Mid Trent Cancer Network Information Prescriptions the story so far

1
Mid Trent Cancer NetworkInformation
Prescriptions the story so far
Lincolnshire
Nottinghamshire

• Elaine Wilson Nurse Director/Project Lead
• Sheila Williamson Project Manager
• 17th January 2008 Network Nurse Directors

2
Aim of the presentation

• Mid Trent Cancer Network Information
  Prescriptions Pilot
• To share with you the work that we are doing
• To get your comments, views and ideas
• To explore opportunities for developing further
  Information Prescriptions can this learning be
  transferred to other cancer networks/areas?

3
Background origins of the pilot

• Our health, our care, our say (DH, 2006) outlined
  a vision that by December 2008
• Everyone with a long term condition or social
  care need and their carers would be given an
  information prescription
• Information prescriptions will become a routine
  part of care, just like prescriptions for
  medicine

4
Information Prescriptions the right
information, at the right time

• The aim of information prescriptions is to
  empower people to
• Manage their care more effectively
• Help them stay more independent
• Feel more in control

Information prescriptions will give everyone
access to the information they need, at the right
time
5
Information Prescriptions Pilots

• The aim of the Information Prescription Pilots is
  to
• Develop a systematic approach to information
  prescriptions
• Inform the design and delivery of IPs
• Provide evidence of effectiveness and their
  impact on the public, professionals and
  organisations
• Building on the results of the pilots,
  information prescriptions will be rolled out
  nationally during 2008

Information prescriptions
6
Information Prescriptions Pilot

• Department of Health IP pilots
• 20 pilot sites nationally covering
• Cancer (Mid Trent Cancer Network, Royal Marsden
  Hospital, Queen Elizabeth Hospital Birmingham,
  Durham)
• Mental Health
• Long term conditions (asthma, diabetes, COPD)
• Arthritis,
• Parkinsons Disease
• Cystic Fibrosis
• Sight loss
• Deaf and hard of hearing
• Our development started in March 2007 and the
  first prescriptions were issued in July 2007

Information Prescription Pilots
7
Cancer Pilot Sites overview
Source OPM Evaluation of Information
Prescriptions Interim Report to the Department
of Health, 2007
8
The Mid Trent Cancer Network Information
Prescriptions Pilot Project
Our Key Objective

• By the end of March 2008 we will have
• Designed, developed and tested Information
  Prescriptions for patients with Lung, Gynaecology
  and Head and Neck Cancers and their carers
  within the Mid Trent Cancer Network
• Explored the opportunities of using Information
  Prescriptions in primary care
• Have developed a website for information
  prescriptions

9
IP Project Stages

• Determine purpose and scope
• Clarify focus
• Build internal support and wider partnership
• Links to existing or future initiatives/policies
• Establish core team and wider infrastructure
• Identify content of and develop directories
• Develop templates, format and content

E V A L A T I O N
Preparation
Internal and external evaluation Discovery
Interviews Audit of scripts Focus
Groups Consortium evaluation

• Recording of IPs
• Quality assurance and evaluation
• Role of IT in information prescribing
• Training and Support
• Engaging stakeholders
• Communication

Development

• The prescribing process
• The dispensing process
• Signposting

Delivery
10
Where we started from..

• With a blank sheet of
• paper and a lot of questions!
• What is an information prescription?
• How is it different to what we do already?
• Why is it called a prescription?
• Is this just another DH must do?
• How can this make a difference?
• How can we get clinicians on board with this?

???
11
How we choose the clinical areas for the pilot?

• Previous work carried out in developing
  information pathways for 3 clinical conditions
• Head and neck cancers
• Lung cancers
• Gynaecological cancers

12
The approach?

• Involvement of voluntary sector
• Information centres
• Cancerbackup
• Macmillan Cancer Support
• Marie Curie Cancer Care
• Continuous improvement approach
• Lets have a go!
• We wont get it right first time!
• Small step changes
• What we end up with may be
• different from what we start with

13
The Process for Delivering IPs?
First prescription issued at any point along the
clinical pathway
Ideally issued by both the CNS and Consultant
CNS is using the IP as a tool to both give
information and to sign post
Core information from the information pathway us
being offered
14
Developing the IP for patients

• Steering group chaired
• by a carer and with patient
• members
• Stakeholder event
• Focus groups with Clinical Nurse Specialists
• Consultation with existing groups such as the
  Network Patient and Public Partnership Group and
  locality groups

15
What is an information prescription (IP)?

• Cancerbackup definition
• A source of personalised information that lays
  out clearly
• and simply the salient points about an
  individuals
• consultation with a healthcare professional about
  their
• diagnosis, treatment and/or care plan and points
  the way
• to other relevant sources of high quality
  information and
• support. It is designed to improve the dialogue
  between
• patients and health professionals and enhance the
  valuable
• face-to-face time within consultations.

16
The Information Prescription
Over 260 IPs have been issued
17
Evaluation at two levels

• Local evaluation
• Focus groups with CNSs
• Audit of scripts and issuing data
• Discovery interviews with patients and carers
• National evaluation
• GfKNoP questionnaires to patients/carers and
  people issuing IPs
• Economic analysis York University
• OPM Pilot Site Learning Sets

18
Benefits of IPs for patients and carers - 1

• Anecdotal data
• CNSs are seeing people bringing
• the IP back for follow up consultations
• It provides a plan
• Avoids duplication or repetition of information
• Brings all the pieces of information together
• IPs are helping patients make informed choices
• Greater dialogue between patient and healthcare
  professional

19
Benefits of IPs for patients and carers - 2

• People like
• having the diagnosis written down
• having a diagram/picture to help explain
• having a point of contact written down

20
Benefits of IPs for Health Care Professionals - 1

• Focus group feedback
• IPs are providing
• a record of the patients consultation
• record of what information has been offered and
  given to patients avoiding duplication
• a focus on patient information needs and how
  these are met
• The IP pilot and process is improving the quality
  of information provided increased focus and
  review

21
Benefits of IPs for Health Care Professionals - 2

• Focus group feedback from CNSs
• Facilitating team working
• Facilitating CNS access to pre - diagnosis part
  of the patient pathway
• Consultants are becoming more involved in
  information giving
• There is transferability of the template and
  process to patients with non-cancer diagnosis
• Greater dialogue between Nurse and patient/carer

22
Further Developments
Information 4U

• Rollout and sustainability
• Other Cancer Pathways
• Training and development
• Ongoing evaluation and feedback
• Resources
• Developing an Information Prescription for
  carers
• Developing an Information Prescription for End Of
  Life Care to be issued in primary care
• Development of an IP e-template
• Development of Mid Trent Cancer Network
  Information4U website

23
Success factors for wider implementation

• Evidence from the pilots indicate the following
  success factors for information prescribing
• Evidence-based and reliable, high quality, timely
  information
• Cost-effective and affordable
• Accessible for all
• Integrated and seamless
• Personalised
• User involvement user-led design and
  development
• Contributes to the improved health of users and
  carers (especially those who are excluded)
• Evolving and dynamic responsive to the changing
  needs of patients and professionals and updated
• Professional and Stakeholder Support
• Well-trained professionals and information
  providers

Source OPM Evaluation of Information
Prescriptions Interim Report to the Department
of Health, 2007
24
Why Information Prescriptions?

• Without information there is no choice. It gives
  patients the power and confidence to engage as
  partners in their health service
• (Better information, better choices,
• better health, DH, 2006)

25
Any Questions?