Type 1 diabetes London commissioning pack

This comprehensive commissioning pack aims to ensure excellent type 1 diabetes services for all Londoners. There are three parts:

• Service specification – Aimed at commissioners, this document details the care to be commissioned for adults with type 1 diabetes, including an overview of diabetes, elements of an excellent service plus commissioning recommendations.
• Clinical management: Optimal pathway – Aimed at providers, this document details the expected clinical care for type 1 diabetes.
• Implementation guide – This document provides the tools for both commissioners and providers to measure, analyse and develop improvement plans for their local diabetes service. It includes a summary of expectations and self assessments for commissioners and providers, performance targets and a sample patient reported outcome measures (PROM) form to collate patient feedback. It also highlights the type 1 care consultation tool (developed by Health Innovation Network and King’s Health Partners), which can be used in the management of people with type 1 diabetes.

Diabetes commissioning pack
London Clinical Networks
September 2016

Access the pack here.

Enhanced recovery programme in gynaecology

"We describe the successful implementation of an ERP in Southend Hospital resulting with no difference in measurable morbidity and mortality, a shorter length of stay, and a high patient satisfaction scores and outcomes."

Enhanced recovery programme in gynaecology: outcomes of a hysterectomy care pathway
D Mukhopadhyay
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u206142.w2524

Read more here.

Improving inpatient care with the introduction of a hip fracture pathway

"A system of payment by results exists for the management of hip fractures in England and Wales. Poor performance against the national standards was noted, reflecting failure to deliver optimal care. Through the introduction of a multi-disciplinary patient pathway and clerking pro forma, the proportion of patients earning the best practice tariff uplift increased from 44.4% to 91.7%. "

Improving inpatient care with the introduction of a hip fracture pathway
M Chamberlain, H Pugh
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u204075.w2786

Read more here.

Delivering High Value Care Pathways

"In this scenario we examine a typical long term condition pathway, comparing a sub-optimal but typical scenario against an ideal pathway. At each stage we have modelled the costs of care, both financial to the commissioner but also the impact and cost on the patient, family and their contribution to society. We show how the Right Care methodology can help clinicians and commissioners to improve the value of the care pathway."

Delivering High Value Care Pathways – Paul Adams – a commissioning scenario
A typical Long-Term Conditions story and how the NHS Right Care approach can help to achieve better value
NHS Right Care
August 2014

Read more here.

Urgent and planned care: operational resilience and capacity planning

"Guidance to support NHS healthcare providers and commissioners with their planning for operational resilience during 2014/15."

Urgent and planned care: operational resilience and capacity planning for 2014/15
Monitor, NHS England and NHS Trust Development Authority
June 2014

Read more here.

RCS commissioning guide: emergency general surgery

"Emergency General Surgery (EGS), and specifically acute abdominal pain, represents a huge inpatient burden of heterogenous diagnoses. Historically, the care of this group of patients has been underfunded and overlooked and there has been resultant variability in the quality of care provided." 

Commissioning guide: emergency general surgery (acute abdominal pain)
Royal College of Surgeons, Association of Surgeons of Great Britain and Ireland
April 2014

Read more here.

RCS commissioning guide: temporomandibular joint disorders

"The aim of this guidance is to provide clarity to commissioning organisations as to the services which should be available to patients with TMD. This guidance aims to address problems that have arisen in recent years with regard to over referral to secondary care of patients with simple problems that could be treated in the community and with others who suffer from a post code lottery with regard to funding of more complex procedures." 

Commissioning guide: temporomandibular joint disorders
Royal College of Surgeons
May 2014

Read more here.

Commissioning guide: weight assessment and management clinics

"This Tier 3 guidance describes the role of the referring GP, what should be achieved in the clinics and who should be referred for bariatric surgery. Given the lack of consistency in the provision of medical obesity services, this guidance should provide an organised structure and evidence-base for treatment"

Commissioning guide: weight assessment and management clinics (tier 3)
Royal College of Surgeons, British Obesity and Metabolic Surgery Society

March 2014

Read more here.

Joined up clinical pathways for obesity

"NHS England should in the medium term prioritise early consideration of the transfer of the majority of adult bariatric surgery to local commissioning, through CCGs, once they have been shown to be functioning well with sufficent volume of patients to justify de-specialising the service."

Report of the working group into: Joined up clinical pathways for obesity
Jamie Blackshaw, S Montel, S King, A Jarvis, J Valabhji
NHS England
March 2014

Read more here.

Improving patient flow across organisations and pathways

"This scan compiled research about the methods used to improve patient flow across organisations or pathways."

Improving patient flow across organisations and pathways
D de Silva
The Health Foundation
November 2013

Read more here.

Is the quality of care in England getting better?

"This paper is a summary of the first annual statement from the QualityWatch programme. It is not comprehensive but provides an overview of our initial research into the quality of publicly-funded health and social care services in England."

Is the quality of care in England getting better?
The Health Foundation, Nuffield Trust
October 2013

Read more here.

Care pathways across the primary-hospital care continuum

"Care pathways across the primary-hospital care continuum enhance the components of care coordination."

Care pathways across the primary-hospital care continuum: using the multi-level framework in explaining care coordination
S Van Houdt, J Heyrman, K Vanhaecht, W Sermeus, J De Lepeleire
BMC Health Services Research, 2013, 13:296

Read more here.

Managing multi-morbidity in practice

"Learning from those sites who responded to the survey suggests there is a need for multimorbid disease management templates and care pathways, and that integrated working with community teams, including pharmacists, can improve outcomes, with the potential to reduce overall consultation times, increase patient satisfaction, reduce polypharmacy and reduce hospital admissions."

Managing multi-morbidity in practice…what lessons can be learnt from the care of people with COPD and co-morbidities?

NHS Improvement
March 2013

Read more here.

How to measure for improving outcomes

The King's Fund has produced two slide sets to help Clinical Commissioning Groups make the best use of measurement to support them to commission for improved outcomes.

How to measure for improving outcomes: a guide for commissioners
The King's Fund
August 2012

Read more here.

Sustainability of healthcare improvement: what can we learn from learning theory?

"Clinicians and leaders shared information about their everyday work and related this knowledge to how the entire clinical pathway could be improved."

Sustainability of healthcare improvement: what can we learn from learning theory?
E Hovlid, O Bukve, K Haug, A Bjarne Aslaksen, C von Plessen
BMC Health Services Research, 2012, 12:235

Read more here.