Creating clinical engagement for effective change

The Map has been a great tool for getting primary and secondary sectors working together to innovate and create the best possible pathway. Identifying which things are best done in which sector helped Wirral reduce AMD waiting times from around 20 weeks to two. The Map makes commissioning easier because it describes how clinicians want things to run. Being evidence-based best practice it provides confidence for building pathways locally

Cathy Gritzner, Director of Commissioning and Performance, Wirral WCT tells how the Map brings clinicians together to create better pathways (4:23)

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Transcription

Cathy Gritzner: It's not about the work it's about the clinical engagement and it's about getting the clinical teams both in the secondary care sector and the primary care sector to work together to put together a pathway that is the best local pathway for the people of Wirral. And it's really easy because it's what clinicians do about providing the very best services they can for the patients and actually it is very energising to be in a room when they are doing it, to see them put these pathways together.

Interviewer: So in many ways, indirectly the Map has brought them together in order to get them to think this way?

Cathy Gritzner: Yes. The Map is the tool that allows the clinical dialogue to take place that allows them to put the service improvements together.

Interviewer: What have been the main benefits of using it in practice for the different levels of health professionals?

Cathy Gritzner: I think it's about certainty around the best practice and best processes. It's around being clear what the benefits are for patients, it's also very clear on what are called the access points, who is to do what, where and when and being clear about what is appropriately done in primary care and what is best done in secondary care so you are actually using the best parts of the whole health economy for the benefits of patients.

Interviewer: So do you suspect then that patients are actually having a better outcome or a better experience of the health Service indirectly because of you using this tool?

Cathy Gritzner: Yes we can certainly say that for the AMD pathway we reduce the waiting times from about 20 weeks to two weeks because we were able to develop a pathway so our local health service provider could provide the services where in the past the patients were all sent into one hospital which was quite a way away. So by using the pathways we have actually opened up the capacity for that whole area of the country.

Interviewer: And there are other health professionals obviously using this other than the clinicians. What's the benefit for them do you think?

Cathy Gritzner: I think there is a lot around education, around skilling up because you are not only using how to use pathways but you are learning about service redesign and how it's easier to work with clinicians when you have that basic understanding of what it is that drives them to provide better services and so that helps with that whole education.

Interviewer: It sounds almost like you are showing people their place in the bigger picture?

Cathy Gritzner: To some extent but also to allow them to innovate because what you are saying is ‘yes this is the way you did do it, how would you like it done?' and they often say ‘well I wouldn't do it like this' and you go ‘how would you do it?' and off they go.

Interviewer: At a Commissioner level has it made your job easier?

Cathy Gritzner: Yes, in a way, because the clinicians are actually telling us how they want pathways to be run, what is the most appropriate pathways and we can then attach the pathways onto the contracts and say these are the things that we do not want you to do but these are the things that we do want you to do, these are the services we want.

Interviewer: What's the benefit then of you also being connected to the National Map?

Cathy Gritzner: I think it's the fact that there is the Map of Medicine team there and I can pick the phone up and talk to any of them. There is the IT support that they can bring and also the fact that they are picking up national data sets, data bases, national guidance and it gives you the confidence that that's all being done as part of the pathway so you haven't got to trawl it yourself but you know it's best practice and it's evidence based and there is confidence that you can actually build on it with your local pathways.

Interviewer: What would you say to other people who are thinking now of adopting this as a tool? Is it worthwhile?

Cathy Gritzner: Yes, it's a great tool for clinical engagement, getting the doctors to think about how they want services to be commissioned and also don't be afraid. I think people think it's a library tool, it's a technical tool, actually it's not it's a change agent tool, it's about how you engage clinicians to think differently to provide better services.