Transcript Kate Greenwell`s presentation

Information Prescriptions: the
answer we were looking for?
Northumbria Healthcare NHS Foundation Trust & Parkinson’s
Disease Society Pilot
Kate Greenwell – Information Prescriptions Project Manager
Overview
1.
Background to Information Prescriptions
2.
Northumbria Healthcare NHS Foundation Trust Pilot
3.
Key findings from patients, carers and health professionals
4.
Our next steps
5.
National support from Department of Health
Why is patient information important?
1.
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To understand what is wrong
To gain a realistic idea of prognosis
To make the most of consultations
To understand the processes and likely outcomes of possible tests
and treatments
To assist in self-care
To learn about available services and sources of help
To provide reassurance and help to cope
To help others understand
To legitimise help-seeking and concerns
To identify further information and self-help groups
To identify the ‘best’ healthcare providers.
Source: Coulter, Entwistle & Gilbert (1998)
Only 1 in 4 of discharged patients were able to list all of his or her discharge
medications, and only 1 in 7 was able to describe the common side effects of
all of his or her medications. 6 out of 10 discharged patients were unable to
name their diagnoses
(Mayo Foundation for Medical Education and Research, 2005)
The problem
86% of people said that being
given more information about
their health and condition
would give them more control
over their health and wellbeing
(Department of Health, 2006, Your Health,
Your Care, Your Say)
GPs do not systematically or proactively
give patients information on accessing
local services. The findings also showed
a lack of co-ordination between health
and social care across organisational
boundaries
(Coulter, A, 2007, Accessing Information About Health and
Social Care Services, Picker Institute Europe)
Patient information is a central theme to recent DH
policies:
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Building on the best: choice, responsiveness and equity (2003)
Better information, Better Choice, Better Care (2004)
Our Health, Our Care, Our Say: a new direction for community
services (2006)
Your Health, Your Care, Your Say (2006)
Our NHS, Our Future: NHS Next Stage Review (2007)
The NHS Constitution (2008)
Information
Prescriptions
the right information at the right time
The DH vision is that everyone with
a long-term condition or social
care need will be guided to reliable
and relevant sources of information
to allow them to feel more in
control, better able to manage their
condition and engage with the
healthcare system and to stay
independent.
Information prescriptions will
become a routine part of care – just
like prescriptions for medicines.
...tailored to help
people with long
term conditions and
carers receive
information they
need to manage the
condition.
…will be given to
people by their
health and social
care professionals
Information
prescriptions
…signposts to
sources of
information about
health and care – eg
Tel nos, website
addresses.
Informed and
empowered
people
Cancer (general):
Durham
Neural and physical
conditions: North Tyneside
IP pilot sites
Diabetes: Darlington
Whole systems
approach: Manchester
Sight loss: Leeds
Dementia: Leeds
Young people’s mental health:
South Staffordshire
Depression, anxiety: Doncaster
Head, neck, lung and
gynaecological cancer: Nottingham
Cystic Fibrosis:
Birmingham
Non-surgical cancer
treatment: Birmingham
People over 65 mental health:
Cambridgeshire
Alzheimer’s dementia: Suffolk
Deaf and hard of hearing:
Oxford
Dementia: Isle of Wight
Adult mental health outreach:
South Essex
Psychosis/Schizophrenia, Bipolar/Manic depression: London
Paediatric pharmacy: London
Complex cancer care: London
Diabetes, Asthma, Arthritis:
London
The process for information prescriptions
Information
Content
Identify sources of
information people
people need to
access
Directories
Establish links to
the content
Access
Made available
through range of
channels
Prescribing
A template in an
appropriate format
Personalised
Process
Specific to the
condition, place
and point on care
pathway
Information prescriptions: the answer we were looking
for?
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Parkinson’s disease is a complex and individualised condition
Northumbria’s coverage
Wide range of health professionals supporting patients and carers
Limited access to IT for both users and health professionals
Limited time during consultations
Stakeholder event
Health and social
care professional
questionnaire
Needs
assessmen
t & scoping
Local PDS branch
forum
Service user
questionnaire
Visits to other pilot
sites
Key comments from people with Parkinson’s & carers:
• Information should be provided at each stage of their condition
• Not just written information – support needed to identify and use
information
• Information should be personalised and timely
• Information on a wide range of topics (e.g. benefits, coping with
Parkinson’s) – not just medical information
• Information should be recorded to allow follow-up by health
professionals
INFORMATION PRESCRIPTION
There is no charge for this item
Patient Details
Name:
DOB:
Address:
Initials of Issuer: ____
Postcode:
NHS Number:
Date of Issue: ____/____/08
Who is the information for? (tick one only)
Patient 
Carer  (complete below)
Consent given:
Doctor
Place of Issue:
North Tyneside  Northumberland 
OR
Specialist Nurse
Yes / No
Carer Name:
Relationship:
Address (if different):
OR
Telephone No (required):
Preferred contact time:
Postcode:
IP issued by..
Where is patient in Care Pathway? (tick one only)
GP referral
Maintenance
Diagnosis
Complex
Starting treatment
Advanced
I would like information on (tick all that apply):
Treatment and care
Carer/family information
Support groups
Practical advice
Self management
Other (Please State):
Overview of info sources
Planning for the future
Benefits and financial
Standard diagnosis pack given
New drug treatment commenced
Additional Information (e.g. sensory/cognitive impairments, preferred language):
Allied Health Professional
OR
GP
OR
Social care professional
Getting your Information Prescription
I would like to have the information (please tick appropriate box):
Posted to the above address
E-mailed to me at (Please give details):
Posted to another address
(Please give details):
Other:
Signature:
Designation:
For examples of Information Prescription templates – www.informationprescription.info/resource
Clinical team
member
Face-to-face
OR
IP issued
PDS Information
& Support Worker
OR
NHS Direct
…assesses info
needs…
OR
By telephone
Verbal
information
OR
Verbally
Written
information
IP issued
Information
needs assessed
OR
Audio
information
OR
DVD/podcast
OR
Information in
different
languages
OR
…delivered…
By hand
OR
By post
OR
By email
In medical
notes
AND
IP issued
Information
needs assessed
Information
delivered
IP recorded…
In patient
outpatient
letter
AND
Patient
letter
copied to
GP
IP issued
Information
needs assessed
Information
delivered
IP recorded
IP followed up
by clinical team
Key findings: Service users
Supportive
Understanding
Informed
choices
Secure
Personalised
Service
Users
Reassurance
Access
Self-care
Supports
verbal
information
Coping
Key findings: Health professionals
Benefits
Barriers
• Emphasise
importance of
information giving
• Wider range of
information topics
• Better identification of
problems
• Better use of
professionals’ time
Health
Professionals
•
Initial resistance
•
Benefits?
•
Initial concerns over
workload
•
Concerns over role &
professional-patient
relationship
•
Training needs?
National evaluation findings - http://www.informationprescription.info/finalreport.html
Our next steps:
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Sharing lessons learnt
•
Information strategy group
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Information centre
•
IT solutions
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Bibliotherapy (i.e. self help books on prescription)
Recommendations for local implementation:
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Engaging clinical teams
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User involvement
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Partnership working
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Use resources available
National Support available for local implementation
Workforce: NHS
Employers
Taking forward local
Implementation
National support for
local implementation
Online resource pack
www.informationprescription.info
/resource
Information quality
assurance: information
accreditation scheme
Information
systems: NHS
Choices
(www.nhs.uk)
Information Prescriptions: the
answer we were looking for?
Northumbria Healthcare NHS Foundation Trust & Parkinson’s
Disease Society Pilot
Kate Greenwell – Information Prescriptions Project Manager