Communicating across care settings in Western Cheshire

Alcohol misuse is one of the biggest challenges facing NHS Western Cheshire with around 6,000 people across the region dependent on alcohol. There were 4,650 alcohol related admissions to hospital in 2007-2008, and alcohol misuse currently costs the Trust over £9.2 million per year. 

NHS Western Cheshire have implemented the first online Alcohol Care Pathway, combining screening, prevention, primary care and specialist treatment services in a multidisciplinary care pathway. The Pathway has increased partnership working, enhanced communications, and acted as a catalyst for the commissioning of new and innovative services across the local health community (LHC).

Role of Map of Medicine

NHS Western Cheshire aims to reduce the increase in alcohol related admissions by 2.25% per year, reducing the impact of alcohol related harm across health and social care and the wider community. NHS Western Cheshire developed a localised Alcohol Care Pathway to underpin commissioning, the achievement of targets and the development of the public health and prevention agenda.

The deployment of the Map of Medicine across the LHC is a key enabler in helping to achieve the benefits of information technology and online care pathways.

Milestones

• The Western Cheshire Alcohol Care Pathway was designed using the national models of care for alcohol mis-users, evidence, case studies and clinical input from the local GP Network.
• The background work undertaken to develop the pathway highlighted a number of areas where delivery and services could be improved.
• The launch of the new alcohol pathway, which covers all four tiers of services offered, was used to introduce alcohol screening advice across the local health care community and embedded it into A&E and community sexual health services.

Challenges

• Developing a consensus on a pathway from a wide range of stakeholders including GPs, public health, Cheshire Joint Alcohol Commissioning Group, Western Cheshire Community Care and Cheshire & Wirral Partnership NHS Foundation Trust.
• The development and introduction of screening advice within GP practices, A&E and Sexual Health Service.

Results

The Pathway has led to the development and introduction of a locally enhanced service for GP practices and the redesign of one tier of services to include GP liaison workers. The Commissioning for Quality and Innovation (CQUIN) system was used to embed alcohol screening advice into A&E and community sexual health services.

The Pathway and resulting engagement with clinicians has led to improved communication across the LHC. Parts of the Alcohol Misuse service are still under development, but the Map of Medicine will allow the Trust to communicate any future changes rapidly across a wide range of partner organisations.

The Pathway is improving the consistency and quality of interventions and services aimed at people with alcohol problems across Western Cheshire.