Introducing the New Community Anticoagulation Service Kwame Amankwa Croydon Clinical Commissioning Group Project Lead
Community Anticoagulation Patient and Public Engagement Event 13 th November 2015 Time 2pm – 4pm Old Coulsdon Congregational Church 336 Coulsdon Road Old Coulsdon, Surrey CR5 1EH
Agenda 2.00 – 2.15pm Sign in; refreshments 2.15 – 2.30pm Welcome & Introductions Presentation: Overview of community anticoagulation services & what will the new service look like? Kwame Amankwa, CCCG Pathway Redesign Manager 2.30 – 2.40pm & Shirley Walker, Anticoagulation Service Manager Questions and answers (Open session) 2.40 – 3.30pm 3.30- 4.00pm Close
Housekeeping
Introducing the New Community Anticoagulation Service... Government’s healthcare reforms - the health service is changing The Health and Social Care Act 2012 Expected Outcomes : 1. Improved health service for the benefit of all patients and the wider community through; • Continuous quality improvement in services • Reducing inequalities • Enabling choice and • Encouraging patient involvement in healthcare. 2. An integrated health system 3. Drive towards managing patients in the community 4. Better, nearer, sooner and more convenient
Why did we want to do it differently in Croydon?
The Community Anticoagulation Services – The History In 2008 Croydon Primary Care Trust (PCT), as part of its local community development strategy, tendered for a community service for the M onitoring of AF patients on anti-coagulant therapy. The aim - To provide monitoring for patients more locally & to reduce pressure on a busy hospital-based service. 4 community providers (two GP practices and two community pharmacies) were successful in being awarded this tender . They were: Selsdon Park Medical Centre Parchmore Medical Centre; A-Z Pharmacy Fishers Chemists CUH managed the complex cases .
The Community Anticoagulation Services – Review • Generally there were issues – longer waiting times, lack of a uniformed provision and lack of flexibility among others. • In 2014 the existing contract with the providers was coming to an end. In line with NHS NHS Procurement and Competition Rules the contracts could not be rolled over and was reviewed. • The Croydon CCG re-tendered the service to commission a service that provided warfarin initiation and on-going monitoring for stable AF patients. • Few of the incumbent providers wanted to continue providing the anticoagulation service.
Introducing the New Community Anticoagulation Service... • Following a robust procurement process in 2014, the CCG awarded Boots UK Limited the contract to deliver community anticoagulation services across the six GP network locations. • The new service commenced on 1 st April 2015 in a phased implementation approach. • The Old Coulsdon Services will transfer to Boots from the 23 rd November 2015.
What are the anticipated benefits of the new service to patients? Flexibility – 7 days extended cover & 1. longer opening hours 2. Choice of clinic A “one - stop shop” service 3. 4. An Advice Helpline with a pharmacist at the end of the line 5. Access to a Croydon University Hospital Consultant Haematologist. 6. The services will be delivered to the Standard NHS Contract & Service specification.
Working together in partnership Shirley Walker, Boots Anticoagulation Service Manager Sabina Daboo, Boots Clinical Lead
Introducing the New Community Anticoagulation Service... • Introduction • Boots previous experience in anticoagulation • The new Croydon Community Anticoagulation Service • Locations and clinics • Transition Arrangements
What else are patients telling us? Excellent - resulting in me having my eye It’s very useful for the pharmacist to be on tests carried out at Boots Bromley. Look hand to answer any questions about forward to further services being current medication that has been established prescribed To be able to speak to the Pharmacist Can't find fault with your and get results immediately is so service, being able to go to a convenient. V happy with service Boots of choice makes life easier. Well done Boots “Super speedy service. I've never waited more than 5 minutes as opposed to an hour and three quarters at the hospital. Easy to contact. People know what they are talking about. Information gets passed on. I rang the helpline and they knew all about it at my next appointment. I would highly recommend the service to other Warfarin patients.”
