Hillingdon Hospitals NHS Foundation Trust (Hillingdon Hospital)
Project Name: The Development of an Integrated Heart Failure (“HF”) Service located at Hillingdon Hospital (part of the Hillingdon Hospital NHS Foundation Trust)
Joint Working Project Summary:
The principal aim of this joint working project is an extension of the current hospital-based specialist HF service through the deployment of an “in-reach” nurse with the purpose of identifying and triaging HF patients so they can be appropriately referred to the relevant Cardiology service and receive specialist HF input; and subsequently coordinating the discharge of patients and liaison with community teams to ensure continuous appropriate care for HF patients after their discharge from hospital (the “Project”) to deliver the benefits to patients of improved access to appropriate diagnosis and treatment, more equitable and consistent access to care and an enhanced experience for patients and their carers who live with HF.
Expected Patient Outcomes for this Project:
The following measures will be evaluated by the Trust:
1. development of an in-patient strategy/protocol and implementation procedures of the same to govern the clinical operations of the HF Service
2. positive increase against the following baseline percentage measures as stated in the most up to date NICOR HF audit (whether published or not) for the Hillingdon Hospital of:
input from consultant cardiologist (%);
input from specialist (%)
HF patients who received discharge planning;
HF patients referred to HF nurse for follow up upon discharge
Outcomes are to be reviewed at 6, 12, and 18 months after the HF Service have commenced
3.Patient satisfaction linked to the HF Service (PREMS)
Start Date & Duration: June 2018
Project Period: 24 months
University College London Hospitals NHS Foundation Trust
Project Name: The North Central London Sickle and Thalassaemia Network Service Development Joint Working Project (“JWP”).
Joint Working Project Summary: The North Central London Sickle and Thalassaemia Network (“the Network”) consists of the University College London Hospital (“UCLH”) and Whittington Hospital (“WH”) as the hubs, linked to the other hospitals of Royal Free, Barnet and Luton. These hospitals, along with community sickle cell centres in Camden and Islington, provide the full range of community based and specialist in-patient, out-patient and emergency care for all ages of haemoglobin disorder patients. This includes approximately 1500 sickle cell disease and thalassaemia patients of which around 450 patients are given regular blood transfusions1. The Network peer review assessment in June 20161 indicated a growing demand on the Network and a need for a major improvement in the planning, coordination and implementation of the Network’s function, activities and services provided to patients in line with the West Midlands Quality Standards for Health Services for People with Haemoglobin Disorders2.
Aims: Novartis and the Network will combine resources, time and expertise for a JWP which aims to improve the quality and consistency of patient care, increase patient awareness of services offered and speed-up access to a range of sickle cell and thalassaemia service elements for patients. The NHS statutory organisation for the JWP will be UCLH. The JWP will be achieved by a Network Pathway Manager (“NPM”), working with Network Healthcare Professionals, to assess the functions and activities of the Network, against the WMQRS standards2, that impact on the patient service pathways. The NPM will also identify opportunities, plan, coordinate and facilitate the implementation of improvements and increased consistency of the service pathways across the Network partner sites in line with the WMQRS standards2.
Novartis and the NHS will jointly fund the salary of the NPM. The NHS will also provide Consultant and other staff time for clinical oversight, training supervision and work with the NPM to achieve the aims of the JWP and generate patient satisfaction and service level reports. Novartis will provide project management resource in terms of organising quarterly project steering group meetings and tracking the progress and impact of the JWP. Progress of the JWP will be subject to meeting 6 monthly milestones.
Novartis will develop a stronger partnership with the NHS, gain a richer understanding of the Network patient pathway WMQRS standards and be able to track improvements in the Network function activities through service level improvements. This will enrich our discussions with other Networks / NHS sites when developing JWP’s.
Expected Patient Outcomes for this Project The NPM will assess the speed, range and quality of service elements available to patients and implement service changes to improve the quality of care in terms of:
awareness of services offered;
quicker access to a range of sickle cell and thalassaemia service elements;
patient understanding of their condition;
the importance of attending clinic visits and good patient management.
