16649 Commissioning Newspaper-A4_Layout 1 04/08/2015 15:46 Page 16
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Managing long-term conditions
Cupris - the doctor in your pocket
On Thursday morning Sheinaz Stansfield came back to face the dragons to
talk about how Oxford Terrace and Rawling Medical Group had improved
access and management of long term conditions. The panel consisted
of Richard Deed, GM AHSN Innovation Nexus, Dr Cliff Richards, chair of
NHS Halton CCG, and Patroklos Sesis, Food Flag Ship programme
manager at Lambeth Council. Sheinaz Stansfield outlined how the
practices set up a retrospective review to measure waste in the
appointments system and discovered that a third of the patients seen by
GPs could be seen by a nurse, and 22 per cent of nurse appointments
were not used. As a result the practices were able to increase nurse
capacity by 49 per cent and improve access to GPs, as well achieving
smear targets. They also won a contract to provide substance misuse
services across Gateshead, and to provide services to eight nursing
homes, allowing them to increase their income.
The next innovation into the den was Cupris, described as ‘the doctor in
your pocket’ and presented by Mike Pallet, the CEO of Cupris. A live
demonstration showed how Cupris improves communication between
doctors and patients using smartphone technology. Mr Pallet attached an
otoscope to the device and used it for a remote diagnosis of problems
within the tympanic membrane in his ear. He described its application in
care homes, or in the homes of people with learning disabilities, to avoid
necessary distress through trips to the hospital. An ophthalmoscope can
also be used for retinal examination.
After some questions about how the technology works Dr Richards pointed
out: “A visualisation of the eardrum is diagnostically flawed. It’s the whole
consultation that matters.” But he added: “Quite a lot of what you are
saying is very interesting – I can see this as a direction we should be going
in.” And Richard Deed offered some words of encouragement: “The
concept, and the way you are delivering it, is absolutely right. It will all
come down to a cost-benefit analysis.”
The panel were generally positive about the scheme although they
wondered whether it would transfer to other localities. Dr Richards said: “I
can see there is an absolute space for this within co-commissioning. But
I’m still slightly suspicious that’s it’s you that makes the difference – so, well
done!”
Newham CCG Children and maternity services through partnership working
Dr Lizi Goodyear, clinical lead for maternity and children’s services at the
CCG, said that although 30 per cent of the population is under 31 years,
general health is still really bad. “The challenges are sometimes bigger
than what the data infers.” The CCG has the youngest population in
England and the highest birth rate, with the highest children’s poverty rate
and the worst obesity levels in the country at ages 4-5 years and 10-11
years.
Dr Goodyear and her co-presenter Satbinder Sanghera, director of
partnerships and governance at the CCG, said that the goal of the
program is to improve health and give children confidence, by
commissioning for population need rather than by diseases or service
lines. Newham has been divided into four clusters, each of which will
begin its first workshops in September. Already caesarean rates have
improved, and pilots will focus on outcomes and key priority indicators to
understand the social factors that are impacting health.
Dr Richards enquired about the vision and advised the presenters: “Next
week, when you do the same presentation, put up a slide that says ‘this is
the vision’.” Patroklos Sesis and Richard Deed both praised the scheme
and Richard Deed asked about the two key points that could be
transferred to other localities. Dr Goodyear replied: “Go and listen to what
other people are doing and localise it. And listen to the people you are
doing it to.” And Satbinder Sanghera pointed out: “There’s no one thing.”
Halton CCG and Widnes Vikings men's health collaboration
After a break for lunch came the most exciting and well received
presentation in the den. Dave Sweeney, director of transformation at
Halton CCG, and James Rule, chief executive of Widnes Vikings, revealed
details of a world record breaking attempt to a fresh panel, consisting of
Anne Blackwood, chief executive of Enterprise East, Roy Lilley, health
commentator and former chair of an NHS Trust, and Adrian Warner from
TRUSTECH. Mr Sweeney and M