GLOUCESTERSHIRE JOINT CLINICAL COMMISSIONING GROUP AND NEUROLOGICAL ALLIANCE
ACTION PLAN – March 2014 – Issue 7
This action plan has been developed following the Neurological Commissioning Support audits and reviews of neurological services
(phase 1 and 2) in the county which was undertaken in 2010 and 2012 respectively. It is based on the recommendations included in the
reports following the reviews.
COLOUR CODING:
Red = Little or no progress yet
Recommendation
Orange = Some progress, issues outstanding
Green = Satisfactory progress
Update
Role for GlosNA
Timescale
1
Provision of Information
a
Ensure copies of out and in-patient
letters are sent to patients.
Gloucestershire Hospitals NHS Trust have
posters at their sites offering information to
patients who request it.
Audit the provision of information to
Neurology patients.
See note 1 below
2014-15
b
Produce an information booklet for
people diagnosed with a neurological
condition answering key questions in
relation to access to services in
Gloucestershire.
Booklet produced and being distributed.
Still issues around distribution.
Investigate outlets for distribution, GP
practices etc. Look at areas to update in
booklet, check links and update where
appropriate.
2014-15
2
Integrated Care Plans and Pathways
a
Development of integrated care
pathways to support patient information
This work continues alongside the
development of the Integrated Care Teams
(ICTs) Teams operating in Gloucester
since January. Planning to launch in
Cheltenham in May, countywide by end of
2014.
Represent views of people with
neurological condition to ICTs
Developing
during 2014
b
Ensure there are integrated care plans
for all individuals living with a
neurological condition and their carers
This links to the development of Integrated
Care Teams.
See note 2 below.
c
Clarity around continuing care needs to
be established and included in care
pathway
Training for GPs is available around
continuing health care. Potential for
Personal Health budgets to be used.
Promote the use of PHBs, link with
charities to increase uptake in
Gloucestershire.
d
Ensure key worker system is
operational across all neurological
conditions
Linked to identification of need and risk
stratification. Being developed across
range of conditions and rolling out in 2014.
Monitor system impact on people with a
neurological condition.
1
Developing
during 2014
Recommendation
Update
Role for GlosNA
Timescale
e
Develop a single point of access for
those with a neurological condition for
signposting/advice
Will be included in GP contract for 2014-15
and rolled out across Gloucestershire.
f
Ensure that people with neurological
conditions should be identified in GP
practice registers.
Coverage varies by condition. Links to risk
stratification. Specific codes for conditions
to be recorded e.g. Parkinson’s.
Promote recording of neurological
conditions on registers with practice
managers.
Ongoing
g
Develop a communication pathway
around community hospitals transfers.
Links to pathway work and Integrated
Community Teams. Aiming to ensure rapid
and effective discharge planning across
conditions.
Monitor and feedback views of people
with neurological conditions
h
Establish a formal process for
repatriation and patient transfers to stop
people falling through the net.
Protocols in place linked to conditions.
Monitor cases and raise issues.
Ongoing
3
Commissioning Services – Respite Care and Carers
a
Explore age appropriate day-residential
care within statutory funding
Scope to use Personal Health Budgets
(PHBs) where appropriate.
Promote awareness of PHBs
2014-15
b
Explore joint commissioning
arrangements with local authority to
access respite provision within statutory
funding.
Third sector provision being explored,
provided by voluntary sector.
c
Focus on information in respect of
respite for carers, carers’ grants and
carers’ assessments.
d
Ensure that carers are informed of their
right to a carer’s assessment and
encourage them to ask for this.
e
Explore the provision of carers
counselling and support services
4
Wheelchair Provision
a
Map problems with wheelchair services
and work with the wheelchair service
providers to ensure the services
provided to people with neurological
conditions are delivered effectively.
Link with Carers Gloucestershire to
publicise GlosNA within Carers
newsletter
Carers now have a legal right to an
assessment of their needs. These are
carried out by Carers Gloucestershire. Data
on carers assessments now being
recorded by Carers Glos
Monitor and raise concerns of carers
Issues raised at Jan meeting of GlosNA.
New manager looking at wheelchair service
contract, Hannah Williams.
Collect and raise issues from members
around quality with the commissioner.
See note 3 below.
2
Ongoing
Recommendation
Update
Role for GlosNA
Timescale
Placements available related to need
Monitor and raise issues in relation to
placements. Link with charities to gather
information.
Ongoing
Contribute to review of service. Raise
issues which come up.
System to be
reviewed
after 6
months
The introduction of Advice and Guidance
will assist this process, also risk
stratification.
Link to surgery patient participation fora
or locality groups.
Ongoing
Wide range of activities available in
community which can be accessed by
people with neurological conditions.
Falls prevention classes available which
can contribute to improved postural
stability.
Help to promote availability of classes.
See note 4 below.
5
Rarer Neurological conditions
a
Explore joint commissioning
arrangements cross-border to
commission services for those living with
rarer conditions such as Huntington’s
6
IT System Opportunities
a
Explore IT systems which could
supplement current services to patients
and provide professional advice to GPs.
Advice and Guidance from the Choose and
Book system for Neurology introduced from
1st Nov. gives GPs access to expert advice
from consultants. First 3 months data
shows slightly increased usage, majority of
cases dealt with by GP with advice.
b
Improve the system to manage follow-up
appointments more efficiently.
Investigate good practice in other areas.
Scope to reduce the number of follow-up
appointments where appropriate.
c
Seek reduction in waiting times to see
consultants.
Advice and guidance aims to reduce the
number of referrals to consultants, so far,
from small initial numbers, this is the case.
7
Training
a
Ensure GPs and frontline staff are fully
trained in the recognition of neurological
symptoms. Develop a training strategy
and co-ordinate the training of generic
professionals and GPs in partnership
with neurologists and the key local
stakeholders including service users and
carers
8
Rehabilitation
a
Look at developing assistive exercise for
on-going rehabilitation.
3
Recommendation
Update
Role for GlosNA
b
Ensure that people with a long-term
neurological condition have access to
psychology services.
Improving Access to Psychological
Therapies (IAPT) programme available to
people with a neurological condition,
available through 2gether trust.
Help to promote services through
membership and links to charities.
Raise issues.
c
Develop, through agencies, the
provision of vocational rehabilitation
Headway reablement project providing
support and being evaluated to inform
future commissioning models.
9
Transport
a
Contribute to the county-wide review of
transport services and ensure the views
of patients with a neurological condition
are effectively represented to the review
body.
GCC reviewing transport. CCG let
community transport contract to Arriva.
Timescale
Ensure links maintained with GCC.
Promote community transport and raise
issues.
Notes
1
It was suggested that Heather Beer, Head of Patient Experience, should be invited to a future meeting at Gloucestershire Hospitals Trust to talk
about this issue.
2
The issue of people arriving to assist a person receiving care in their own home was raised as a new issue. In this situation it can be difficult
sometimes to establish the name of the care provider, although often there is associated paperwork in the house to identify the provider. Philip
Jones – Joint Commissioning Manager, will be invited to the next meeting to talk further about ICTs.
3
If a person doesn't qualify for funding for a wheelchair he or she is not even able to access advice about how to obtain one and the types of chairs
available. Hannah Williams is the new contact for the wheelchair contract and will be reviewing the contract during 2014 so will be discussing issues
with GlosNA and other interested parties. She spoke about the facility to obtain top up funding from the Barnwood House Trust.
4
In certain areas, e.g. Bristol, funding is provided by local Parkinson’s UK and MS Society groups for specialist exercise courses (including falls
prevention).
4