NHS Derbyshire County
When six PCTs merged in 2006, there were a number of different cardiac rehabilitation pathways operating across the county.
We commissioned an effective, consistent, equitable cardiac rehabilitation service to ensure the best possible health outcomes for our population.
We completely redesigned the pathway and service model for cardiac rehabilitation, taking it out of the hospital and into the community.
Local clinicians and patients were engaged in developing the commissioning strategy and new service model. An external clinician was also involved in the tender process enabling commissioners to make informed decisions and challenge current practices.
We carried out a baseline assessment to understand current levels of activity and financial commitment. A multi-disciplinary group defined the key outcomes and functions of the new pathway and reviewed national evidence and best practice. A patient tracking system formed a key part of the monitoring requirements to show where patients were leaving the pathway.
We developed a business case, service specification and identified funding and savings to the PCT. A formal procurement process was followed and a provider was identified in March 2010.
The new service includes community based clinics and programmes to improve patient access across the county and increase links with primary and community services. Patients ‘opt out’ rather than ‘opt in’ to assessments with a dedicated member of the cardiac rehabilitation team to answer their questions and discuss their needs. This allows patients to make a more informed decision about their rehabilitation choices which could include home visits, web based or telephone support.
Combined, this allows patients to move more seamlessly into programmes that better suit their particular need. The whole systems approach has resulted in Derbyshire being a major contributor to the Department of Health’s commissioning pack for cardiac rehabilitation to help other PCTs to develop their service.
Contact Details: Martin Cassidy, Head of Commissioning for Long Term Conditions on 0115 9316165 or martin.cassidy@derbyshirecountypct.nhs.uk
