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Breakfast sessionSesiwn Frecwast

Evidence Into Practice: A sustainable clinical change management programme for long term conditionsTystiolaeth i Ymarfer: rhaglen rheoli newid clinigol

gynaliadwy ar gyfer cyflyrau hirdymor

Speaker: Alex ForsterSiaradwr: Head of Sales & Marketing MSD

Pennaeth Gwerthiant a Marchnata MSD

Hosted by: Noddir gan:

@welshconfed#wnhsreality15

01/16‐1140870‐0000                                                                       Date of Prep Jan 2015

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Why MSD

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In the UK, MSD places great importance on the development of service solutions which add value

to the NHS. We currently provide a diverse portfolio of service offerings that are adding value to the

NHS while transforming MSD into a true healthcare company

MSD is a global healthcare leader working to address unmet health needs. We provide innovative medicines, vaccines and animal health products to help improve health and well-being. We work with customers in 140 countries to deliver broad-based healthcare solutions.

Why MSD

We provide more than medicines.......

“

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MSD Healthcare Services: Who are we?

We have developed a range of high quality services that are purchased by UK customers to add real value to patient care.

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Our Healthcare Services offer Solutions Beyond the Pill

1998-present

We have developed an LTC clinical change management programme proven to support Primary Care to implement NICE guidelines and improve confidence of care across their multidisciplinary teams

We support the patient directly through our self-care service that activates patients through Health Coaching while keeping them out of hospital through Remote Monitoring

2008 -present

2013 -present

MSD provide informatics solutions that impacts 33% of the UK practice population enabling Health professionals turn information into insight

Insight through Analytics

Enabling Patient

self-care

Changing Clinical Behaviours

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WellUndiagnosed

1st LTCMulti LTCs Acutely

unwell Admission

We can provide solutions for LTCs across the Patient Journey

Screening for undiagnosed unwell

Health Check appropriate patients

Holistic treatment of patient through improved LTC consultations

Access to right Treatments and Services at the right time

Improving access at point of care

Optimising Medicines use

Promotion of Patient Self care

Improving the patient discharge experience

Support following hospitalisation

Prioritising risk through stratification

Reducing risk of re-admission

MSD Informatics

MSD Informatics have been providing analytic solutions to the NHS since 1998 and are delivering real value at national, CCG and practice level across the UK. MSDi has a range of capabilities that include a unique risk profiling solution for Long Term Conditions through to a comprehensive service for NHS Health Check Programme delivery.

more about……

www.msdinformatics.com

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more about……

Our Remote Patient Monitoring service has helped change the lives of acutely unwell patients with long-term conditions. Closercare uses the latest monitoring technology combined with patient coaching techniques to embed patient self-care. We assess impact on the patient by using the PAM algorithm.

www.closercare.co.uk

We have also developed a range of accredited online tools that help assess and deliver clinical education. These can be co-created with localities as bespoke educational services

more about……

Clinical Learning and Change Management

Both services are supported with accredited education through Univadis, MSD’s global online learning resource for Health Professionals. www.univadis.co.uk

is a structured programme that transforms Primary Care teams resulting in both improved patient care and in-year savings in diseases like diabetes and COPD www.evidenceintopractice.co.uk

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Managing Long Term Conditions More Effectively In Primary Care

• Similar Challenges Across the UK

• Welsh Diabetes Delivery Plan

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1. Understanding your practice

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1. Understanding your practice

2. Review, understand, plan to change

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3. Measure and Share

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Impact on QOF

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Data on file, NHS Greenwich - May 2011

*Risk Factor Targets Based on NICE Type 2 Diabetes Guidelines, CG87, May 2009                                                    Data on File MSD, September 2012 

Greenwich PCT Amalgamated Data: Number of Patients Achieving NICE Endorsed* Risk Factor Targets at Baseline and Follow‐Up 

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Impact of the EVIDENCE into PRACTICE™ programme on Diabetic 25 Medicine Outpatient attendances and CVD admissions in NHS Greenwich pilot sites (14) compared to non pilot sites (32). Figures standardised per 1000 patients with diabetes.

7. Data on file - NHS Greenwich May 2011

• 12% decrease in Diabetic medicine Outpatient attendances (in comparison to 1%    increase in non‐pilot group) 

• 8% decrease in all CVD attendance (in comparison to 2% increase in non‐pilot group)

• Greenwich PCT have Calculated that the programme’s impact in relation to saved CVD attendances and Diabetes OP attendances are £177,734 and £23,385 in the pilot practices respectively. A total of £ 201,119 (average of £14,366 per practice).

