Parkinson’s Awareness Week 2016: Good practice in commissioning and the clinic

April 22nd 2016 category Healthcare News

Parkinson’s Awareness Week 2016 brings focus to not just Parkinson’s but other movement disorders and the people affected by them.

Listen to patients

In our video Matt Eagles talks about his experience of Parkinson’s, and especially from his perspective as a younger person with young children himself. Listen to the patients, is his message. Each person with Parkinson’s is different, he says, so listen to what they are saying. In his experience that doesn’t always happen.


Smart commissioning

The Neurology Intelligence Report published this week co-authored by Sue Thomas and Deborah Matthews at NHiS Commissioning Excellence, reinforces this point. Too many people with Parkinson’s are being admitted to hospital unnecessarily, and this is often because services are not tailored to and addressing their needs as an individual. Parkinson’s is a long-term condition, and the people affected often have complex needs. If anything the report should be a wake-up call that we need to look closely at what people with Parkinson’s need if we are to get services right.

For individual CCGs getting services right means delivering better care and improving outcomes. The report authors found that hospital admission costs for neurology patients in the Wessex region have gone up drastically between 2009 and 2014, from £51 million to £73 million, largely driven by a huge increase in both admissions and outpatient appointments.

Looking more closely at the patients being admitted the report identifies a raft of avoidable admissions for problems that could have been prevented with more proactive care in the community. Amongst people with Parkinson’s the most common reasons for admission were respiratory dysfunction, urinary tract infection, and fractures, falls and injuries – all largely avoidable problems with the right well-planned anticipatory care. These patients also fell into the group for whom hospital stays were longer, so it is imperative that commissioners put a priority on prevention with the primary focus on keeping people with Parkinson’s as well as they can be.

Best practice guidelines

Another aspect to staying well is getting medication right. For those Parkinson’s patients who find their oral treatments are not working well, it is essential that clinicians can easily navigate the steps towards referring these patients for non-oral therapy (apomorphine, intestinal levodopa gel infusion (Duodopa), and deep brain stimulation. For the right patients, these treatments can be truly life changing).

The team at NHiS Commissioning Excellence is very proud to have contributed to the work to launch a new best practice pathway for the use of non-oral treatments in Parkinson’s, which has been devised by clinicians to make the referral process for these therapies more explicit.

“We are delighted to have been able to develop this pathway for improving access to non-oral treatments. Having one single pathway, relevant to everyone, across all disciplines including all aspects of care, for non-oral treatment makes good sense and ensures better standardisation of treatment for people with Parkinson’s.”

Sue Thomas, Chief Executive of Commissioning Excellence

This new pathway means that for the first time, clinicians have a clear road-map for the use of the non-oral therapies, and we hope that in the future more patients will have the opportunity to have a discussion with a specialist about whether these treatments might have a role. 

Central to the pathway is ensuring clinicians know the referral routes for non-oral therapy and to make access fair across the country. It is not good enough that management of Parkinson’s is currently so variable, which means many patients who could benefit from non-oral treatments cannot access them.

Putting excellence into practice

There is so much excellent work going on around the UK and we particularly wanted to flag the Parkinson’s and other Movement Disorders Health Integration Team (MOVE-hIT) in the Bristol area which consists of clinical staff, scientists, charity and industry representatives, and patients. This team is working tirelessly to improve patient pathways in Bristol, and their main objective is to evolve, over the next 10 years, a high quality, high impact, internationally-recognised system for Parkinson's and other movement disorders. This will incorporate and integrate all aspects of clinical and social care, translational research and competency based education, supported by first class management and commissioning.
The Commissioning Excellence team has supported the MOVE-hIT group to carry out an audit of their service across the trust including extensive patient consultation, data analysis and provided a report and action plan for strategic development.

"HES Data and a subsequent audit of our services enable us to develop an overview of how services were working and how patients viewed those services. This impartial needs assessment has catalysed discussions with the CCGs we serve and within our trust enabling development of a new 9 year strategy for the MOVE-hIT."

Dr Alan Whone, Director of MOVE-hIT who has recently won an award for his work in Bristol and Lucy Mooney, Deputy Director of MOVE-hIT

Commissioning Excellence has additionally supported the team to start work on an integrated Parkinson’s pathway which maps out best practice in Parkinson’s care right from diagnosis through the whole course of the condition.

2016 and beyond

Altogether the picture for Parkinson’s this week is a bright one: dedicated commissioners and clinicians (not to mention patients, charities and scientists) are working towards ensuring that every single person affected by Parkinson’s in the UK receives the gold standard in care, and we are extremely proud to be part of that

About the Author

April 22nd 2016 category Healthcare News

Commissioning Excellence

As one of NHS England’s recognised niche specialist commissioning support providers, we offer a full range services to assist you in improving patient outcomes. Our experience covers all long term conditions, with a particular specialism in the field of neurology.

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