1. NHS Southern Derbyshire Clinical Commissioning Group Southern Derbyshire CCG Quality Improvement CQUIN & other AKI stories Sally Bassett SDCCG AKI Pathfinder Project Manager

2. NHS Southern Derbyshire Clinical Commissioning Group Why SDCCG got involved AKI impacts pathways across commissioning Drive to improve quality & patient safety NCEPOD report ‘Adding Insult to Injury’ Chief Nurse & Deputy commitment & lead CCG Board sign up: Patient Story & briefings

3. NHS Southern Derbyshire Clinical Commissioning Group SDCCG 57 local general practices CCG is Derby City, and the southern part of Derbyshire County covering Amber Valley, South Dales and South Derbyshire. Commission health services on behalf of over 525,000 patients Vision - continuously improve the health and wellbeing of the people of Southern Derbyshire, using all resources as fairly as possible Think Kidneys- a fall in the number of preventable episodes of AKI & a reduction in deaths associated with AKI

4. NHS Southern Derbyshire Clinical Commissioning Group Commissioning tools CQUIN – quality & innovation Locally Commissioned Service Framework for Primary Care National standard contract for providers – community, Mental health, EMAS, acute etc Contract levers & penalties consistent Consistent quality schedules Prescribed monitoring arrangements Exploring Care Homes sector

5. NHS Southern Derbyshire Clinical Commissioning Group AKI CQUIN 2014 -16 Agreed CQUIN worth £1,045,746 Year 1 focus on Risk Assessments & Discharge Summaries Year 2 Acute Kidney Injury risk assessments 1a - all adult emergency admissions risk assessed within 24 hours of admission & interventions  Medicines Reconciliation  Medicines Optimisation  Daily U&E’s 1b - AKI Discharge summaries Discharge summaries that are sent to GPs to include:  Stage of AKI  Type and frequency of blood tests required  Relevant prescribing advice (NICE guidance)

6. NHS Southern Derbyshire Clinical Commissioning Group Primary Care Locally Commissioned Service Framework (LCSF) Year 1 Baseline survey undertaken by clinical staff, 500 responded with peer review activity follow up - – Programme of Academic detailing & education/awareness – Quality Forum, Meds Management, Community etc – Evaluation framework – building on GP survey & Academic detailing Year 2 negotiating  Survey 2 & extending to build work into Care Home alignment work e.g. GP led peer review sessions in Care Homes  Continued support and awareness raising

7. NHS Southern Derbyshire Clinical Commissioning Group Developing resources Policies, Procedures & Guidelines on AKI guidelines to support care planning on discharge  Shared Care Pathology PC guidance for PC  Sick Day Rules  Read codes approved

8. NHS Southern Derbyshire Clinical Commissioning Group AKI in Care Homes Care Home Advisory Service Power training for key trainers is visual, motivational, empowering C 160 homes Think Kidney Champs Launch days November Resource packs Evaluation

9. NHS Southern Derbyshire Clinical Commissioning Group Lessons Learnt  Senior Leadership vital  Can-do attitudes & pace  Ambition & innovation to improve care  Patient voice  Strong team committed to a shared vision  Contractual levers

10. NHS Southern Derbyshire Clinical Commissioning Group Contact Details Sally Bassett - sally.bassett@southernderbyshireccg.nhs.uk sally.bassett@southernderbyshireccg.nhs.uk https://www.thinkkidneys.nhs.uk/wp- content/uploads/2015/07/Southern-Derbyshire- Case-Study-Two-Perspectives-on-a-New- Approach-to-AKI.pdf