INTEGRATED CAR E SYS TEMS
operations and some other planned operations taking place at Sunderland Royal Hospitals. Plans also include the development of a new state-of-the-art integrated diagnostic and imaging centre at South Tyneside District Hospital. With workforce a perennial issue in the NHS, Trusts will have to increasingly rely on data and technology to make best use of staffing resources.
Waiting lists in Wakefield In the eight months analysed by the MTG, Wakefield CCG had the highest number of completed pathways in seven of them. This is, in large part, thanks to the creation of a Shared Referral Pathway (SRP) in July 2020, which was implemented across the Mid Yorkshire Hospitals NHS Trust. The SRP was created through open collaboration between primary and secondary care using SystmOne software which gives GPs and secondary care clinicians greater choice and control over a patient’s pathway, allowing commissioners and providers to work closely together to support the patient and ensure that a timely intervention was achievable and consistent. The benefits of the SRP are already being seen in cardiology – with a 30% overall increase in secondary care support to patients compared to the year before. The number of GP routine referrals to secondary care also reduced by 60% while the number of eConsultations rose by 50% relative to the same months in 2019.
Overall access to care has increased while the number of patients that need to be seen in a traditional outpatient appointment setting in secondary care has reduced.
Cardiology in Halton and Warrington In Halton and Warrington, severely ill heart patients are provided with world class care in the Acute Cardiac Care Unit (ACCU), where eight beds of the high care area of the ACCU are equipped with state-of-the-art monitoring equipment. There is also access to a designated area to undertake emergency procedures, such as temporary pacemakers for acutely ill patients, along with other
NOVEMBER 2022
complex and invasive procedures. The high care area of the ACCU also provides the surveillance of telemetry channels to monitor up to eight patients chosen to wear a portable monitoring device and have their cardiac rhythm and heart rate transmitted. This data is interpreted by specially trained telemetry nurses within high care, where an electronic report is generated and provided for the medical staff. Much of this innovation is testament to the five-year Cardiovascular Disease (CVD) programme which has been working with the HCP and Innovation Agency to adopt additional initiatives. This board has led on the development of clinical pathways in line with the Long Term Plan priorities and shows that, while the sharing of best practice is important nationally, the new Integrated Care Systems can also learn from the high performing component CCGs they are now made up of.
Innovation forged through crisis? The transition to ICSs has come amidst the health service’s worst ever crisis. Yet MTG’s latest report shows that there are regions that are succeeding against the odds, which are providing commissioners and those who sit on Integrated Care Boards (ICBs) with working examples of best practice in the NHS. If any positives are to be drawn from the COVID-19 pandemic, it is that staff shortages, chronic pressure on services and growing waiting lists have, in many instances, forced our health service to be innovative in order to survive. It is now up to the Government, NHS England and local service providers to ensure that post pandemic and into the future, these instances of best practice are rolled out to those regions that need them most. Some have been years in the making,
and rely on local expertise of systems and procedures, but meaningful intervention for persistently struggling regions can be based on the best practice examples of the effective utilisation of data, the integration of primary and secondary care and the use of innovative medical technology.
Tackling challenges We often speak of NHS struggles as almost beyond the control of local NHS decision makers, but we can restore a degree of agency to those regions struggling if we remain committed to using the best of our health service to raise standards and provide every patient the world class quality of care the NHS is capable of delivering.
CSJ
About the author
Barbara Harpham is chair of the Medical Technology Group (
www.mtg.org. uk), a not-for-profit coalition of patient groups, research charities and medical device manufacturers working together to improve patient access to effective medical technologies.
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