Project charters

1
Project charters

• Birmingham
• Derbyshire
• Manchester
• Stour
• Torbay

2
Can the clinical and economic benefits of
education for Heart Failure patients be expanded
in high risk populations through innovative
enrolment strategies?

• Problem statement
• 5 of hospital admissions are related to heart
  failure (HF), half of which could be prevented
  through support with self care management (NSF
  for CHD, 2000). Specifically, evidence indicates
  that comprehensive education about heart failure
  reduces hospitalisation for this condition by
  nearly 40 (Coll, 2002).
• Since the incidence of heart failure is up to 4
  times higher in the South Asian (SA) patients
  (BMJ, 2003), this group could benefit most of
  education programs. South Asian population is
  very large in Birmingham but an important
  limitation to the implementation of these
  effective education programs is the challenge of
  targeting difficult to reach population.
• Patients involved
• SA patients with mild, moderate and
  moderate-severe HF.
• Potential benefits
• Increase in rate of enrolment of SA patients with
  HF in education programs
• Increase the rate of completion of education
  programs
• Reduce the number of drop-outs from education
  programs
• Increase the confidence in management of the
  disease and overall patient satisfaction
• Long-term reduction of hospital admissions
  through improvement of clinical outcomes (disease
  management and progression)

• Levers for shift to be tested
• Segmentation program specifically targeting a
  high risk culturally sensitive patient population
• Integration joint enrolment effort by nurses,
  GPs and community leaders
• Proposed measures
• Size of target population
• Increased number of patients interested in the
  course and increased waiting lists
• Increase in number of patients attending and
  completing the programme
• Increased confidence and satisfaction by patients
  and carers
• Cost-benefit modelling extrapolating in a
  mid-term or long-term scenario to evaluate
  potential benefits in terms of avoidance of
  admissions.
• Project team
• Project Lead Karen Naylor
• Programme Manager Janine Ginn
• Timetable
• Early July sign off of charters and measures
• End July - finalise design and plan for field
  testing and sign off of all the data and metrics
  to be measured
• August programme and intervention design

3
Can integrated early care in a pain clinic
improve management and satisfaction of Low Back
Pain patients?

• Problem statement
• The provision of pain management is unevenly
  distributed across this health economy. The lack
  of a multidisciplinary team in Primary care
  results in patients receiving fragmented and
  inconsistent care. Research evidence supports the
  need for assessment treatment by doctors,
  physiotherapists, clinical psychologists, and
  clinical nurse specialists.
• Patients involved
• Patients with low back pain as a primary
  diagnosis.
• Potential benefits
• A one stop shop enabling patients to see
  several health professionals in a single visit
  will reduce the need for multiple out patient
  appointments.
• The development of an agreed treatment plan early
  in the patient journey will result in the patient
  seeing fewer and more appropriate secondary care
  specialists.
• Patients not requiring high level intervention
  will be managed in Primary care.
• Consistent early advice/ intervention should
  result in earlier return to work impacting on
  DHSS ( unemployment incapacity benefits) and
  the high total cost to GDP of back pain ( 11
  billion in 2003 Van de Houltard)
• Patients satisfaction with the service provision
  will increase

• Levers for shift to be tested
• Integration joint enrolment effort by all health
  professionals involved in low back pain
  management
• Simplification from a journey that involves
  multiple referrals and intereferrals to a
  one-stop shop
• Substitution of acute services for community
  services
• Proposed measures
• Reduction in number of visits, referrals and
  intereferrals
• Earlier diagnosis and treatment for patients
• Decreased waiting times
• Increased patient satisfaction with management
• Savings for the NHS (extrapolation)
• Cost-benefit analysis (extrapolation)
• Project team
• Project Lead Eve Jenner
• Project Champion Barbara Hoggart
• Programme Manager Janine Ginn
• Timetable

4
Can urinary continence in women be appropriately
managed in the community so that early and
effective more efficient treatment is provided?

• Problem statement
• There is a need for a co-ordinated, comprehensive
  fully integrated continence service across the
  whole health economy
• 2.5 4 million with urinary incontinence (RCP
  1995) (Under reported)
• 42 of women over 18yrs of age in UK have urinary
  incontinence.
• Women with stress incontinence wait an average of
  4 years before going to their GP to admit to a
  problem.
• Within Birmingham East and North there is
  currently no integrated journey for continence
  management, resulting in a fragmented service for
  our patients. There are multiple referrals to
  multiple health professionals across the area,
  resulting in complex journeys and confusion for
  the patient.
• Patients involved
• Women over 40 diagnosed with urinary
  incontinence.
• Potential benefits
• Simplify the patient journey that leads to
  earlier treatment
• Reduce the resource use associated with disease
  management by reducing the number of referrals

• Levers for shift to be tested
• Segmentation program specifically targeting
  women over 40 years old diagnosed with urinary
  continence
• Simplification more simple patient journey
• Substitution management of most patients in the
  community
• Proposed measures
• Reduction in the number of out patient referrals
  to urology / gynaecology and inter-referrals
  (reduction in the hand offs between health
  professionals during the patients journey)
• Improved times from symptoms to diagnosis and
  diagnosis to treatment.
• Increased use of the triage service
• Cost-benefit modelling
• Project team
• Project Lead Annette Woodward
• Programme Manager Janine Ginn
• Timetable
• End July sign off of charters and measures
• Mid August - finalise design and plan for field
  testing and sign off of all the data and metrics
  to be measured and collection of baseline data
• September enrolment