (15/39) o Are asked about lifestyle (I2/39

3. MUNROS is funded by the European Commission FP7 programme www.abdn.ac.uk/munroswww.abdn.ac.uk/munros Patient satisfaction

4. MUNROS is funded by the European Commission FP7 programme www.abdn.ac.uk/munroswww.abdn.ac.uk/munros Some comments  Consideration of findings  Despite seeing multiple professionals patients regard GP as main carer  Patients have little involvement in care yet are very satisfied  Are patient expectations too low?  Or are we aspiring to the wrong service model?  Recruitment has been challenging and intensive and is ongoing  Scotland: 36 secondary care sites and 60 GP  European-wide multiple issues  Slow recruitment -so only preliminary findings at this stage 

5. MUNROS is funded by the European Commission FP7 programme www.abdn.ac.uk/munroswww.abdn.ac.uk/munros

6. MUNROS is funded by the European Commission FP7 programme www.abdn.ac.uk/munroswww.abdn.ac.uk/munros Approach Setting: – Nine EU and Associate Countries – 12 Hospitals and 60 primary care settings per country – Three clinical pathways: Type 2 diabetes, Breast cancer, Heart disease Methods – Routine data, and literature reviews – Case studies, surveys, economic modelling, workforce planning – Surveys: professionals, managers, patients

7. MUNROS is funded by the European Commission FP7 programme www.abdn.ac.uk/munroswww.abdn.ac.uk/munros Care received for CHD: information/education

8. MUNROS is funded by the European Commission FP7 programme www.abdn.ac.uk/munroswww.abdn.ac.uk/munros Care received for CHD: monitoring

9. MUNROS is funded by the European Commission FP7 programme www.abdn.ac.uk/munroswww.abdn.ac.uk/munros Patients’ perception of organization of care