Improving planned care

At its Board meeting on 19 April, the Planned Care Alliance approved the proposal to establish a temporary Planned Care Citizens’ Panel. The aim of this virtual panel will be to support the Alliance with communications around its planned care recovery strategy. This important strategy sets out how we’ll work together across the whole of planned care to restore services and address the increased waiting list. 

The panel’s input and expertise will help ensure that public information is relevant, clear and that it gets to the people who need it – patients and their families, carers and services users across West Yorkshire and Harrogate. The panel will be in place for 12 weeks from 21 June to 10 September.

More information about the panel is available on the
Planned Care Citizens’ Panel page.

We know that many people have privacy or dignity issues with hospital gowns and prefer not to wear them. Sometimes, having to wear a hospital gown for a scan or examination is necessary but in most cases, you can wear your own clothes. We have developed a series of clothing guidance information leaflets that explain what to wear, and what not to wear, when attending hospital for a particular scan or examination.

Covid-19 continues to have a severe impact on capacity for hospitals to carry out routine operations and planned (elective) care procedures. 

Hospitals are working hard to maintain Priority 1 surgery (urgent within 72 hours) and Priority 2 surgery (urgent within 4 weeks) during the pandemic but many routine hospital services have been suspended.

Plans are being developed for how local health services will work together to address the significant waiting list for planned care, once we see a sustained reduction in the rate of new Covid-19 cases across the region.

Although 2020 was an incredibly difficult year, we did see many healthcare improvements, innovations and advancements. There has been a significant increase in the use of online communications, services and processes to help deliver health care services safely, and to support people’s health and wellbeing.

More people than ever before have used technology, including telephone and video consultations to talk to healthcare professionals. A lot of people have made healthier lifestyle choices since the start of the pandemic and many have found effective ways to help manage a health condition whilst healthcare services have been restricted.

We have produced the following ‘Working together’ case studies to give you a brief outline of some of the work that has been going on during the pandemic to offer safe and effective options for healthcare at this challenging time.

• Virtual Consultations
• First Contact Practitioner Physiotherapists in Primary Care
• Improving Outpatient Appointments

Flash glucose monitoring, or Flash for short, uses a sensor that is placed on the back of the upper arm and worn externally by the user, allowing glucose information to be monitored using a mobile app. This information helps the user and their clinical team to identify what changes are needed to insulin administration to achieve optimal glucose control, and therefore reducing the risk of adverse outcomes.

The original roll out of Flash only applied to select patients with type 1 diabetes. The vast majority of people who have diabetes and a learning disability have type 2 diabetes so would have not met the original criteria for Flash. All patients with a learning disability and type 1 or type 2 diabetes, who use insulin to manage their condition, will now be offered a flash glucose monitor at their next review.

Our commissioning policy for flash glucose monitoring has now been updated to reflect this change. You can view the policy, along with further information about Flash, in our Medicines and prescribing commissioning policies section.

Covid-19 has had a major impact on planned care services across West Yorkshire and Harrogate.

During the first peak of the pandemic, health services had to take the difficult decision to temporarily stop carrying out most planned care procedures. This was done to keep both patients and staff safe whilst services focussed on treating patients who had contracted the virus.

Things are far from being how they were before Covid-19 but planned care services that were temporarily stopped have restarted gradually and in the safest possible way for patients and staff.

This section ‘planned care services in changing times’ gives an update on the current situation with planned care in West Yorkshire and Harrogate.

It also looks at how patients are being prioritised, what patients need to know before they go into hospital for a planned care procedure and how patients are being supported whilst they wait for a planned care procedure.

The First Contact Physiotherapy Practitioner Programme places physiotherapists in GP practices as a first point of contact for people with MSK conditions. Having direct access to an experienced physiotherapist means there are no unnecessary delays for MSK patients in receiving the care they need.

The West Yorkshire and Harrogate Joint Committee of Clinical Commissioning Groups met in public on Tuesday 14 January 2020 where it agreed the adoption of single commissioning policies for hip replacement surgery and arthroscopic hip surgery, to be implemented across the region within the next 12 months. The policies align with the wider musculoskeletal (MSK) pathway that was introduced back in May 2019.

The Committee also agreed a single clinical pathway and policy for cataract surgery, with a timescale of up to three years for implementation. Under the new pathway, better use will be made of the many community optometrists we have in West Yorkshire and Harrogate and this will have a number of benefits for eye care services and the people who use them.

The West Yorkshire and Harrogate Joint Committee of Clinical Commissioning Groups met in public on 5 November 2019 where it agreed the adoption of single commissioning policies for knee surgery. These standardised policies cover knee replacement surgery (arthroplasty) and keyhole surgery on the knee (arthroscopy) and will be implemented across West Yorkshire and Harrogate within the next 12 months.

The policies can be found in Our West Yorkshire and Harrogate commissioning policies section, on the orthopaedic and musculoskeletal (MSK) page. You'll also find 'mapping and gapping' documents that show how the single policies compare to the existing policies of our local Clinical Commissioning Groups (CCGs).

The West Yorkshire and Harrogate Joint Committee of Clinical Commissioning Groups met in public on 5 November 2019 where it agreed the adoption of a single clinical pathway and commissioning policy for hydroxychloroquine and chloroquine retinopathy monitoring.

These drugs are used to treat various conditions, particularly autoimmune diseases like rheumatoid arthritis, but they can cause side effects. Some people who take them for more than five years, or in high doses, are at increased risk of damage to their retina, a condition known as hydroxychloroquine retinopathy.

The introduction of this pathway and policy will ensure that local patients who are prescribed hydroxychloroquine or chloroquine are effectively monitored, preventing avoidable sight loss and avoiding unnecessary interventions.

View all our previous programme updates here.