Transcript Efficient use of FP10 garment provision

“Review of Lymphoedema
Garment Provision:
FP-10 Project”
Gillian McCollum
Lymphoedema Lead
Belfast HSC Trust
18 Feb 2009
Presentation Outline
Background
 Aims and objectives of project
 Anticipated outcomes of project
 Process
 Key outcomes
 Future plans
 Summary

Background



Lymphoedema garments worn on a life
long basis – 2 provided every 6 months
Service in Belfast City Hospital managing
patients from all over the region
Increasing prevalence
Background



2006/07: £30K spent on lymphoedema
G&S in Belfast Trust (no specific G&S
budget for lymphoedema)
Increase in order turn around times
(on average 8 weeks)
Greater range of lymphoedema garments
available on FP-10
Background


CSR 2008/09 – 2010/11:
Belfast Trust: £343m (3% pa)
efficiency savings over
next 3 years
New ways of working
Main Aims of Project


Reduce lymphoedema service garment
expenditure
Ensure patients have timely access to
compression garments
Objectives of the Project


Change current practice by instigating
the use of FP-10 prescription
Develop efficient system of obtaining
compression garments on drug tariff
Anticipated Outcomes
Decrease lymphoedema service
expenditure
 Shared funding of garments
 Increase GP/pharmacist awareness
 Decrease waiting time for garments
 Maximise benefits of CDT
 Increase patient satisfaction

Process
Consultation with stakeholders
 Benchmarking
 Standardised prescription request
form/letter to GP
 Data collection form for audit
 Education re FP-10 system
 Patient criteria

PRESCRIPTION GARMENTS RECORD
Patient name & Date
Tel contact
details
GP Practice &
Pharmacy
Mrs J Smith
028 9099 9999
Dr Brown
Dunluce HC
4/03/08
Number & full
description of
garment (to allow
for costing)
Combined
armsleeve with grip
top, standard
Alliance Pharmacy length, size IV,
CL II (x1)
2 week follow
up call
comments:
Pt has received
garment
Key Outcomes: Initial Audit
Two Week Follow Up Comments
10%
20%
15%
Pt not been to GP yet
Pt not been to pharmacy yet
5%
Pt received incorrect garment
GP unable to find order codes on database
Pt received garment
GP put incorrect details on script
Unable to contact pt
15%
30%
5%
Key Outcomes
Waiting Time:


30% of patients received
garment by 2 week follow up
All patients received garment
by end of 10 week period
Key Outcomes
Expenditure:


£1,752 savings for
lymphoedema service
(over 10 weeks)
Projected annual savings
of £9,110
Next Steps
Refined local FP-10 process
 Further consultation with GPs and
pharmacists
 Promotion of drug tariff usage
throughout region
 Re-audit after 6 months:
10 week period (July – Sept 2008)

Key Outcomes: Re-audit
Two Week Follow Up Comments
6%
Wrong garment
received
2%
4%
9%
4%
Garment received
(no issues)
Unable to contact
patient
Patient not been
to pharmacy yet
75%
Patient not been
to GP yet
Pharmacy issues
with FP-10
Re-Audit – Key Outcomes
Waiting Time:


75% received garment within 2 weeks
Range of time to get garment on FP-10:
1 day – 3 weeks (average of 4 days)
Re-Audit – Key Outcomes
Expenditure:
62% increase in the number of FP-10
requests
 £2,968 savings for BCH lymphoedema
service (over 10 weeks)
 Projected annual savings of £15,434

Future Plans
Increase awareness
 Audit admin time involved business case for admin support
 Extended scope practitioner
 Patient satisfaction questionnaire
 Potentially decrease number of face
to face reviews

Summary



Life-long management:
major implications on service funding
Need to identify more efficient and
effective ways of working
Local drug tariff ordering system
improved over a 6 month period
Summary

The utilisation of FP-10 to obtain
lymphoedema garments resulted in
significant savings for the BCH
service and has the potential to
greatly reduce patient waiting time
for garments
For a full list of garments available
on FP-10 go to:
www.nhsbsa.nhs.uk/prescriptions
and click on drug tariff, then
electronic drug tariff, then
Part lXA appliances –
lymphoedema garments