Gray2011

New challenges - new roles - new competencies Supporting primary care

commissioning. Anne Gray, Commissioning LibrarianNHS Milton KeynesUHMLG Conference, June 2011

June 2011 UHMLG Conference, Soton

MK Commissioning Librarian – a history

2004-09 Outreach Librarian MK Hospital Library – training primary care clinicians / literature searches little strategic impact ; improved knowledge not services

2007-10 Quality MK - Health Foundation programme Testing processes supporting whole system quality

improvement which is patient centred, clinical led and evidence based

Evidence support to service redesign teams, journal clubs in GP practices and primary care teams, alerting services

2009 PCT created Commissioning librarian post to inform commissioning (Cf Clinical Librarian)

2010 PCT reorganisation??


Commissioning Librarian Important to align service in line with

the current strategic objectives of the organisation - Financial balance (QIPP challenge) High quality health services Support transition (to Clinical

Commissioning Groups) Strategic objectives have changed


Commissioning Librarian Supporting pathway review and service

redesign Alerting services Searching for information

Retrieval, selection, appraisal, summarise Knowledge Zone:

www.qualitymk.nhs.uk Information skills training Links to NHS library networks


Day to day work

No physical library (SLA with local hospital) Open plan office with commissioners/managers Meetings!!

Member of strategic Programme Boards (Planned Care; Unplanned Care; Mental Health, Delivering Capabilities, Stroke network, Neurological Conditions LIT)

Understand the current issues Direct requests for evidence / examples etc Unsolicited reports Support the teams by highlighting relevant resources

as and when appropriate


Products

Web portal – Quality MK Knowledge & Learning Zones www.qualitymk.nhs.uk Hot topics, national alerting services, key

resources, GP Consortia development, public health intelligence, elearning,

Local alerting services Knowledge@lert for Commissioners Contribute to other alerts in organisation FYI highlighting particular resources to individuals

“unlock the door” Evidence search service – push and pull


Use of evidence in commissioning

“Using evidence is not an open and shut case. Producing evidence to aid commissioning is not enough”Ref: The need for clarity in evidence based commissioning.

HSJ 26 May 2011 p23-25 Academic research project - observations and

survey Identified two themes

Need different forms of evidence clinical and non-clinical Plurality rather than hierarchy of evidence Different types of evidence need to work together

Importance of timing Very much reflects experience in practice


Plurality of evidence

HSJ 26 May 2011 p23-25


Evidence used by commissioners Survey n=300Very/quite important

Local public health intelligence

Expert advice Examples of best

practice Local policies Guidelines Government pubs Benchmarking Cost effectiveness

Not important/did not use

General published literature

Professional association guidance

Management studies Academic research Management

consultantsHSJ 26 May 2011 p23-25


Evidence searches

Time intensive Understand the question Search Read / extract / appraise Summarise

Types of question How have others done it? Outcomes, KPIs, benchmarking Data/models to support development of

specifications


Evidence searches Current topics include

Impact on hospital use (re)admission, OPD, A&E, community care

Self management, decision aids Outcomes based contracting

Examples Has anyone charged for DNAs? Outcomes of MSK services service specifications eg Community cardiology,

MSK, Urgent Care Predictive modelling tools Return on Investment in telehealth/telecare GPs in A&E departments Why are our antenatal admissions so high? What self care tools will we need to support our new

MSK Clinical Assessment & Triage services?


Example: MSK CATS spec.


Search results included

•Anticipated case mix based on audit from existing service

•MSK self care resources

•MSK patient decision aids

ALSO

•Indication of impact on referral to acute care

•Contact info


Measuring impact

Difficult to quantify Literature search impact survey – small

pool of requestors But

Librarians are “pollinators” – Prof Paul Glazsiou

http://www.qualitymk.nhs.uk/default-ContentID-3011.htm


Nothing stands still

Evidence required by commissioners will not change, but the environment will Clinical Commissioning Groups (GP Consortia) NHS Commissioning Board – national and

regional PCT Clusters Public Health England NHS Evidence

Quality MK www.qualitymk.nhs.uk PCT website – future?


Thank You

Anne [email protected]

Documents

Gray2011