1. Copyright 2011 Right Care What to Change Service Reviews & Cases for Change Professor Matthew Cripps BA MA CPFA Programme Director NHS Right Care August 2013 Online Learning Series Right Care for Populations

2. 2 Where to look What to change How to change PRINCIPLES OF CHANGE Delivering Value

3. CURRENT SERVICE FUTURE SERVICE Fit for Purpose Efficiency and market options Supply and capacity options No/ low benefit Step 1 – define: Step 3 – categorise : Step 2 – define: Redesign, Contract, Procure Contract, Procure, Divest Step 4 – recommend : Maintain Divest Service Review Pathway – Diagnostic steps Fit for Purpose Efficiency and market options Supply and capacity options

4. C1Circulation health check Health Check C2NICE CVD prescribing Primary Care Management C3Appointment following emergency admission Pathway Reform - Outpatients C4Cardiology post-NE pathway redesign Pathway Reform C5Cardiology referrals threshold Threshold policy C6Cardiology diagnostics Diagnostics pathway reform C7Cardiac Intermediate care setting Pathway Reform - Secondary care - Community care C8Non-elective percutaenous coronary intervention pathway Pathway Reform - Contract management C9DVT pathway Pathway Reform C10Cardiology self care Expert Patient Programme C11Telephone consultation Pathway reform - Follows up C12Cardiology Excess bed day reduction XSBD ratios C13Cholesterol management (statins) Prescribing policy C14Heart failure prescribing Prescribing policy C15Reduce multiple first outpatients appointments Pathway Reform - Outpatients management C16Varicose vein treatment threshold Threshold policy

5. 5 Online Learning Series Right Care for Populations Follow Right Care online Subscribe to get a weekly digest of our blog alerts in your inbox, Receive occasional eBulletins Follow us on Twitter @qipprightcare Find the full series at: www.rightcare.nhs.uk/resourcecentre