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Vascular Checks in Bolton Industrially Scaled and Systematically Applied

. . Health Inequalities 2010. Reduce deaths from heart disease and stroke and related diseases by 40% in people under 75. Health Inequalities 2010. Narrowing the GapMales 74.6 years 2.3 year gapFemales 79.0 years 2.1 year gapGreat Lever, Halliwell and Crompton67.5 yearsBradshaw82.2 years.

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Vascular Checks in Bolton Industrially Scaled and Systematically Applied

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    1. Vascular Checks in Bolton Industrially Scaled and Systematically Applied  Dr Stephen Liversedge PEC Chair Lynda Helsby Project Lead

    4. Health Inequalities 2010 Reduce deaths from heart disease and stroke and related diseases by 40% in people under 75

    5. Health Inequalities 2010 Narrowing the Gap Males 74.6 years 2.3 year gap Females 79.0 years 2.1 year gap Great Lever, Halliwell and Crompton 67.5 years Bradshaw 82.2 years

    6. Health Inequalities 2010 National Support Team visit 3 most ‘profitable’ areas to address Existing cardiovascular disease Diabetes Prevention of cardiovascular disease

    7. Health Inequalities 2010 National Support Team visit Industrial scaling Systematically applied

    8. Primary Prevention of CHD 2006-2008 Incentive scheme Improve your position by 10% or 20% 10 practices didn’t participate Poor data in a further12 practices 74,769 target 31,518 assessed as at April 2007 Missing 43,251 Registers 15% to 25%

    9. How were we doing?

    10. Primary Prevention of CHD Logarithmic Incentivisation 30% Ł 1.00 40% Ł 1.50 50% Ł 2.00 60% Ł 3.00 70% Ł 4.50 80% Ł 6.50 90% Ł 9.00 100% Ł12.00

    11. Logarithmic Incentivisation

    12. Costs 286,000 population 88,660 need assessment (31% of list) 70% is 62,062 @ 4.50 Ł279,275 80% is 70,925 @ 6.50 Ł471,651 90% is 79,794 @ 9.00 Ł789,960 100% is 88,660 @ 12.00 Ł1,003,920

    13. Work and Pay How much? 31% of list 620 for each GP 80% achievement 496 patients Ł3224 90% achievement 558 patients Ł5022

    14. Everyone must be involved - Staff Project Manager Health Trainers Data Quality Facilitators Practice Managers and reception staff Practice Nurses All GPs All Primary Care Staff And Secondary Care Staff

    15. Everyone must be involved –The Public Local Authority The Bolton News Local Radio - Tower FM Work Places Supermarkets Pubs Betting shops Mosques

    17. Practice Reports – Monthly Audit

    18. Practice Trajectory

    21. What is left to do?

    22. How are we doing?

    23. Results Preventing Heart Disease Improved performance ‘Beyond QOF’ Better Diabetes, Hypertension, CKD registers Better Primary Health Care Teams Better Primary Prevention Registers 9,097 on register at 2007 Currently 17,646 @ January 2009 24,000 expected on register…….eventually

    24. Before

    25. After!

    26. Workstreams Information Data Quality Clinical Engagement Outreach work Health trainers Marketing Local Enhanced Scheme Near Patient testing Clinical Governance

    27. Learning Points - Information Regular reports vital for practice and project team Adapt information depending on outcomes Interpretation of information is variable Project team must focus on information and act accordingly

    28. Learning Points - Data Quality Assume nothing Ensure searches are systematic Support is necessary for running searches Training requirements exposed Capacity of Data Quality Facilitators

    29. Learning Points - Clinical Engagement Clinical Leadership is essential Time to build relationships Understand your Primary Care Get a lead in each practice Culture and ethos determines the success

    30. Learning Points - Outreach work Good marketing exercise Well received everywhere Data quality and transfer Cost issue Duplication Targeted outreach the most effective

    31. Learning Points - Health Trainers Vital Moveable resource Adaptable Flexible Resilient Enthusiastic

    32. Learning Points - Marketing Branding – appealing, recognised, catchy Launch event success Publicity Media involvement Banners Cost

    33. Learning Points - Local Enhanced Scheme Grab attention Different - logarithmic incentivisation Acknowledges work already done Acknowledges it gets harder No strings attached Aims for 100%

    34. Learning Points - Near Patient Testing One stop shop Helps with needle phobics Training /Quality assurance issues Cost Laboratory support

    35. Learning Points - Clinical Governance Risk calculation tools Management of risk register patients Training Support NICE guidance

    36. Final Learning Points 1 Select your project team carefully Shared ambition Enthusiastic Informed Prepared to challenge Prepared to support

    37. Final Learning Points 2 Health Inequalities:

    38. Final Learning Points 3 The Last 20% Half (10%) mean to attend Busy…. and Well Work commitments Last 10% Ghosts Needle phobics 4 urban myths Leave me alone

    39. Final Learning Points 4 To do it this way you need Clinical Leader Project Team Incentive scheme Peer group cluster analysis Practice Visits Health Trainers Outreach Publicity All equally important

    40. Before

    41. After!

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