Current Commissioning Projects
Elective Care Services
Elective Care is planned care where patients are referred to specialist services by their GP. These services can either be provided in a hospital or in a primary care setting.
Lead: Dr Sheila Borkett-Jones
Objective: To deliver more effective and efficient services that add quality to the service provided by re-designing the pathways of patient care.
Background
Hertfordshire PCTs have written a strategy entitled, Delivering Quality Healthcare in Hertfordshire, which, among other objective across the county, sets out proposals to redevelop Watford General Hospital while seeking a significant shift of services from Secondary to Primary Care. The Government has published numerous strategies, which require PCTs to develop services closer to patients’ homes in community settings. WatCom has developed an Elective Care Plan to analyse the scale of change required locally and to agree how this can be implemented over the next four years.
The principles behind these service shifts are:
- Improved quality of care for patients
- Care provided more locally and quickly
- A more holistic approach to care in line with the rest of Primary Care
- A multi-disciplinary approach to care supporting skill development
- Innovative use of technology and new ways of working
- More cost effective care
As WatCom develops business cases to manage through each service shift it will use these criteria to determine whether the new care pathways being designed are for the benefit of local patients, the Practice Based Commissioning (PBC) Group and the PCT.
The generic model through which services will be shifted will be along the lines of a Clinical Assessment and Treatment Service (CATS) which would be established to deliver treatment which is appropriate for delivery in primary care through a consultant led approach and with GP clinical leadership to support the ongoing development of CATS.
WatCom’s plan is to take each speciality in turn and implement the maximum shift within a 12-18 month period for that speciality, starting with high volume specialities.
The programme for 2009/10 will include Musculo-Skeletal, Dermatology, Ophthalmology, Gynaecology, Ear, Nose and Thorat and Chronic Obstructive Pulmonary Disease. Updates for these specialities will be provided on the website as the service re-design takes place and services are commissioned.
Lead: Dr Sheila Borkett-Jones
Objective:
To provide a MSK Clinical Assessment and Treatment Service (CATS)
Status:
It is planned that the current MSK Clinical Assessment Service will become a CATS by providing treatment and incorporating consultant-led care. It is planned to develop access through the CATS to MRI scans. Discussions have started to take place to enable this to happen.
Lead: Dr Sheila Borkett-Jones
Objective:
It is planned to establish a Dermatology CATS for WatCom by 1 April 2008. The purpose of this scheme is to manage referrals to specialist dermatology services. The service will be led by a GP Clinical Lead including clinical triage with specialist input and multi-professional provision of services. Patients would be referred to secondary care when there is a need for hospital based specialised services.
Status:
WatCom has issued an Intention to Commission Notice inviting Expressions of Interest to provide this service and are currently engaged in the procurement process.
Urgent Care
Lead: Dr Jeremy Schindler
Objective:
It is planned for there to be an Urgent Care Centre at Watford General Hospital by 2010 as well as an Accident & Emergency Department.
Status:
WatCom is leading the commissioning process for this. It has been agreed that West Herts Hospitals Trust (WHHT) need to be moving towards an urgent care model that is clinically led by GPs and discussions are taking place to see if this can be reflected in the current Service Level Agreement held with the Trust. An earleir opening date than planned is a key objective of this project.
Data and Referral Management
Lead: TBA
Objective:
To support practices in the collection of robust, meaningful data and to validate that data against hospital data provided.
Status:
WatCom must ensure that all data and GP referrals are accurately recorded and managed so that the cost of activity stays within the budget. This includes validating hospital data to ensure it is correct and only valid payments are made.
Medicines Management:
Lead: Dr Clair Moring
Objective:
To ensure WatCom works collaboratively to manage prescribing budgets and to maintain high quality patient care
Status:
A PCT Medicine Management group meets regularly to monitor progress against budget, identify savings and instigate appropriate mechanisms for achieving them.
Enhanced Primary Care Services
Lead: Dr Clair Moring
Objective:
To offer a range of Enhanced Primary Care Services for practices to participate in which are in addition to the services provided within the General Medical Services Contract. This will provide additional services for patients speedily and closer to their homes.
Status:
A project group is working to look at the existing enhanced services and suggest new ones to be offered out to practices. Once agreed, the list of enhanced services for 2010/11 will be published on this website.
Community Nursing
Lead: Dr Clair Moring
Objective:
To improve the provision of community nursing services
Status:
The project team are working with the PCT Provider Services to provide input to the development of a Service Level Agreement for Community Nursing Services to improve the quality of the patient’s journey.
Adult Mental Health
Lead: Dr Wendy Sainsbury
Objective:
To provide Community Mental Health Services to patients with mild to moderate mental health problems close to their homes.
Status:
An Enhanced Primary Mental Health Service commenced on 1 October 2007 working with Herts Partnership Foundation Trust. A single Enhanced Primary Mental Health Team provides a ‘one stop shop’ for patients with mild to moderate mental health problems delivering:
- Assessment and triage of referrals from GPs
- Signpost service to appropriate community resources
- Short term interventions
- Computerised Cognitive Behavioural Therapy (CCBT)
- Referral into secondary Community Mental Health Services
- Referral into short term counselling services
The Enhanced Primary Mental Health Team comprises Graduate Workers and Link Workers with all WatCom member practices able to access the service since July 2008. Due to the success of this project not only for WatCom patients but as a model for other PBC localities, WatCom expects to develop its involvement in the Joint Commissioning of all mental health services across Hertfordshire during 2009/10.
Chronic Obstructive Pulmonary Disease (COPD)
Lead: Dr Coina Ciobhanu
Objective:
To provide cost effective, efficiently functioning, multi disciplinary services in community settings for COPD patients.
Status:
Work is taking place on a West Herts wide project to re-design the pathway for patients with COPD. The aim will be to prevent unnecessary hospital admission, reduce the length of hospital stays and to actively plan and manage patient care in the community in COPD Community Clinics using a multi-disciplinary team.
Lead: Dr Marie Anne Essam
Objective:
To design and install a more effective and accessible service for patients with diabetes.
Status:
We are actively supporting the re-design of services for West Hertfordshire patients in collaboration with our four neighbouring commissioning localities covering Dacorum, Hertsmere and St Albans & Harpenden. Meanwhile, we are prompting efforts to optimise the effectiveness of the existing service.
Lead: Dr Kevin Barrett
Objective: to ensure the development of any new premises in the locality, whether for member practices or to stand alone, aligns with the overall service development objectives outlined in the commissioning plan(s)
Status: WatCom is actively working with the PCT to identify exisiting sites and those that have the potential to meet certain parameters resulting from analysing the facility resoruce requriements of those current practice development plans as well as those arising from the WatCom commissioning plan.
The development of projects and strategies for the 2010/11 WatCom Commissioning Plan is underway and taking place with the challenge of achieving financial balance (or better) at the end of 2012/13, i.e. three years time.
Once the plan is approved it will be available via this web-site.