1. The Map from a clinical perspective and how to engage Clinicians and embed the Map into clinical workflow Dr Amir Hannan Full-time General Practitioner Primary Care IT Lead, NHS North-West Map of Medicine clinical lead, NHS North-West amir.hannan@nhs.net

2. Summary Why the Map of Medicine? What can it do for us? How can it help?

3. Why the Map of Medicine ? “Medicine used to be simple, ineffective and relatively safe. Now it is complex, effective and potentially dangerous” Sir Cyril Chantler, former Dean, Guy’s, King’s and St Thomas’ Medical and Dental School The Report of the Public Inquiry into children’s heart surgery at the Bristol Royal Infirmary 1984-1995

4. What can it do for us ? NIDDM patient in 50s having a hypo 2.1. Feels unwell and lightheaded but not drowsy. Needs advice NOW. What do you do?

9. !

10. www.diabetes.org.uk

14. www.gpnotebook.co.uk

22. What does this have to do with Commisioning and Providing services and Education? Hard way vs the EASY way BUT we need to gain confidence in the pathways…. AND understand this is the start of a journey and not the end… It SUPPORTS the discussions and possibly the need for LOCALISATION Gaining TRUST in this does not happen overnight or after a talk - only after you unlock its secrets as I have shown do you begin to gain confidence

24. Use the patient as an “untapped resource” for Practice Based Commissioning

25. NHS Choices - www.nhs.uk - Health Guides available for the publicwww.nhs.uk Map of Medicine Health Guides Map of Medicine Health Guides

26. NHS Choices - www.nhs.uk - Health Guides available for the publicwww.nhs.uk

27. NHS Choices - www.nhs.uk - Health Guides available for the publicwww.nhs.uk

28. NHS Choices - www.nhs.uk - Health Guides available for the publicwww.nhs.uk

29. NHS Choices - www.nhs.uk - Health Guides available for the publicwww.nhs.uk

36. So why do I recommend the Map of Medicine 1.Easy to use 2.Available NOW 3.FREE for the whole of the NHS 4.Up-to-date and accredited for supporting evidence-based delivery of care 5.Can be localised for your needs 6.Support and training available for all staff 7.Opportunity to send instant feedback 8.All future IT systems in the NHS will have this integrated as the preferred knowledge management system for the NHS 9.Patients can also access the Map of Medicine via www.nhs.ukwww.nhs.uk 10.Will support future referral pathways as multiple providers including the private sector deliver services for NHS patients

37. So how do we engage clinicians and embed the map in clinical workflow ? This is not going to be easy! Think CLINICIANS and PATIENTS (in a patient-led NHS)

38. Who ? Different drivers for different people –You will know what the best strategy is - this just gives certain considerations –High quality care –Special interest eg gynaecology, cardiovascular medicine or chronic disease groups such as diabetes group, palliative care group –Local “community of interest” within an LHC eg consultant, GP, nurse, OOH clinician –Training sessions eg Target –Appraisers - PUNS and DENS –Trainers and trainees –Offer locum cover for a clinician that wants to come to an event during the day - champions can be nurtured as well as innate ability! –Locums / salaried GPs and nurses / general invitation –Poorly performing clinicians –Non-medical prescribers / Nurse Practitioners / Chronic disease nurses / pharmacists and other allied health professionals –Out of Hours clinicians (GPs and Extended Nurses) –Equitable Access clinics, other “new” surgeries –PBC groups Commissioning new services Limiting costs by looking at referral patterns / prescribing –Expert patients, Self Care groups, Patient Participation Groups, Outpatient clinics

39. Embedding in Workflow Much more harder! Think WHY before HOW, WHAT and WHEN Diffusion of innovation Incentives / disincentives Appraisal folder “MoM” day with a gap analysis when fully staffed Share ideas / tips with each other within a clinical team Encourage Significant Event Analyses on user case scenarios (lessons learned when it went well as well as when it did not go as well) We can make it EASIER if we identify the right people AND create the right environment for them to learn KEEP IT SIMPLE!

40. Pictures taken from www.mediclicks.net For further information please see www.mapofmedicine.com Or contact Ketan Patel, Implementation Manager, info@mapofmedicine.com