Wednesday, 10 July 2013

NHS News: the London Strategic Clinical Network

"Dr Nic Losseff, a colleague and friend of mine is the first Clinical Director of the London Neuroscience Strategic Clinical Network. The strategic clinical networks will bring stakeholders -- providers, commissioners and MSers - together to create alignment around programmes of transformational work that will improve care. The commissioning and provision of neurological services is complex, with responsibilities split across Clinical Commissioning Groups (CCGs), specialist commissioners, community services, acute hospitals, primary care and specialist hospitals. Despite some individuals receiving outstanding services, it is clear that more can be done in many areas to coordinate and improve care for MSers. The London Neuroscience Strategic Clinical Network is developing links with stakeholders in order to consult on its proposed work plan which will help improve the care for people with MS and other neurologic conditions across London."

The five priority workstreams for consultation by the London Neuroscience Strategic Clinical Network are:
  1. Setting clear commissioning standards for quality and safety in the management of patients with acute and chronic neurological conditions
  2. Agreeing implementable models of integrated care that provide a population approach, developing individual care plans and promoting self management
  3. Developing a central resource for information on both conditions and services, that aids self management, and becomes a directory signposting patients, carers and professionals
  4. Developing an education programme for non neurologic-trained professionals, particularly at the handover point of the patient pathway
  5. Developing enablers for improvement including incentives, communication and innovation

"If you interested in reading more about the proposed strategy you can read the document online. What is interesting is the following graph that is published in the document showing the number of MS admission actually increasing. The document implies that this is a negative. What is actually happening here relates to natalizumab infusions. Most hospitals in London, including ours, log these as day case admissions, which allows us to charge more for the infusions. Who said a business ethos has not entered the NHS management strategy? We are in the process of setting-up a natalizumab home-infusions service to address this ludicrous situation. What we really need is more granularity of the reasons behind the MS-related admissions. It is my experience that relapses are now a very infrequent cause of MS-related admissions. Why? Because of the impact of DMTs on relapse rates. Not only do DMTs reduce the frequency, but they also reduce the severity of relapses. What we need to show to the commissioners or payers that this is really the case. Welcome to the new NHS!"




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