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Mansel Aylward presentation WSPCR 2010

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Mansel Aylward presentation WSPCR 2010

  1. 1. 3rd November 2010How the Public Health Wales Trust can help build theintegration of services, teaching and research.Professor Sir Mansel Aylward CBChair Public Health Wales Public Health Institute
  2. 2. Public Health Institute:Conceptual Clarity•  Research, policy, practice in an iterative relationship Research Policy•  Creating a space for Knowledge dialogue and Space knowledge creation•  The art and science of making a Practice differencePublic Health Institute
  3. 3. Conceptual Clarity•  Research and development•  Professional development•  Multi disciplinary/ Multi sectoral•  Focusing resources on the big questions•  Wales in the worldPublic Health Institute
  4. 4. What are we trying to achieve?•  A healthier, happier and fairer Wales•  Reduce premature mortality•  “Life to years” as well as “years to life”•  Reduce inequity/inequalityThrough…•  Translating what we know works into practice•  Scanning the horizon- taking the long term view•  Seeking “early wins”Public Health Institute
  5. 5. Organisational Design•  A clear identity•  Professionally driven but stakeholder focussed•  Networked model with a small physical corePublic Health Institute
  6. 6. Moving Forward•  Early progress is possible, building on existing functions and relationships•  Adopt an experimental pathfinder approach- maternal and child health•  Grow the concept around core functions and solid delivery•  Map existing networks and resources•  Engage potential partners in dialoguePublic Health Institute
  7. 7. Moving Forward•  Work within existing structures e.g. NISHCR, Academic Health Sciences Collaboration•  Explore funding possibilities-MRC, ESRC, Lottery, CharitiesPublic Health Institute
  8. 8. Primary Care supporting Public Health•  Promoting health of the population –  Patient empowerment; self management; –  Promoting public health messages –  Supporting Care in the community•  Improve safety and quality –  Safe systems –  Clinical effectiveness –  Encourage appropriate and more efficient use of primary & secondary care services•  Primary care data –  Prevalence, activity, benchmarking –  Audit & Feedback
  9. 9. Implementing StrategyNationally coordinated, locally deliveredNational agendas need local expertise and dataMost of the population have contact with their General practice every year
  10. 10. Public Health Wales & Primary CareNational organisation •  Primary Care Quality and Information Service •  Primary Medical Care Advisory Team •  1000 lives plus •  Evidence Based Sources •  Observatory •  Pharmaceutical Public Health
  11. 11. Welsh BacksAIMTo minimise the financial, personal, and psychosocial effects of mechanical low back pain in Wales by promoting the ‘stay active’ message
  12. 12. Strategic Approach•  Consistent, clear and concise messages•  Identify appropriate resources•  An effective dissemination strategy•  Work with key stakeholders to deliver the strategy•  Monitor, evaluate, feed back
  13. 13. Appropriate Resources The Back Book WeMeReC bulletin Interactive desk aid
  14. 14. % 10 20 30 40 50 60 70 80 90 100 0 Anglesey Bridgend Powys Denbighshire Vale of Glamorgan Monmouth Pembrokeshire Swansea Caerphilly Blaenau Gwent Wrexham All WalesLocality Cardiff Carmarthenshire Ceredigion Neath Port Talbot Newport RCT Flintshire Book (Nov 2007-Sept 2010) Torfaen Conwy Merthyr Tydfil Gwynedd % of Welsh Practices Ordering The Back
  15. 15. WeMeReC BulletinCase studies sent to •  2,470 GPs •  2,900 pharmacists (first time participated)Completed by •  688 GPs (28%) 247 paper copy and 441 on line •  103 pharmacistsBulletin & copy of Back Book sent to •  2,470 GPs / 2,900 pharmacists
  16. 16. OutcomesChange in GP behaviour –  Significant increase in number of GPs giving the stay active message –  Decrease in number of GPs advising restChange in population health beliefs –  Staying active with back pain –  Not resting with back pain
  17. 17. Clear Messages•  Work is generally good for people’s health•  Early intervention is important to prevent long term worklessness•  For people with back pain ‘staying active’ usually means staying in work•  Addressing the psychosocial issues
  18. 18. Appropriate ResourcesHealthy Working Wales website •  E-learning •  Desk aids •  Downloadable leaflets / publications •  ‘Ask the expert’ e-mail adviceHealth and Work Advice LineThe Back BookNational Education Programme •  RCGP half-day accredited training
