librarians and commissioners
Post on 12-Feb-2016
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Librarians and Commissioners
Mike RoddhamHead of Library & Knowledge Services
Why?Ensuring local people get the best quality
health servicesby
Ensuring services are commissioned according to the best available evidence
What?The importance of languageWhere do we fit in the commissioning cycle?What they want and what they don’tThe service model & how it will change usThe importance of relationshipsChallenges and Gains
But not necessarily in that order
http://www.commissioningboard.nhs.uk/2012/02/03/commissioning-intelligence-report/
Whatquestions
do we need toanswer?
8. What are our future plans? 1. How healthy?
2. What’s really happening
in this system?
3. How much?
4. How do we compare?
5. Are my providers delivering what they agreed?
6. How could things be better?
7. What difference
have we made?
4. How do we compare?
Q4.01: Where is there clinical / activity / cost / outcome variation vs
local, national, international, best practice?
Q4.05: How do we compare for value for money,
outcomes and productivity against similar areas / best practice
over time?
Q4.04: Do current pathways reflect evidence-based good practice?
Q4.02: Are we delivering national standards of care
for patient experience, quality and outcomes?
Data
D4.01: Age-sex deprivation standardised comparative data at practice level for commissioned activity
D4.02: Primary care data extracts providing integrated analysis of with acute activity e.g. prevalence rates vs admissions / screeningsD4.03: Comparative benchmarking data (e.g. QOF Data sets, NCHOD, NHS Comparators, NHS Atlas of Variation, Better Care Better Value indicators
D4.05: Benchmarked GP referrals analysis
D4.06: Practice profiles (needing national standards)
D4.07: National guidance, PROMs, utilization reviews
S4.01: Practice-level, regional and national bench-marking of disease prevalence, activity, productivity and costs
Types of service & tools
S4.02: Analysis and presentation of productivity indicators by programme / project
S4.03: Clinical pathway mapping and modelling and cost comparators
S4.04: Providing evidence and information on comparative health outcomesS4.05: Statistical analysis of variation and correlations e.g. Statistical Process Control
Look at the model. Which areas do you think we can contribute to?
Targeting There are areas where we can contribute effectively, e.g.service redesign, pathways, individual funding requests
There are areas where we can’t,e.g, contract compliance
Be realisticTarget your message
Targeting
Be specific, don’t generalise
Concentrate your fire on target areas but don’t miss
Use examples from •Commissioning Handbook,•knowledge4commissioning
an opportunity.
Wordsmithing
Read up – HSJ, reports, DH stuff, NHS Commissioning website
Understand their mindset
Talk their languageKnow their world
Wordsmithing
Literature searchingTrainingLoansBooks & journalsLibrary
•Finding evidence•Create the evidence base•Identify national & international best practice
•Horizon-scanning•Knowledge management•Decision support
Literature searching
Literature searching
Literature searching
Literature searching & reviewing
Current awareness
Organising information
WordsmithingWatch for changed meanings
IntelligenceEvidenceKnowledge management
Analysts and commissioners believe in Safety in Numbers
Data analysis
Wordsmithing
Don’t describe the services you offer
Present the benefits that the commmissioners gainTalk outcomes, not processes
i.e. not literature searches but “confidence in their decisions”
They Don’t Want
Piles of photocopies
Reference lists
To have to come to the library
Bureacracy and form-filling
Don’t offer training!
Our unique selling point – “we find it for you.”
We have professional skills they can exploit to save money and improve patient services
They don’t want it, they won’t use it.
What Do They WantInformation on what works
Information on how others are coping (we can offer not just UK, but international)
Information on what doesn’t work
Reviews, summaries, time-savers
What Do They Want?• Information they can rely on• Information they can base decisions on
• Evidence they can hide behind• Information that enhances what they already have
What do they have? DATADATADATA
DATADATADATADATADATADATADATADATADATADATA
DATADATADATA
DATA
• Always Historical• Somewhat predictive of activity• Says ‘what happened,’ ‘when,’ ‘how many,’ ‘how often’
• Doesn’t say ‘why,’ ‘what else,’ ‘how do we change’
• Not always reliable
Major Change
Get them thinking beyond the data
Examples, stories, vignettes are really important
Relationships• Develop them
• Exploit them
• Use champions
Work through people you know to reach those you don’t
Likely ProspectsBusiness intelligence leads/ directors don’t talk to the analysts
IFR / PIN leads Understand need to justify expenditure
Public health still need library support.
GP members, education committees, clinical effectiveness & research committees
CCG or CSU?
What You Could DoYou might need to loss-lead to show them the benefits
Set it up as a project with option to make permanent
Work together across services if you aren’t co-terminous with a CCG. Use their borders, not yours. Also looks better to customers
Challenges
• Work out of the library – physically and mentally!
• Change your mindset – think like the customer
• Sell your skills not your resources
More Challenges
Summarising and reviewing
Needs better service monitoring
Learn to sell yourselves – exhibitions, marketing materials, publicity, Facebook
Gathering feedback on service impact & activity
More Challenges –A Different Sort of Enquiry
Health Visitor involvement in early interventions for improving children's language development & early communication skills.
The Troubled Families Initiative - any information? On intervention strategies in particular..
Best Practice initiatives to reduce inappropriate GP referrals in planned care:Cardiology, Gastroenterology, Neurology, General Surgery - Upper GI, Colorectal, Breast, Vascular
GP direct access to head CT scanning - any protocols, reasons why if not
Risk stratification for Long Term Conditions; which risk stratification tools work best; any local examples; within the last year; review articles within the last 3 yrs
Is there any new evidence to support revision of the local referral guidelines on hip pain, knee pain and low back pain?
Innovative community ENT services; national examples/best practice; primary care based/community-led
Is peanut allergy in children more prevalent in the UK? If so, why?
Impact of weight management services (Tier 3/4); does engaging in them lead to e.g. reduction in incidence of diabetes, hip/knee replacements, etc.
GainsUnderstanding
Respect
Feel good
New skillsChampions
Secures services
Non-MADEL income
New user groups
Direct contribution to improving local health
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