Improved patient satisfaction of the patient service pathway, measured via a patient satisfaction questionnaire, covering the following elements:
access to a Clinical Nurse Specialist (“CNS”) / key worker and 24 hour telephone advice line;
patients concerns and queries dealt with effectively by HCPs;
provision of information to build patient knowledge of condition;
access to Holistic Needs Assessments (assessment of social, family, emotional and lifestyle / work needs);
choice of consultation with a Doctor or CNS via telephone.
The generation of a patient newsletter and patient access to a Network website to provide updates on local service development and guidance to access services.
Financial Contribution: As detailed in the Joint Working Agreement Start Date and Duration: June 2018 with an expected duration to the end of June 2020. Project Period: 24 months
Joint working project summary: This Joint Working Project aims to introduce new molecular techniques into routine clinical practice. The project aims at achieving the following objectives:
Identifying companion or stand-alone diagnostics for introduction in patient pathways across Scotland and to inform on the current Scottish process to approve the mentioned companion or stand-alone diagnostics for the relevant medicines carried out by the Molecular Pathology Evaluation Panel (“MPEP”)/ Molecular Pathology Consortium (“MPC”) (The “Scottish Process”)
Developing pathways across Scotland incorporating relevant companion or stand-alone diagnostics and appropriate sequential testing strategies including Next Generation Sequencing (“NGS”) and other novel technologies to routine practice
Development and evaluation of bioinformatics pipelines for somatic cancer in collaboration with University of Glasgow colleagues:
Develop a protocol to evaluate genomic signatures in response to chemotherapy.
Provide a finalised protocol for genetic testing to support clinical trials
Capture and utilize the project service data to demonstrate that the service is financially sustainable for NSD
Attend a Scotland wide educational meeting where the NHS, academia and industry are represented to promote the benefits of Joint Working Project between industry and the NHS in Scotland
Expected patient outcomes for this project The Project extension shall aim at furthering and consolidating the objectives already achieved through the Project in the previous year, and namely improving patient outcomes by incorporating a prognostic and diagnostic tool in the relevant patient pathways across Scotland, for specific drugs to be identified, by optimising the use of medicines in suitable patients.
Start Date & Duration: January 2015 Project period: Project extended for a further 12 months. It started in January 2015 and will now end in July 2019. Amendment agreement: June 2018 Project end date: July 2019
NHS South Lincolnshire Clinical Commissioning Group, Lakeside Healthcare Limited Allied, Health South Lincolnshire Limited
Project Name: Heart Failure Upskilling and Pathway Redesign Project
Joint Working Project Summary:
The overall aim of this JWP is to strengthen the delivery of routine care to HF patients to allow them to live longer and healthier lives and to minimise unwarranted variations in care.
This will be achieved by implementing the following:
undertaking audits to update the current HF registry in GP practices;
Practice Nurses, with the support of Clinical Pharmacists, undertaking stratification triage (virtual and/or on-site); where it is identified that treatment does not meet best practice according to NICE guidelines, these patients will be invited to initial Practice Nurse HF clinics, to review and optimise treatment;
patients in need of advanced medicines optimisation will be flagged by the In-Practice HCP to their GP for referral to the virtual MDT
virtual MDTs to review patients needing specialist drug or interventional therapies and complex cases prior to referral;
Community HF Specialist Clinics to provide specialist HF input to patients referred by the virtual MDTs;
a legacy framework for Practice Nurses to perform baseline HF patient reviews under GP guidance based on NICE guidance (NICE CG108)
Expected Patient Outcomes for this Project:
The following measures will be evaluated by the NHS:
overall increase in prevalence change (accurate pre/post LVSD cohort) for the GP practices in scope versus the prevalence baseline identified prior to the GP practice level audit (baseline provided by QOF measures);
increase in the number of patients receiving guideline directed medical therapy, against as the baseline provided by NICOR measures;
completion of specifically tailored HF patient template form for 100% of patients on LVSD register (including capturing NYHA classification) during 6 monthly reviews, this is something that will be introduced with the Project;
PREM (Patient experience / satisfaction with service) evaluation, this will be carried out by comparison of patient experience before and after establishment of the new the HF service