18 Week Pathway Discussion about potential IM&T issues
-
Upload
branden-gonzalez -
Category
Documents
-
view
26 -
download
0
description
Transcript of 18 Week Pathway Discussion about potential IM&T issues
![Page 1: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/1.jpg)
18 Week Pathway
Discussion about potential IM&T issues
![Page 2: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/2.jpg)
18 Week Pathway
• Delivering this 18 week patient pathway is one of the most significant reforms in the history of the NHS.
• “By 2008 no one will wait longer than 18 weeks from GP referral to hospital treatment”, NHS Improvement Plan (June 2004)
![Page 3: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/3.jpg)
By December 2008 staff will need to have access to IT solutions that enable them to see where every patient is in relation to their 18 week pathway – this is a huge challenge
![Page 4: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/4.jpg)
IM&T Challenges
• 18 Weeks will be the most challenging target that the NHS has faced in terms of planning, delivery and performance measurement
• However, prior to Lorenzo the transition from referral (via Choose and Book?) to treatment will need to be recorded on multiple ‘stand-alone’ IT systems
![Page 5: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/5.jpg)
IM&T Challenges
• The 18 Week target will have a significant impact on information systems
• Referral-to-treatment (RTT) performance measurements commenced in January 2007?
• From CDS v6? central returns will need to include 18 Weeks tracking information
• How will this achieved if information is held on multiple IT systems that do not use a common episode reference?
![Page 6: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/6.jpg)
To monitor a patient journey, it will be important to be able to link patient activity together creating a unique pathway identifier
A pathway status field that will also be needed to identify the clock start / stop. For example;
– Admission as day case or inpatient– Start of outpatient treatment– No need for treatment in secondary care
Unique pathway identifier
![Page 7: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/7.jpg)
Unique pathway identifier
• Will the unique pathway identifier be:
– The Choose and Book unique booking reference?
– A locally generated value – eg. Concatenate hospital patient identifier with the referral request received date?
– Will it have to be a combination of both (when will CaB book be fully rolled-out)?
– What happens if a patient is allocated more than one care pathway?
![Page 8: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/8.jpg)
Potential issues
• There are many ways in which the 18 week pathway can be started and these will be difficult to record / keep a track of, eg:
– Referrals to secondary care from General Dental Practitioners and Optometrists
– Decision to Admit through A&E– Where a national screening programme identifies the
need for further diagnostics or treatment the clock starts at the point of the result being known
– etc
![Page 9: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/9.jpg)
Potential issues
• The same issue applies to the clock stop, and it will be a challenge to record this accurately given the varied scenarios eg:
– Where treatment starts in parallel with diagnostic testing the clock does not stop
– If a patient does not attend twice the clock will be stopped and the patient returned to their GP
– etc
![Page 10: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/10.jpg)
Potential issues
• Access to diagnostics is recognised as a major potential bottleneck
• How will tertiary referrals be handled?
![Page 11: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/11.jpg)
Data quality / availability
• Patient tracking will require a lot of additional computer data inputting
• This will require major upgrades to existing IT systems and/or the development of new interim solutions
• The capture of the additional data required will be a major undertaking in terms of training / change management
![Page 12: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/12.jpg)
Impact on legacy systems
• Upgrading legacy systems to capture 18 Weeks information will be complex and expensive – eg. PAS systems don’t always assign the same
episode number in each of stage of a patient’s care pathway (referral, waiting list, appointment etc)
• A significant amount of complex systems integration may be needed to link each stage of the pathway and enable patients to be tracked effectively
• All of these developments will be difficult and costly to achieve in the timescales given
![Page 13: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/13.jpg)
CATS
• PCTs - Are you thinking of delivering this as a provider?
• Are you looking to do this in partnership?
• You will be part of the 18 week pathway, although you have just 4 weeks from assessment to outcome, including diagnostics
![Page 14: 18 Week Pathway Discussion about potential IM&T issues](https://reader035.fdocuments.us/reader035/viewer/2022072014/56812e0c550346895d937a87/html5/thumbnails/14.jpg)
Questions?