Rhuari Pike
Assistant Director,
Trent Cardiac Network
Tel: 01623 676119
Email: rhuari.pike@sfh-tr.nhs.uk
Summary:
This is seen as an opportunity for the Trent Cardiac Network to showcase some of our work this year in relation to the service changes below.
These are consistent with an improved Patient experience, streamlined care pathways, stakeholder involvement, Network development and good progress towards the strategic aims of the National Service Framework for Coronary Heart Disease.
These improvements are selected as they demonstrate added value, value for money, improved quality of care and a collective strategic approach to planning.
We are proud of our achievements to date, and are glad to be able to share our work with colleagues.
Abstract:
1.Agreement and implementation of Acute Coronary Syndrome protocol across Network, reflecting good practice, and with contributions from all Cardiologists.
2.Angioplasty Development Strategy written and agreed by Clinicians.
3.Implementation of Cardiac Resynchronisation Service across Trent from April 2006.
4.Development and launch of Network Website containing separate areas for health professionals and Public/Patients – www.tcn.nhs.uk
5.One of two Networks nationally selected to pilot 18-week target Heart Access Project.
6.Extremely close working relationship established with the SHA in relation to performance monitoring.
7.Good progress in relation to Inter Hospital Transfers, especially: Trent IHT audit running since April 2005, development of electronic referral and scheduling system between tertiary centre and DGH's.
None of these improvements would have been possible without the support of the Clinicians, Commissioners, and Staff.
The Network has sub groups established, specifically the Clinical Advisory group, Specialised Cardiac Services group, and Network Strategic Board, comprising membership from across the Trent Health Community, and these have combined to coordinate the planning aspects of these changes, supported by commitment from the individuals and organisations necessary to implement the changes.
With a Patient and Public Involvement Strategy still being implemented within the Network, this has not been easy.
We have, however, made full use of the Discovery Interview process to identify issues and themes, and these have been fed into the planning process at every opportunity.
As a consequence of the Inter Hospital Transfer audit, a new role was identified for a Transfer Coordinator at Nottingham City Hospital. This has been developed for both Cardiology and Cardiac Surgery. In addition, the Clinical developments, for example the development of angioplasty services and the cardiac resynchronisation service development, are hoped to contribute to the recruitment and retention of senior Clinicians within this region.
Monitoring of access to thrombolysis has given further opportunities to support the development of Paramedic pre-hospital thrombolysis in both Lincolnshire and East Midlands Ambulance Services.Inter Hospital transfer times have reduced from an average of 8-10 days (Oct 2004), to 3-5 days (Sept 2005) and are further reducing.
Access to thrombolysis has improved with nearly 60% of Patients receiving thrombolysis within 60 minutes of their call for help (Sept 2005) against a baseline of 32% (March 2003).
Network website launched July 2005, and has received over 600 ”hits” to date.
Agreed pathway for the management of Patients diagnosed with Acute Coronary Syndrome (ACS). Starts with call for help, and possible subsequent thrombolysis, and then lays out a clear pathway through to revascularisation.
This, in conjunction with the Inter Hospital transfer work, has reduced the time from index event (i.e.; heart attack) to definitive treatment. In addition, it has promoted a closer working relationship between the District General Hospitals and the tertiary centre, Nottingham City Hospital, leading to a more team-based approach to Patient care.
A common protocol like the ACS protocol brings people together in a managed way, taking into account rural and urban areas, thereby increasing base line knowledge for all involved by everyone following the same protocol.
The web site is accessible to all including patients helping bring workforce and patients closer
Much of this work is documented on our web based national reporting system, RAPPORT ONLINE, which is a system previously used by the CHD Collaborative, and now redeveloped for use by Cardiac Networks. This ensures spread of information both locally and nationally.
HeartLinks implemented in Lincolnshire to support the access to thrombolysis issues. This is a quarterly newsletter shared amongst all organisations in Lincolnshire, supported by the Network and edited by a Cardiologist, amongst others.
Any learning within the Network is additionally spread to all areas by the Network Service Improvement Managers, one being embedded in each health community.
Dedicated day utilised for the launch of the ACS protocol. Chaired by our Lead Clinician, and involving several exciting speakers this gave an opportunity for health colleagues to absorb the protocol and ask any questions.
This submission is not an exhaustive list. There are many more achievements of the Trent Cardiac Network that have not featured here due to the constrictions of space.
As an example of a working Network, we believe that the Trent Cardiac Network is a fine example, demonstrating joined-up services, which reflect good practice and an improved service user/carer experience.
We have the infrastructures to support these partnerships and to capitalise on knowledge sharing and improved communication to ensure sustainability.
We therefore welcome this opportunity to spread our achievements and learning to a wider audience, throughout the Trent health community.
