University Hospitals Coventry and Warwickshire("UHCW") NHS Trust
Project Name: Cardiac Rehabilitation and Treatment Optimisation for Heart Failure Patients
Joint Working Project Summary:
Implementation of nurse-led Heart Failure clinics, including a comprehensive Cardiac Rehabilitation programme for patients who fulfil defined referral criteria with the aim of delivering a patient-centred service, which optimises the patients’ health and well-being, enhances their quality of life and minimises the risk of recurrent cardiac events.
The nurse led clinics will consist of: (i) initial clinic assessments; (ii) group education; (iii) mid-way clinics and (iv) exit clinics in readiness for discharge back to the GP.
Expected Patient Outcomes for this Project: The following measures will be evaluated by the Trust:
patient numbers seen by the Cardiac Rehabilitation programme with concurrent nurse-led Heart Failure clinics: target of up to 200-220 per year;
patients discharged from the Cardiac Rehabilitation programme with concurrent nurse-led Heart Failure clinics: target of up to 130 per year;
patient satisfaction linked to the Cardiac Rehabilitation programme with concurrent nurse-led Heart Failure clinics (PREMS): target of up to 96% of patients surveyed;
increased proportion of patients with LVSD receiving guideline-directed pharmacological therapies at 30 and 90 days post-discharge (measured against the NICOR 2016 report);
submission of business case for the future funding of the Cardiac Rehabilitation programme with concurrent nurse-led HF clinics to the relevant NHS authorities.
Start Date & Duration: 10/04/2018, 24 Months
Project Period: 24 months
University Hospitals Bristol NHS Foundation Trust
Project Name: The Bristol Royal Infirmary Endocrine Service Improvement Joint Working Project (“JWP”).
Joint Working Project Summary The Bristol Royal Infirmary (“BRI”) is part of the University Hospitals Bristol NHS Foundation Trust. The BRI clinical endocrine team (“the NHS team”) provides a local endocrine service and also operates as a tertiary regional hub. There is a growing demand on endocrine services with a significant proportion of Clinical Nurse Specialists (“CNSs”) time triaging, scheduling and undertaking the endocrine patients for Dynamic Function Tests (“DFT”). These DFT’s are an important, albeit time-consuming, aspect of diagnosis and tailoring a treatment plan for endocrine patients. The DFTs are run over a number of hours, for each patient, with a series of blood samples taken and the checking of fluctuating hormone levels.
Aims A JWP between the NHS team and Novartis to improve the BRI endocrine services and the quality and consistency of endocrine patient care. A new band 5 full-time endocrine nurse will triage, schedule and undertake the DFTs for endocrine patients. This will benefit the NHS team by increasing the capacity of the CNSs to concentrate on more effectively undertaking, implementing and coordinating a series of service activities, such as CNS led clinics. It will also improve the timely access to service activities and improve the efficiency and flow of endocrine patients along the endocrine patient pathway. This will free-up Consultant and endocrine CNS time for complex clinical case management and reduce inappropriate administrative tasks for clinical staff.
Novartis will benefit from an improved reputation and stronger partnership with the NHS team, along with a better understanding of the endocrine patient pathway standards which the NHS teams work to. This will enrich Novartis discussions with other NHS sites when developing other JWP’s.
The NHS team and Novartis will form a project steering group (“PSG”) to initiate, review and measure the progress of this JWP. Aggregated and anonymised service level and patient satisfaction reports of the endocrine service will be generated by the NHS team and viewed at PSG meetings. Novartis will not have access to any patient specific treatment or clinical outcomes data. The results of the JWP will be included in a JWP summary report to provide evidence for the long-term financial sustainability of the service, solely funded by the NHS, after completion of the JWP.
Expected Patient Outcomes for this Project Improved access and quality of care across the endocrine patient pathway in terms of the following: • treatment delivered within 18 weeks; • diagnostic tests completed 6 weeks from general patient referral; • injectable endocrine therapies would be initiated within 4 weeks of the clinical need being identified; • DFTs to be completed within 2 weeks for urgently referred patients.
Improved patient satisfaction of the young person in transition from paediatric to adult endocrine services in terms of the following: • introduce the young person to one of the adult endocrine CNSs during transition period; • awareness of how to access the adult endocrine CNSs by telephone or email; • knowledge of condition and its long term management at time of transition from paediatric to adult endocrine services; • the opportunity for holistic assessments through the joint paediatric and adult endocrine CNS; • signposting to relevant support groups; • patient awareness of when the first appointment in adult endocrine services should be; • CNS present for extra endocrine patient support at first appointment in adult endocrine consultant clinics.
Financial Contribution: As detailed in the Joint Working Agreement Start Date and Duration: Start date by the end of April 2018 with an expected duration to the end of July 2019 Project Period: 15 months