Quick wins and good practice to meet the target

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Quick wins and good practice to meet the target
Paula Baraitser, Marie Kernec
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• Reasons for optimism
• Creativity and commitment at local level in
  difficult circumstances
• Senior engagement and resource availability as
  target bites
• Learning from everyones mistakes - towards good
  practice
• Additional support in place from the NCSP
  national team

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• Numbers and systems
• The challenge is huge and increasing
• Strategic planning for systems to deliver volume
• To meet the target will need to deliver on all
  fronts
• The future is embedding an expectation of annual
  screening among users and providers
• The developing role of the CSO

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• Quick wins and Best practice
• Sustainable screening in core clinical services
• Access those who do not use core services and
  stimulate demand through
• Website based testing
• Mail outs
• Social marketing
• Outreach

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CASH

• Challenge
• We are family planning
• Practical solutions
• Monitor footfall and give feedback
• All YP given a pack at reception
• Hearts and minds - this is the first step towards
  integrated SH service provision

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General Practice

• Challenges -
• Sexual health is not always a priority
• Reluctant to raise SH in non-SH consultation
• Solutions-
• LES
• Practical training
• Feedback/support
• Pop ups, reminders
• Involve whole team

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Community Pharmacy

• Opportunities
• High street/long hours/geographical coverage
• Challenges
• Low volume so far
• Solutions
• Performance manage against EHC provision
• Lots of training/support

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Mail outs and postal testing

• Opportunities
• Quick win
• Challenges
• Response rates
• Cost effectiveness
• Solutions
• Practical tips
• Link to the test of the screening programme

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• Generating best practice
• guidance
• Evaluation of key initiatives reported using
  standard form
• Grouped by themed
• Reviewed in conjunction with published evidence
• Best practice guidance, dated and under constant
  review on the website

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Generating effective contracting guidance

• Wide range of contracts and remunerations/incentiv
  es around England, without consistency among the
  different providers screening activity 1-15
  treatment PNM 10-over 100.
• Agree consistent remuneration frameworks across
  the sexual health economy.
• Use remuneration frameworks to engage all
  chlamydia screening providers.
• Highlight chlamydia screening activity and
  remuneration when hidden in block contracts.
• Tariff per screen associated to retrospective
  payments linked to targets for screening numbers
  seem most effective.

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Generating effective contracting guidance

• Remuneration specifications should not only focus
  on screening but relate to all elements of the
  pathway.
• Remuneration frameworks should ensure Chlamydia
  screening is integrated in Sexual Health.
• Ensure governance and remuneration frameworks are
  also in place for non-NCSP provision.
• Close collaboration work between commissioners
  and providers.
• Benchmark your remuneration frameworks against
  other PCTs, in order to ensure your contracted
  services show value for money and cost
  effectiveness.

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Generating effective contracting guidance
Calculate your local unit costs following a
clear, consistent and detailed pathway, to
support consistent local tariffs development to
be used across the health economy.
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Generating effective contracting guidance

• Limited published studies on effective unit costs
  for chlamydia screening
• Pilot study 2000
• Overall cost of screening per person tested,
  including treatment and PNM costs
• Portsmouth 46, Wirral 36
• Healthcare costs from several years ago, need
  inflationary review 25
• included incentives paid to GP/other providers
  (Portsmouth 17, Wirral 10)
• Adams et al 2004
• Average estimate for screened and not infected
  20
• Average estimate for screened and infected 31
• Average estimate for partner treatment 27
• Healthcare costs from several years ago, need
  inflationary review 12 testing and overheads
  costing need review
• Several local chlamydia screening costs studies
  on going

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Generating effective contracting guidance next
steps

• Finalise gathering and review of contracting
  specifications for chlamydia screening
• Database available on the NCSP website for
  information and benchmark
• Gather and review existing local costing studies
• Complementary field costing reviews
• Initial recommendations on remuneration April
  09

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Support from the NCSP Regional
Facilitators Mary.Macintosh_at_hpa.org.uk Paula_barai
tser_at_mac.com Marie.Kernec_at_hpa.org.uk