CREST Guidelines One year on

1
CREST Guidelines One year on

• Jennifer Holmes
• BAPEN April 2005

2
2004

• Enteral tube feeding guidelines launched April.
• Over 6000 copies distributed in Ireland, England
  and Scotland
• Enquiries to allow reproduction in Primary Care
  Trusts.

3
Financial issues

• 2002 -2004 cost implications
• 2005-2007 financial allocations , Trusts and
  Boards in negotiations over Service and Budget
  agreements. Trusts working on delivery plans.

4
Reform, Modernisation and Efficiency

• Key challenge to the HPSS for the forthcoming
  years is to increase efficiency, improve
  effectiveness and enhance quality.
• Monies are available regionally for reform and
  modernisation schemes.
• Trusts working with local health and social care
  economy groups to bid for resources available
  from Reform and Modernisation Fund

5
Governance

• Trusts 0rganisationwide system of risk
  management and arrangements for all aspects of
  governance.
• Quality standards to be used by Regulation and
  Improvement Authority in conducting Clinical and
  social care inspections within Trusts
• risk assessment and management of medical
  devices,
• - control and reduction in incidence of
  healthcare acquired infection
• - organisation promotes implementation of
  recognised guidelines.

6
User Experience

• Requirement on service commissioners and
  providers to engage users and carers and
  communities in the planning, delivery and
  evaluation of health and personal social services.

7
Guidelines and link to Reform Agenda

• Patient Focus
• Pathway of Care
• Provide framework for risk assessment
• Guidance for documentation, training and learning
  goals for patients.
• Discharge communication
• Model for service delivery that aims to provide
  seamless service across hospital/community
  interface.
• Regional approach to management of this group of
  patients reduce inconsistencies
• Incorporated into minimum care standards for
  nursing homes.

8
Challenges

• Regional barriers identify and produce action
  plans
• Regional procurement procure things as
  effectively as possible (PCEG)
• Patient register/database

9
Procurement

• NHS Purchasing and Supply Agency responsible
  for making sure the NHS makes the most effective
  use of its resources. Ultimate target being to
  release money that could be spent on patient
  care.
• www.pasa.doh.gov.uk
• Guidance for Trusts on the procurement cycle for
  enteral feeds and associated products.
• Guidance for Trusts on presentation/product days
  for enteral feeds and associated products.
• PCEG want to move on this when time and resources
  permit.

10
Database

• Need information to inform business cases,
  procurement, service planning/developments.
• Community patient numbers, adult and
  paediatric, spread across different suppliers,
  private sector nursing homes
• Hospital patient numbers, adult and paediatric,
  specials and contract volumes.