What will Boots provide in Croydon? • Initiation of Warfarin for newly diagnosed AF patients • Transfer & ongoing maintenance of stable AF patients • A service run and managed by a team of dedicated anticoagulation pharmacists supported by a clinical lead pharmacist at the Bromley hub • Access to a consultant haematologist for anticoagulation pharmacists in an advisory capacity Changing NHS • Flexibility for patients to move between sites • Initially matching all current clinics with an opportunity to grow in response to patient need
Proposed Clinic Days and Locations Boots Croydon Anticoagulation Service Clinic Days MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY AM Addiscombe Road Parchmore Addiscombe Coulsdon Parchmore tbc Purley Whitgift Whitgift Purley (9/11) Valley Park Coulsdon(from 7/12) New addington(11/11) PM Addiscombe Road Parchmore Addiscombe Purley Parchmore tbc Purley(from7/12) Whitgift(23/11) New addington Coulsdon(9/11) Coulsdon tbc Number of Clinics 3 from 7/12 2 3 from 9/11 2(from 9/11) 2 1(tbc)
Proposed Patient Transition timeline March April May June July August Sept October November December CCG Letter/Patient Engagment/ Patient Parchmore Transfer Go Live Patient Engagment Fishers CCG Patient /Patient Pharmacy Letter Transfer Go Live Patient Engagment CCG Patient /Patient A-Z Pharmacy Letter Transfer Go Live CCG Letter/Patient Engagment/ Patient Parkway HC Transfer Go Live CCG Letter/Patient Engagment/P atient Old Coulsdon Transfer/Go MP Live CCG Letter/Patient Engagment/ Selsdon Park Patient MP Transfer Go Live
BOOTS UK LTD ANTICOAGULATION HUB CONTACT NUMBER 0208 466 5372
Some patients questions from our previous events & our responses Q: How will we know what is going to happen after the 23rd November 2015? Who will tell us about our next appointment? A: All existing appointments before the 23 rd November will stay the same. The new provider (Boots) has worked with the existing provider to transfer all the existing patient data onto their data system. Very shortly, starting from tomorrow, all patients will be contacted and given information about the changeover. Patients who have existing appointments after the 9 Nov will be offered an appointment as close to the time and date of that appointment, where possible.
Some patients questions from our previous events & our responses Q: At the current clinic we have a waiting room big enough for about 8 or 9 people. Older people often like to come early, well before their appointments, so they can sit and chat and sit in the waiting room for quite a long time. Where are they going to sit in that tiny Boots store, there’s no room? A: We will have a very small waiting area but will have room for a couple of chairs. Most of the appointments will be very quick, about 10 minutes in total, so we don’t anticipate that people will have a long wait. But we don’t want people to feel that they have to arrive too early ahead of their appointment, if they arrive on time for their appointment we won’t have too much of a queue.
Some patients questions from our previous events & our responses Q: Why have you changed a service we are happy with? We get respect at the Parkway clinic. Parkway is a great service, why change it? Is this just about money? A: The CCG is legally obligated to put services out for tender when a contract with a provider ends. There are circumstances where contracts can be extended; however, the procurement of services is a process that the CCG must follow. Under the rules all current providers can bid as well as new potential providers. The bids are assessed against a whole range of criteria. We also want to take into account the hours and days that a service can be available to patients in the future. This may include evenings and weekends and is important for patient choice. The service specification included a requirement for later openings and weekend clinics and more sites. The existing providers did not meet the requirements. Since 2008 there has been a move towards locating more services within the Community to try to improve patient access.
Some patients questions from our previous events & our responses Q: When I had to go in to hospital for an operation my Warfarin was stopped and I had to go to St Georges Hospital for the treatment, which was an injection. Will Boots be able to supply this service ibn the future? A: Boots will not be able to provide the treatment if injections are required for the treatment. The patient will go back to University Hospital Croydon if that is the case. In the future if patients are about to have an operation but do not require injections Boots pharmacists will be able to help patients manage their warfarin.
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