University Hospitals Birmingham NHS Foundation Trust
Project Name: Improving MS patient management using NeuroQuant/LesionQuant software
Project Period: September 2017 – September 2019
Project Summary: The principal aim of this Joint Working project is to deliver the benefits to MS patients of enhanced clinical and radiological evaluation and management of their disease. It aims to do this by the use of brain volume measurements (BVL) and automated lesion counts and volume measurement (ALC) by utilising NeuroQuant and LesionQuant software which enables BVL and ALC to be measured. Increase in MS lesion load, lesion volume and brain volume loss are endpoints that correlate with disease progression and have implications for patient disease modifying treatment escalation and de-escalation decisions and patient outcomes. The Trust will be one of the first centres in the UK to bring these measures into routine clinical practice and will share their expertise to inform best practice across MS centres in the UK.
Expected Patient Outcomes:
Accurate radiological evaluation of patient’s disease
More informed decision making around the management of patient’s disease
Appropriate disease modifying treatment escalation and de-escalation for MS patients (in line with national guidance) leading to better patient outcomes
Nottingham University Hospitals NHS Trust
Project name: Nottingham University Hospitals NHS Trust Melanoma and Renal Cell Carcinoma (“RCC”) Service Development Project.
Joint working project summary: This Joint Working Project (“JWP”) aims at establishing an improved Melanoma and RCC clinic through the provision of a Melanoma and RCC Clinical Nurse Specialist (“CNS”).
Currently patients are seen at an existing clinic (which also provides an after care service, including a telephone service) constituted by a Melanoma and RCC Consultant, a Melanoma Consultant and a part-time Clinical Nurse Specialist (“CNS”). However, due to high patient numbers, patients are allocated insufficient times, both at initial consultation and follow-up treatment care. As a consequence, there is a need to improve the Melanoma and RCC service and expand the capacity of the existing clinic, which will be achieved by the addition of a full-time CNS (the “Additional CNS”), with relevant knowledge and skills. The additional CNS will provide support in Melanoma and RCC clinics and also increase the provision of the after care service, including the aforementioned telephone service.
The Melanoma and RCC service will be improved by combing the existing skills and resources of the Trust and Novartis Pharmaceuticals UK Limited (“Novartis”). This will improve the current clinic by helping with the stratification of patients to different models of care that better fit their needs and provide education to patients and holistic support to improve and enhance patient care and experience.
The Joint Working Project (“the Project”) will see Melanoma and RCC patients appropriately referred into the Trust from neighbouring hospitals across the Midlands. These patients will follow a defined patient pathway where they will be stratified into different models of care depending on their clinical needs. The Trust’s Melanoma and RCC team will ensure all team members are upskilled in new Melanoma and RCC developments, disease area, current patient management, treatments and attendance of Advanced Nurse Prescribing course for the proposed Additional CNS. All Melanoma and RCC Patients will be educated at the Melanoma and RCC clinic on their disease and treatment options providing holistic support to ensure optimal treatment management.
Expected patient outcomes for this project: it is expected the new Melanoma and RCC clinic will improve the quality of care by establishing a nurse-led clinic and implementing local disease guidelines/management and specifically:
improving the collection, management and availability of patients’ information available at the patient’s first clinic appointment to facilitate clinical decisions, as compared to baseline by month 9, 15 and 22;
patients that are more complex will be seen by the consultant. This will be done by increasing capacity in the clinic by stratifying patients for the new nurse-led clinic and free up the consultant time to see more complex Melanoma and RCC patients;
improved patient experience and satisfaction by ensuring all patients receive the appropriate information and support at the key points in the Melanoma and RCC pathway (holistic needs assessment and increase in patient satisfaction);
improved patient adherence to therapy through additional support of CNS to ensure optimal use of their medicines;
increase in trained resources, according to completion of assigned training within the timeframe of the project;
Reduction in patients’ waiting times during clinics that often run;
collection of all data relating to the impact of the nurse-led clinic on the care provided to the relevant patient population to support the generation of a business case to obtain funding of the service form the local commissioners.
Start Date and Duration: September 2017 – October 2019 Project period: 24 months
September 2017 to May 2018 – App development May 2018 – December 2018 – App promotion
Joint Working Project Summary:
To develop a patient self-monitoring app in conjunction with Bart’s Health NHS Trust that can be promoted to other NHS units across the UK. The app will help facilitate improved monitoring of patient outcomes in AS and PsA and to also help improve quality of life through in-app patient support. The app will be promoted to patients via their HCP (through patient leaflets developed by Novartis) and via social media (Twitter, Facebook and Google).
The intention of the app is to facilitate self-monitoring of AS and PsA by patients and provides the facility for patients to notify their HCP if their condition deteriorates or fails to improve. This could lead to an increase in the identification of patients not adequately controlled on their conventional or biologic DMARD therapy and consequently lead to an increase in treatment switches, including initiation of biologic therapy. Note: no patient data will be shared with Novartis.
Expected Patient Outcomes for this Project:
Improved management of AS and PsA as patients can monitor their response to treatment and the impact the disease (AS or PsA) has on their every-day lives. This will allow tracking of patient outcomes over time – with all data remaining in-app and confidential - which can then be fed back to their HCP to ensure appropriate and optimal intervention.
Start Date & Duration:
September 2017 with app development completed by end May 2018. 12 months technical support of the app will also be provided following completion of app development.