Change made at a rapid pace to improve patient experience and care

Earlier this year, with support from the North East Commissioning Support Unit, Doncaster Clinical Commissioning Group (CCG) in partnership with Healthwatch Doncaster and a range of local health and care organisations led a review of three key areas of health to address issues and improve patient experience.

The ‘Northern 100 day challenge’ focussed on spinal care, fibromyalgia and ophthalmology.

The spinal care focus was to make it easier for people in Doncaster to access timely appointments for spinal injuries. A team of health and care professionals worked tirelessly to work with GP practices in Doncaster to increase the number of referrals to the ‘First2Physio’ service. The team set an ambitious target to increase the number of referrals made by GPs by 15%.

Spinal Care team

At the end of the 100 day challenge, the number of referrals from GPs to the service increased from an average of six per week to 18 and this number continues to rise. As well as a review of how referrals are made, the team also worked closely with a number of patients to find out what information is given to help and assist the recovery process. A new, easy to understand leaflet has been created, with the support of patients and will be issued to all GP practices in Doncaster over the coming weeks.

Today, Doncaster CCG Governing Body will hear from a patient who was referred to First2Physio for an assessment following a period of back pain. Mr Havenhand will share his views of what worked well and what could be done to further improve the service, which will include a call for exercises to be demonstrated so they can be completed at home and the offer of follow up appointments to provide further advice and support.

Jim Chapman, Quality Improvement Lead Coach at Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust said: “I am delighted with the progress the spinal team have made to increase the number of referrals made by GPs.

“Whilst there is more work to be done, the 100 day challenge was a great example of partnership working where multiple individuals and organisations came together to identify and issue and work innovatively and collectively to identify a number of solutions.”

Fibromyalgia was also identified as a prime area of focus to improve patient experience and outcomes.

Fibromyalgia team

Previously, the wait for a Rheumatology outpatient appointment was approximately five months. The 100 day challenge team set out to was to pilot an integrated therapy programme which combined mental health and physical health services and professionals with the ultimate aim of decreasing the wait time between patients attending their GP with symptoms and therapy and receiving treatment.

A brand new therapy programme was developed for ‘suspected fibromyalgia’ and ‘consultant diagnosed’ fibromyalgia, both consisting of an initial two week diagnosis and a further optional 6 week core therapy course for patients who require further support.

During the 100 day challenge, a number of patients agreed to be part of the pilot; some of their feedback included:

  • “All of the learning was useful, I learnt so much.”
  • “Learning self-management techniques for fibromyalgia, pain and anxiety”
  • “I’ve learnt how to accept my condition and go forward to support my needs”
  • “Having an explanation of fibromyalgia was most useful”
  • “Learning a lot about pain and how to manage it myself and with the support of others”

The fibromyalgia pilot has now been extended for six months to further develop and refine the joint therapy offer.

Rachel Stagg, Therapy Manager, Musculoskeletal Outpatients Clinical Specialities at Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust said: “One of the key challenges at the start of the challenge was to identify ways we could reduce the length of time patients were having to wait to receive treatment for fibromyalgia.

“Working together at pace not only meant that we were able to develop two new therapy programmes, it also resulted in a dramatic reduction in the time patients had to wait to receive treatment. There is more work to be done to engage with and provide information to help GPs and the extension of the pilot will help identify and explore further ways how we can roll this out across Doncaster.”

Ophthalmology was the third key area, specifically to reduce the number of children and young people not attending their eye appointments. The group reviewed the ophthalmology pathway from start to finish, looking at the appointment process, the letters issued to parents, through to the understanding of young people and the importance of their appointment.

Ophthalmology team

The Trust’s Ophthalmology team – who deal with the diagnosis, treatment and prevention of diseases affecting the visual system – delivered an interactive session to the students of Grange Lane Infant Academy. Not only did they give an educational talk to the class, but they also organised a series of rotating workshops and, finishing with a poster prize completion. The purpose of the visit was to raise awareness about the valuable service that the eye clinic provides to the public, as well as to highlight the impact that not attending an appointment can have on the NHS.

Ian Dawson, Head of Orthoptic services at Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust said: ‘’It’s crucial that we reach out to children about this at an early age. At their stage in life, eyes are still developing and we need to ensure that they are properly looked after.

“By going to see the students, showing them what we do, and reassuring them that there’s nothing to be afraid of, we hoped that we could encourage them to speak with their parents, so that they don’t miss their appointments.”

The 100 day challenge work undertaken by the ophthalmology team resulted in a 2.5% reduction in the number of children and young people that did not attend their appointment in February 2019, compared with February 2018.

Karen Leivers, Head of Strategy and Delivery for Planned Care, Doncaster CCG said: “The 100 day challenge really demonstrated how teams and organisations can come together to identify and issue and think of practical solutions, at pace, to improve patient experience and outcomes.

“I look forward to working with the teams to progress this great work even further and look at other areas where a similar approach could be adopted.”