Coe White IntegratedClinPathwa ys

Integrated Clinical PathwaysReality or just a dream? : 

Integrated Clinical PathwaysReality or just a dream? Andy Coe & Diane White Coventry & Warwickshire

Background to clinical pathway project –drivers for change : 

Background to clinical pathway project –drivers for change Meeting standards (quality) Darzi; access v. centralisation Specialisation 24/7 consultant cover European Working Time Directive Sustainability Patient experience

Local context –commissioner expectations : 

Local context –commissioner expectations Integration into a single service for Paediatrics and Neonates Standardised service model for Maternity services Collaborative approach to implementation, that addresses: Leadership Stakeholder participation Management Accountability Governance

Provider expectations : 

Provider expectations Satisfy local community needs Meet requirements for Local access Onward care: established predictable pathways Clinical governance across systems Regulation Standards set locally, regionally and nationally in guidance and reports …..in other words….. To deliver services that meet quality standards and are financially viable

Provider expectations : 

Provider expectations That we work together to establish a system of care that: ensures long-term sustainability of workforce supports recruitment and retention deals with EWTD delivers appropriate teaching, training and development to the workforce maintains standards of professional competency

Slide 6: 

Children’s and Maternity Services Board: Structure and Relationships

Commissioning to implementation : 

Commissioning to implementation Identify key areas, issues or priorities Maternity Network Steering group Childrens Network steering group Joint Services Strategic Board Commissioning leadership Project team, authority and accountability Clinical leadership Clinician, commissioner and provider ownership Contract setting KPI Complete loop on performance

Clinically led work streams : 

Clinically led work streams 21 work streams 2 stakeholder consultations May/Nov 09 Inclusion in contracts Implementation 2010

Some examples : 

Some examples Critically ill and injured children Emergency surgery, MSK, anaesthetics Epilepsy, diabetes, oncology, cardiology, gastroenterology Audiology Integrated care LLC Low risk antenatal pathway Obesity, diabetes, mental health, ID IUT Neonatal followup

Banana skins : 

Banana skins Organisational momentum Organisational changes Organisational stability (staff mobility) Cross organisational working/suspicions/silos Sign up Individual agendas

But the success….. : 

But the success….. Sign up (most of the time) Clinically ownership, commissioner supported And now appearing in contracts