supporting people in dorset to lead healthier lives commissioning the dorset community persistent...
TRANSCRIPT
Supporting people in Dorset to lead healthier lives
Commissioning theDorset Community Persistent
Pain Management Service
Why is it so Painful to Commission Pain Services?
18th December 2012Nichola Arathoon
Supporting people in Dorset to lead healthier lives
The Commissioning Cycle
Health Needs Assessment
Prioritisation and Workplan
Development
Current Service Review
Service Design and Planning
Securing the services
Contracting & Implementation
Manage Performance and Demand
Manage Quality and Outcomes
Supporting people in Dorset to lead healthier lives
• Secondary care delivered injection based service in three acute providers
• Long waits for repeat injections
• Patient complaints
• Press involvement
• Board of Governors
Background
Supporting people in Dorset to lead healthier lives
Service review Pan Dorset
•Complaints
•Pathway
•Activity
•Capacity
•Funding
Service Review
Supporting people in Dorset to lead healthier lives
•Best practice research
•Interventional Procedures in the Management of Spinal Pain Policy
•Multidisciplinary team triage of new patient referrals
•Post injection patient diary
•Increased funding for backlog patients on to new pathway
Service Redesign
Supporting people in Dorset to lead healthier lives
Service Specification for bio psychosocial model of pain management
•Dorset Clinical Commissioning Group•MSK Clinical commissioning Programme•Dorset Pain Society•Patient and carer involvement•Secondary care involvement•Primary care involvement•Education
Service Redesign
Supporting people in Dorset to lead healthier lives
ETHOS:To enable adults living with persistent pain (of at least 3 months duration with a definitive diagnosis, including Medically Unexplained Symptoms, and/or when the patient and GP agree and accept that the pain has become chronic) to understand and come to terms with their pain and to adopt strategies for living, which allow them to lead as fulfilling and independent lives as possible.
Dorset Community Persistent Pain Management Service
Supporting people in Dorset to lead healthier lives
To encompass:Primary care educationThe provision of supported self-care and optimised medical therapy delivery in Primary Care at the onset of pain and appropriate onward referral to the Community Pain Management Service
The clinical serviceThe provision of enhanced pain management treatments and strategies
Dorset Community Persistent Pain Management Service
Supporting people in Dorset to lead healthier lives
•To support GPs in enabling their patients to live with persistent pain•To work with and educate GPs to safely optimise the use of analgesia•To educate GPs in the benefits of self management tools and techniques including motivational interviewing, the Expert Patient Programme and the Pain toolkit•To identify and work with GPs with a Special Interest in persistent pain management•To refer patients to the community persistent pain management service in a timely manner
Primary Care Education
Supporting people in Dorset to lead healthier lives
•Community based•Locality provided•Single point of access•Multidisciplinary pain specialist team: Physiotherapist, Occupational therapist, Psychologist, Doctor and Nurse•Interdisciplinary working with Secondary Care clinicians, community health services, medicines management teams, community mental health teams, substance misuse teams, community matrons, return to work services and voluntary agencies
The Clinical Service
Supporting people in Dorset to lead healthier lives
•Triage of referral form•Individual assessment and screening in to appropriate support/treatment•Personal care plan with goal setting and review with key worker•Provision of cognitive and behavioural therapies with psychological support•1:1 and/or group pain management – health professional or peer led•Interventional therapy
The Clinical Service
Supporting people in Dorset to lead healthier lives
•Within groups
•Pain Chain/buddy
•Telephone help line
•Dorset Pain Society
•Peer led pain management courses
Peer Support
Supporting people in Dorset to lead healthier lives
Stakeholder engagement •Secondary care clinicians and managers•Primary care clinicians•Patients and public
Communication strategy•Current providers•Current patients•Media
Information and activity•From current service in to new service
Lessons learned
Supporting people in Dorset to lead healthier lives
The Commissioning Cycle
