Gray2011

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Gray2011

  1. 1. New challenges - new roles - new competencies Supporting primary care commissioning. Anne Gray, Commissioning Librarian NHS Milton Keynes UHMLG Conference, June 2011
  2. 2. June 2011 UHMLG Conference, Soton MK Commissioning Librarian – a history  2004-09 Outreach Librarian MK Hospital Library – training primary care clinicians / literature searches  little strategic impact ; improved knowledge not services  2007-10 Quality MK - Health Foundation programme  Testing processes supporting whole system quality improvement which is patient centred, clinical led and evidence based  Evidence support to service redesign teams, journal clubs in GP practices and primary care teams, alerting services  2009 PCT created Commissioning librarian post to inform commissioning (Cf Clinical Librarian)  2010 PCT reorganisation??
  3. 3. June 2011 UHMLG Conference, Soton Commissioning Librarian  Important to align service in line with the current strategic objectives of the organisation -  Financial balance (QIPP challenge)  High quality health services  Support transition (to Clinical Commissioning Groups)  Strategic objectives have changed
  4. 4. June 2011 UHMLG Conference, Soton Commissioning Librarian  Supporting pathway review and service redesign  Alerting services  Searching for information  Retrieval, selection, appraisal, summarise  Knowledge Zone: www.qualitymk.nhs.uk  Information skills training  Links to NHS library networks
  5. 5. June 2011 UHMLG Conference, Soton Day to day work  No physical library (SLA with local hospital)  Open plan office with commissioners/managers  Meetings!!  Member of strategic Programme Boards (Planned Care; Unplanned Care; Mental Health, Delivering Capabilities, Stroke network, Neurological Conditions LIT)  Understand the current issues  Direct requests for evidence / examples etc  Unsolicited reports  Support the teams by highlighting relevant resources as and when appropriate
  6. 6. June 2011 UHMLG Conference, Soton Products  Web portal – Quality MK Knowledge & Learning Zones www.qualitymk.nhs.uk  Hot topics, national alerting services, key resources, GP Consortia development, public health intelligence, elearning,  Local alerting services  Knowledge@lert for Commissioners  Contribute to other alerts in organisation  FYI highlighting particular resources to individuals “unlock the door”  Evidence search service – push and pull
  7. 7. June 2011 UHMLG Conference, Soton Use of evidence in commissioning “Using evidence is not an open and shut case. Producing evidence to aid commissioning is not enough” Ref: The need for clarity in evidence based commissioning. HSJ 26 May 2011 p23-25  Academic research project - observations and survey  Identified two themes  Need different forms of evidence  clinical and non-clinical  Plurality rather than hierarchy of evidence  Different types of evidence need to work together  Importance of timing  Very much reflects experience in practice
  8. 8. June 2011 UHMLG Conference, Soton Plurality of evidence HSJ 26 May 2011 p23-25
  9. 9. June 2011 UHMLG Conference, Soton Evidence used by commissioners Survey n=300 Very/quite important  Local public health intelligence  Expert advice  Examples of best practice  Local policies  Guidelines  Government pubs  Benchmarking  Cost effectiveness Not important/did not use  General published literature  Professional association guidance  Management studies  Academic research  Management consultants HSJ 26 May 2011 p23-25
  10. 10. June 2011 UHMLG Conference, Soton Evidence searches  Time intensive  Understand the question  Search  Read / extract / appraise  Summarise  Types of question  How have others done it?  Outcomes, KPIs, benchmarking  Data/models to support development of specifications
  11. 11. June 2011 UHMLG Conference, Soton Evidence searches  Current topics include  Impact on hospital use (re)admission, OPD, A&E, community care  Self management, decision aids  Outcomes based contracting  Examples  Has anyone charged for DNAs?  Outcomes of MSK services  service specifications eg Community cardiology, MSK, Urgent Care  Predictive modelling tools  Return on Investment in telehealth/telecare  GPs in A&E departments  Why are our antenatal admissions so high?  What self care tools will we need to support our new MSK Clinical Assessment & Triage services?
  12. 12. June 2011 UHMLG Conference, Soton Example: MSK CATS spec.
  13. 13. June 2011 UHMLG Conference, Soton Search results included •Anticipated case mix based on audit from existing service •MSK self care resources •MSK patient decision aids ALSO •Indication of impact on referral to acute care •Contact info
  14. 14. June 2011 UHMLG Conference, Soton Measuring impact  Difficult to quantify  Literature search impact survey – small pool of requestors  But  Librarians are “pollinators” – Prof Paul Glazsiou  http://www.qualitymk.nhs.uk/default-ContentID-3011.htm
  15. 15. June 2011 UHMLG Conference, Soton Nothing stands still  Evidence required by commissioners will not change, but the environment will  Clinical Commissioning Groups (GP Consortia)  NHS Commissioning Board – national and regional  PCT Clusters  Public Health England  NHS Evidence  Quality MK www.qualitymk.nhs.uk  PCT website – future?
  16. 16. June 2011 UHMLG Conference, Soton Thank You Anne Gray Commissioning.librarian@miltonkeynes.nhs.uk

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