Expanding Choose and Book to Rapid Access Chest Pain Clinics

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Expanding Choose and Book to Rapid Access Chest
Pain Clinics Jane Mulholland Northern Cardiac
Network Director
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Choose and Book - rapid access chest pain clinics

• Jane Mulholland
• NNCC

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A conversation

• Martin Wilson

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Don't let the situation confuse you...
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Racpc targets

• Currently out of choice programme
• 2 week target

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Patients - per week

• North of Tyne - 50 patients
• South of Tyne - 52 patients
• No waiting list
• Able to flex capacity
• Considered a good service by all
• Dont meddle with something that works!

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NNCC
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Process

• SHA choose and book leads meeting
• Piggy back cancer meetings
• Create a new group for racpc
• Piggyback existing cb meetings
• Ask!

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Answer

• Link with existing CB groups

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NNCC

• Sunderland planning
• Gateshead- contact made
• South Tyneside contact made

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North of Tyne CB group

• Map current racpc pathways
• Identify proformas
• Identify clinic structures and rules
• Identify similarities and differences
• Identify issues to be resolved
• Decide the way forward

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• NHCT

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• WGH/HGH

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NTGH

• Information
• RACPC also takes referrals from Cardiologists.
  Cardiologists send all new patients with chest
  pain to RACPC instead of out-patients. The
  clinic also receives referrals from AE and ECU
  to try and take a loop out of the system, as
  patients were being discharged from AE/ECU and
  GPs were then referring patients to the RACPC.

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Example
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The good news

• All book directly on to PAS
• All use proforma / fax referral with similar
  criteria exclusion and reason for referral
  criteria the only difference
• All have dedicated admin
• All use telephone for appointments when possible
  so low DNA rate
• In effect patients are offered a choice of
  appointment

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Challenges- flexibility and control

• Maintain flexibility with clinic availability
• Maintain ability to manage capacity and waiting
  lists efficiently
• Clinical decision making
• It needs to be at least as good, as we already
  have

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Next steps

• Work through the challenges to develop a workable
  model Pareto principle
• Mapped current pathways RACPC against the CB
  process
• Not confident yet that we can maintain gold star
  standard
• Need to explore with NNCC how we overcome
  challenges.
• Further meeting with RACPC teams
• Think about the directory of service
• Maintain momentum

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More good news

• Tom Dunkerton
• Garry Schulz
• Sue Shaftoe
• John Hancock
• Tim Baker
• Peter Berry
• Donna Aydon
• Brenda Stenhouse

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Be determined in achieving your goals...