Integrating healthcare communities

Dr Shyamal
Mukherjee

The recently-established Wirral Primary Care Trust identified early on that Map of Medicine provided opportunities for clinicians and managers to work together to tackle local issues and improve patient care.

The role for Map of Medicine

An audit revealed high levels of inappropriate referrals and unscheduled or emergency re-admissions with associated cost pressures. Patient needs were poorly communicated across the local healthcare community. The Trust also needed to reflect service organisation to meet the government’s 18 week referral-to-treatment target.

The Map & Commisioning: Dr Shyamal Mukherjee MBE & Cathy Gritzner (3:23)

The Trust decided to tackle clinical localisation of Pathways in up to three of its priority areas. Priority areas included trauma and orthopaedics, urology, ENT, palliative care, and COPD.

Milestones

• Establishing a designated project management resource − a working group with membership drawn from across the healthcare community
• Setting up a workstream within an overall programme designed to support the 18 week referral-to-treatment target
• Testing existing Map of Medicine pathways in various settings, then reviewing them for local relevance
• Localising pathways to deliver better patient outcomes and best practice

Challenges

• Achieving clinical engagement and manager involvement. Clinicians particularly needed reassurance that the Map tools are easy to use and will achieve quality outcomes
• Setting up a robust clinical governance process for the medico-legal responsibilities that come with localising pathways
• Obtaining human resources for creating and managing local Pathways, particularly the resources required for training on the Map Management Software

Results

Localised pathways have been developed for age-related macular degeneration (AMD), trauma and orthopaedics, ENT and urology.

Implementation is still underway but patient referral times have already improved. For example, for patients with AMD the journey has fallen from 10 weeks to just 10 days. 

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