Perfect Patient Pathway Sheffield City Region Test Bed Programme www.ppptestbed.nhs.uk @Perfect_Pathway #PerfectPathway
Objectives 1. Provide an ongoing platform for testing, refining and scaling-up innovations. 2. Re-design pathways, bringing combinatorial technologies and system transformations to support holistic and personalised care. 3. Embed the culture of transformation and improvement in NHS and other health and care organisations. 4. Support co-ordinated decision-making across health and care, informed by real-time data and predictive analytics. 5. Evaluate the combination of new technologies and service re-designs producing robust and objective results that can be shared and disseminated .
Evaluation Methodology Clinical Benefits Product Technology environment Value proposition Usability Service redesign Baseline Validated Security Change Data collection unmet need management Regulatory Logic model Readiness compliance Ethics approval Effectiveness (medical devices, Access to market Consent form Economic analysis IG) Competitors Information sheets Programme theory Quality standards User requirements Recruitment Scalability strategy Synergies Lab testing (other products, Public involvement programmes, Deployment Clinical champions projects...) requirements Deployment plan
Strategic decision support Intelligence Centre Vision Risk Vigilance analysis Patient empowerment Alerts Self-management Data System integration Care Patient primary care secondary care social care mental health community care Group support A model supporting holistic and personalised care for people across England to support both physical and mental health needs
Programme Areas of Testing CareTRx Programme: Adherence to asthma medication People who use insulin to manage their diabetes Falls prevention Falls prevention
Programme Areas of Testing Digital Care Home Project Monitoring vital signs to support remote decision making
Progress to Date • To date, we have recruited or provided a technology-related assessment for 446 patients across all on-going projects. • Deployed devices within 483 patient- participants’ households or related care home. • 11000 care records analysed through analytics to inform project areas. • Through our digital monitoring platform within care homes, as at Jan 2018 we have managed to address 135 ‘alerts’ without escalation to A&E through support provided by Sheffield’s Single Point of Access (SPA) service and further GP support. • The evaluation of these intervention-based projects is on-going with the final report in July 2018 • Link with Long Term Conditions Board – building the business case across the ACP to support digitisation of care homes • Part of Digital workstream of the ICS
Key Programme Learning to Date • Agile programme design and implementation : adapted and changed scope on all the projects to fit the changing needs and commitment of stakeholders and organisational readiness. • Real world testing : started with problem areas and testing with pathways, not isolated service elements. • Methodology : developed approaches from problem identification through to testing and evaluation framework that can be replicated • Wide Stakeholder Engagement: currently engaged with over 1000 people through the programme: primary care, secondary care, community services, care homes, universities, charities, voluntary sector, private sector partners, commercial and non commercial across systems • Patient Involvemen t: been real strength in the programme and gained valuable insight and input from patient groups. Changed approaches and materials as a result of feedback. 69 participants in the PPI group. • Alignment with Integrated Care System : developing alignment with digital workstream and building legacy 8
Key Programme Learning to Date • Service evaluation : very challenging to evaluate when the parameters change, scale and scope change. • Innovation/product lifecycles : pace of innovation can mean testing products that will be overtaken by next version/generation of products • Failing forwards : important element of learning cycle and to be recognised as part of the process, testing is vital in any product/service development • Patient Recruitment Variables : o Innovator capacity and readiness- this has caused delays and limited the patient cohorts from the original plans Patient readiness – people with long term conditions are in different stages of behaviour o change to try different approaches to greater self management o Capacity of the staff and time available- there are so many initiatives in place across all the pathway areas and staff have limited time to adopt and support new projects Impact on the evaluation approach – any service/recruitment changes need to be o discussed and agreed with the evaluation team if there is an impact on the methodology o Interdependencies with other teams/staff- i.e. Falls team has limited capacity to meet additional demand and revise the service model, SPA team capacity, community nursing team capacity for the Digital Care Home project. 9
Next Steps • Evaluation of Wave 1 July 2018 • Bid for Wave 1.5 March 2018 – recommendation for local adoption Aligns with ACP LTC Board – need to build the case with CCG Care Home Outcomes project for the business case • Wave 2 EOI April 2018 – bid to be submitted June 20 th with start date of 1 st Oct 2018 if successful. 156 NHS sites applied 256 Innovators applied 3 or 4 Test Beds nationally • Developing as part of the ICS • Strategy for Innovation for the Sheffield region
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