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EEA Pathfinder UCLH

Introduction. To investigate the return on investment of investing more resource in the identification and recording of EEA Overseas patients.Start to understand what the

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EEA Pathfinder UCLH

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    1. EEA Pathfinder UCLH Presentation to Games-Time Planning, Delivery and Legacy 25th January 2012

    2. Introduction To investigate the return on investment of investing more resource in the identification and recording of EEA Overseas patients. Start to understand what the “baseline” is for the number of EEA patients in NHS trusts versus those currently recorded. To research, develop and test educational, training and comms tools and tips to improve identification and recording of EEA Overseas patients. To identify process and system improvements to improve identification and recording of EEA Overseas Patients.

    3. Why UCLH? Large central London trust with many EEA overseas patients. Dedicated Overseas Visitors team who were already significantly increasing recording. Supportive senior management. UCLH Education Centre to help with the development of tools and training. One of the first Trusts to sign up to the portal in 2009. Designated hospital for the Olympics Family. Named as top London NHS hospital according to the Dr Foster Hospital Guide in November 2011. Macmillan Cancer Centre opening in April 2012.

    4. Phase One – Evaluate Backlog Additional resources employed to “free up” staff to tackle the backlog of planned and unplanned treatment recording. Information department produced report that included potential cases for review – additional 5300 records. Each record was individually investigated to obtain E112s and EHICs. Recording was then extended to the National and the Heart hospitals. These extra resources on recording are delivering impressive returns:-

    5. Phase Two - Research The priority of the first quarter was to conducting a research programme to understand current recording of EEA visitors and what the gaps and barriers are to improving recording. Focus groups have already been conducted with A&E staff, admissions staff, ward clerks and consultants’ secretaries. As well as gaps in knowledge, training and comms these groups have identified gaps in process and procedure that are hindering recording of EEA patients.

    6. Phase Two – Research Detail METHODOLOGY Identify key points of admission and invite staff to focus groups. KEY FINDINGS Gaps in knowledge. Working in isolation. Excessive workloads. Limited knowledge. Induction training. Misunderstanding of eligibility. Overwhelming loyalty to NHS plc. Focus groups were an incredibly positive experience. Keep it simple – if in doubt contact overseas team. Every staff member must be responsible. Staff should not be concerned about duplication.

    7. Phase Two – Research Outcomes IMPROVED PROFILE Overseas section on Trust website. Intranet information page has been developed for access to all staff. Posters everywhere. Regular intranet feature. Internal TV monitor feature. Generic E-mail address. IMPROVED TRAINING New induction materials. Quick tips and guidelines. Overseas handbook for staff. Overseas handbook for patients. Standardize all official hospital letters and forms. A & E leaflet.

    8. Phase Two – Research Outcomes cont IMPROVED COMMUNICATIONS Consultants’ Audit day at the Heart Hospital. Consultants’ Secretaries – lunchtime presentations. Admissions/Booking staff and management at the new Macmillan Cancer Centre. QEP Open Day – Information stands in the main hospital. Regular attendance at monthly ward clerk meetings. Regular involvement with “After Action Reviews” concerning overseas patients. And anyone else who wants us.

    9. Evaluation Backlog 2009 documents were not routinely collected. Costs could not be submitted. Patient activity – overseas team not being notified. Patients were being recorded as NHS on patient administration system.

    10. Backlog Approach April 2011 - two months spent tidying up outstanding activity sitting on portal. Activity report produced (ZZ codes). This resulted in an impressive increased recording value of:

    11. Backlog Approach Report of additional 5300 episodes. 2750 Inpatients – 2550 Outpatients. 50% required investigation. Work with DWP extremely helpful. Chasing emails for costs not submitted.

    12. Backlog process Process followed:- EPR system check. CDR system check. Contacted appropriate performance/business manager. Requested case notes. Contacted consultants/secretaries. Contacted health authority in host country – usually co-operative. Last resort – contact patients. Ł150 Outpatients Episodes, not cost effective. Portal – very easy to use.

    13. Summary The increase in recording has been impressive but there is still more work to do. Educational tools will be tested and once approved, distributed. UCLH Overseas Project Package will be available for NHS Trusts to assist in tackling EHIC under-recovery and improve reporting. Credit card machine pilot with Visa. Investigate the use of social media. An incentivisation proposal will also be developed by the Department of Health.

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