Choice – 6 Steps, 6 Actions, 6 Weeks
C
H
O
I
C
E
• Step 1 – Conduct self assessment / baseline exercise of current position
• Step 2 – Highlight and communicate aims and goals
• Step 3 – Obtain training and resource pack
• Step 4 – Initiate 6 Actions
• Step 5 – Collect evidence
• Step 6 – Evaluate progress and review wider options and longer term plans
1
Consider
Current
Position
Highlight
Aims and
Goals
Obtain
Training/
Support
package
Initiate
6 Actions
Collect
Evidence and
sources of
assurance
Evaluate
Impact /
agree next
steps
1) Patients aware
of their Choices
What is the
current level of
awareness ?
Set awareness
goal (Minimum
standard 1)
Patient
Awareness
Pack
1.1 to 1.6
eRS survey data
about levels of
awareness
Improved
Patient
experience and
Patient
Activation Scores
2) GPs
Aware and want to
support Choice
What is the
current
utilisation of
eRS ?
Set
engagement
goal
GP Awareness
Pack
2.1 to 2.6
eRS utilisation data
Reduced levels
of referrals and
DNAs
3) Information
for
Shared Decision
Making
What
information is
currently
available ?
Set shared
decision
making goal
(Minimum
standard 2)
Choice
Information
Bank and GP
Training Pack
3.1 to 3.6
eRS survey data
about shared
decision making
Improved RTT
and reduced
referrals
4) Build Choice
into
Contracting and
Commissioning
Plans
What do
current plans
say about
choice ?
Set
commissioning
goals
(Minimum
standards 3,4
and 5)
CCG Training
Pack
4.1.to 4.6
Changes in
contracting and
commissioning
plans and intentions
Improved levels
of supported self
management
5) Choice
embedded within
referral models,
protocols and
clinical pathways
Baseline
current services
and referral
patterns
Set RTT goals
(Minimum
standards
6,7,8, and 9)
Demand
Management
Guides
5.1 to 5.6
eRS referral data
Reductions in
demand and
improved RTT
performance
6) CCG Assurance
systems are in
place for choice
What systems
are already in
place ?
Set increased
level of
assurance goals
Choice
Assurance Pack
6.1 to 6.6
CCG Internal Audit
and statements of
internal assurance
Has Controls
Assurance level
improved ?
6
STEPS
6
ENABLERS
1) Actions for raising Patient
awareness of Choice
1.1
Draft Patient Choice policy statement (good practice version available)
1.2
Creation of Patient Awareness Pack ( using editable materials provided for
use in clinics, surgeries and practice websites)
1.3
Obtain CCG Board support of policy and approach – (draft board paper
provided)
1.4
Distribute Patient Awareness Packs to GP surgeries – using materials
created in 1.2 above
1.5
Distribute Patient Awareness Pack to patient groups and other partners –
using above materials (see suggested distribution list)
1.6
Conduct social media campaign / local awareness events to promote
Patient Awareness Pack
2) Actions for raising GP / referrers
awareness and use of Choice
2.1
Identify CCG GP lead ( Choice Champion ?)
2.2
Present ‘choice benefits and opportunities paper’ to local GP network
meeting (draft paper to be provided)
2.3
Prepare GP Awareness Pack (including links to enhanced use of eRS, latest
Directory of Services (including which one require approval), Shared
Decision Making, and navigator programmes)
2.4
Test and refine GP Awareness Pack
2.5
Approval / sign off of GP Awareness Pack
2.6
Distribute GP Awareness Pack to all GP Practices
3) Actions for providing relevant
Information for choice and shared
decision making
3.1
Ensure NHS Choices and eRS DOS are up to date with local provider
services and notify GPs of any change of providers or services
3.2
Creation of Choice Information Bank – (pre populated template provided
linked to NHS Choices / Patient.co.uk and local provider websites and
including what choices are available by specialty)
3.3
Sign off / approval of Choice Information Bank
3.4
Roll out to GP Shared Decision Making Training Packs
3.5
Creation of Choice Information Bank in multiple formats
3.6
Distribution / Launch of Choice Information Bank
4) Actions for building Choice into
Commissioning plans
CCG Training Pack covering…
4.1
Assess availability of choice (by specialty ?)
4.2
Analysis of changes in referral patterns
4.3
Investigate any changes in referral patterns
4.4
Identify capacity gaps in provider landscape where patients would benefit
4.5
Address gaps by decommissioning and recommissioning as appropriate
4.6
Establish Advice and Guidance services from named consultants for
mental and inclusion of mental health care referrals on to e-RS
5) Actions to embed Choice into
referral models, protocols and Clinical
Pathways
With focus on Demand Management and RTT performance
5.1
Identify elective demand pressure points and red / green RTT providers
5.2
Assess and quantify ‘smoothing’ opportunities for targeted services
including Independent Sector
5.3
Contact relevant GP practices /referrers and providers and review accuracy
of relevant Directory of Services (eRS DOS) for relevant services
5.4
Provide Demand Management Guides and training for GPs
5.5
Provide Demand Management Guides and Training to Referral
Management Centres where appropriate
5.6
Switch on eRS capacity flags (in agreement with RCO team)
6) Actions for assuring and enforcing
Choice
Supported by Choice Assurance Pack
6.1
Identify individual who has lead responsibility for choice on CCG
Governing Body
6.2
Monthly board reporting of eRS utilisation and availability of appointments
(automated feed)
6.3
Add choice as a standard agenda item for contract management meetings
6.4
Report patient awareness of choice on CCG website (provided routinely as
eRS survey extract)
6.5
Review NHS Improvement investigation reports relating to Choice (relevant
copies provided)
6.6
Publish legal rights to Choice on CCG website
Personalisation and the
Future of Primary Care
• Better
– Access
– Information
– Integration
• More
– Control
– Convenience
– GP contact time
• Less
–
–
–
–
Appointments required
Waiting time
£££ on acute and urgent care
Disruption and inconvenience for patients
Personalisation and Choice in
Primary Care
1
Front of House Choices- Improved signposting and navigation- using
standardised GP Practice websites with link to community health services,
social prescribing and self care support
2
Personalised Planning and Scheduling – Booking appointments, ordering
prescriptions , access to medical records +test results and person centred
care planning / IPC personal health budgets
3
Convenient Access- Multiple forms of access and new consultation types
(video /email/instant messaging / translation services) available any time
and any place
4
Shared Decision Making and Choice of Referral - Directories of Services /
eRS / Capacity Flags / Advice and Guidance Services / Social Prescribing
5
Consent and Control - of personal information and shared health records
6
Offline Choices - when the human touch is needed - eg Pharmacy First
Patient Choice and GP Access
•
•
•
•
38% would like appointments before 8am
76% would like appointments after 6.30pm
79% would like appointments on a Saturday
50% can not access an appointment on the
day they wanted