  19. 19. Effective Dissemination RCGP Events 200 GPs CPD Sessions (350 GPs) & practice visits (400 GPs) 750 GPs Online resources (Deanery learning modules; WeMeReC modules, HWW website) 600 GPs Mailing of information to signpost to resources (such as Back Book, signposting documents, WAMH in PC, online resources, CPD session and RCGP events) 2000 GPs
  20. 20. Collaborative Working•  Welsh Assembly Government•  Cardiff University•  Postgraduate Deanery•  Welsh Medicines Resource Centre•  Royal College of General Practitioners•  Institute of Rural Health•  Health Boards•  Harvard University and other international Universities•  Department of Health (England) and Department for Work and Pensions
  21. 21. Progress To DateBack pain pathway agreed •  Focuses on ‘stay active’ message •  Includes advice on fitness to workBack pain educational tool completed •  Produced and promoted by the DeaneryWeMeReC module on management of depressionPractice visits ongoingCPD and RCGP accredited events arranged
  22. 22. Primary Care Quality &Information Service (PCQIS)Assists Health Boards, practice teams andindividual primary care practitioners toimprove the quality of the care that theydeliver by: • Providing access to evidence-based quality improvement guidance and tools • Encouraging review, reflection and revision
  23. 23. PCQIS Supporting Health BoardsNHS Wales Annual Operating Framework 2010/11 •  Improving patient care in the community •  Chronic Conditions Management •  Primary Care Services •  1000 lives Plus Programme •  Health Care Associated Infections
  24. 24. PCQIS & 1000 Lives Plus ProgrammeLHBs will be required•  To set appropriate local targets for the reduction of harm•  To demonstrate participation and sign up to coding of clinical data, process of data entry and sign up to mini-collaborative –  Anticoagulation Monitoring –  Chronic Heart Failure (Wrexham project) –  Reducing Falls –  Infection Control / Hand Hygiene (support HCAI)Toolkits completed or in progress to support these
  25. 25. Clinical Governance PracticeSelf Assessment ToolObjectives for the production of a web based tool: •  To be used by practices to review progress made in the development of CG processes within their practices •  To provide assurance to HBs of the same •  Reference for inspecting bodies, such as HIW as evidence that appropriate CG activity is occurring in practices •  That can support revalidationPrimary Care Quality and Informa3on Service 
  26. 26. The Principles •  Standardised model across Wales •  Developed by practitioners and other stakeholders •  Endorsed by GPC Wales & RCGP •  Designed to help practices review, monitor & improve systems within their practice •  Completed by practice teamPrimary Care Quality and Informa3on Service 
  27. 27. Content •  Patient experience – environment, access •  Health & Safety – infection control, waste, premises, security •  Risk management – clinical risk, business risk •  Clinical effectiveness – guidelines, audit •  Prescribing •  Relationships with external bodies •  Workforce – skills, recruitment, appraisal, training •  LeadershipPrimary Care Quality and Informa3on Service 
  28. 28. CGPSAT – Supporting the GMC Deanery Revalidation Project •  Pilot Project run in Wales 2008-9 •  Three robust single systems fundamental to GMC criteria –  Appraisal –  Managing performance concerns –  Clinical Governance •  Project tested the three systems in general practice and engagement by LHBs – Wales is advancing ahead in UK with national linked systemsPrimary Care Quality and Informa3on Service 
  29. 29. CGPSAT – Supporting the GMC Deanery Revalidation Project •  If these systems not in place, practices and LHBs would have to generate evidence on CG through other routes •  CGPSAT useful, could be used by LHBs better. Needs to be more robust •  Substantial changes made to CGPSAT in 2010-will be released in NovemberPrimary Care Quality and Informa3on Service 
  30. 30. New Work - Predicting/ IdentifyingAreas of Risk & Good Practice:Practice Profiling •  CGPSAT •  Referrals •  QOF •  Hospital data •  Audit •  No of staff WTEs •  Questionnaires •  List size per •  Complaints and notional WTE incidents •  Deprivation •  Immunisations •  Income/Cost per •  Risk assessment patient
  31. 31. IntegrationService •  Coordinating function which facilitates delivery of public health through primary careTeaching •  Contributing to undergraduate and postgraduate teaching •  Input into curriculum developmentResearch •  Evidence into practice •  Identify topics for research
  32. 32. Professor Sir Mansel Aylward CBContact:Email: Mansel.Aylward@wales.nhs.uk

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