• Greenwich PCT have also assessed the potential impact that we will achieve through the extension of the programme to all practices: this is estimated at £731,688

•Actual impact; £903,324

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The UKPDS Outcomes Model is a computerised simulation designed to estimate Life Expectancy, Quality Adjusted Life Expectancy and costs of complications in people with type 2 diabetes. It uses the equations and algorithms published in the UK Prospective Diabetes Study (UKPDS). 

The model was developed using data from patients with newly‐diagnosed type 2 diabetes who participated in the UKPDS 2 and were followed up for between six and twenty years. It predicts likely outcomes using risk factors that include; age, sex, ethnicity, duration of diabetes, height, weight, smoking status, total cholesterol, HDL cholesterol, systolic blood pressure and HbA1c.

The UKPDS Outcomes Model is able to simulate event histories that closely match observed outcomes in the UKPDS and that can be extrapolated over patients’ lifetimes. The model allows simulation of a range of long‐term outcomes, which should assist in informing future economic evaluations of interventions in Type 2 diabetes 

A model to estimate the lifetime health outcomes of patients with Type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68). PM Clarke, AM Gray, A Briggs,AJ Farmer, P Fenn, RJ Stevens, DR Matthews, IM Stratton, RR Holman. Diabetologia 2004; 47:1747–1759. 

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Data on File MSD  ‐ November 2012

Modelled 10 year risk of diabetes/ cardiovascular related events

Modelled outcomes across a population of 1000 patients with Diabetes over a 10 year period show:

11.9% increase in life expectancy equating to an average of 0.7 additional years of life per patient (5.9 years at Baseline – 6.6 years at follow‐up)

13.3% increase in Quality Adjusted Life Expectancy equating to 0.6 additional quality adjusted life years per patient (4.5 years at baseline – 5.1 years at follow‐up)

•6.5% reduction in the incidence of Ischemic Heart Disease over 10 years = 4 Patients

•6.6% reduction in the incidence of Heart Failure over 10 years  = 12 Patients

•17.6% reduction in the incidence of Stroke over 10 years  = 21 Patients

•12.9% reduction in the incidence of Myocardial Infarction over 10 years  = 12 Patients 

•26.3% reduction in the incidence of Blindness over 10 years  = 5 Patient

•9.4% reduction in the incidence of Amputation over 10 years = 5 Patients

•14.3% reduction in the incidence of Renal Failure over 10 years = 1 Patient

•19.2% reduction in all deaths over 10 years  = 104 Patients 

Data on File MSD November 2012

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Modelled outcomes across a population of 3900 patients with Diabetes over a 10 year period show:

11.9% increase in life expectancy equating to an average of 0.7 additional years of life per patient (5.9 years at Baseline – 6.6 years at follow‐up)

13.3% increase in Quality Adjusted Life Expectancy equating to 0.6 additional quality adjusted life years per patient (4.5 years at baseline – 5.1 years at follow‐up)

•6.5% reduction in the incidence of Ischemic Heart Disease over 10 years = 16 Patients

•6.6% reduction in the incidence of Heart Failure over 10 years  = 47 Patients

•17.6% reduction in the incidence of Stroke over 10 years  = 82 Patients

•12.9% reduction in the incidence of Myocardial Infarction over 10 years  = 47 Patients 

•26.3% reduction in the incidence of Blindness over 10 years  = 20 Patient

•9.4% reduction in the incidence of Amputation over 10 years = 20 Patients

•14.3% reduction in the incidence of Renal Failure over 10 years = 4 Patient

•19.2% reduction in all deaths over 10 years  = 406 Patients 

Data on File MSD November 2012

The UKPDS model also calculates the health care costs associated with each modelled fatal or non‐fatal diabetes‐related complication. The costs that accrue in all subsequent years are also taken into consideration. The default costs are derived from the UKPDS paper  and have been updated using the Hospital and Health Services Price Index to reflect health care resource use in the United Kingdom. 

Based on the avoided complications modelled, an average saving of £148.30 per patient with diabetes over 10 years can be calculated. 

This equates to £148,300 for a diabetes population of 1000 patients over 10 years

Or £578,370 across 3900 patients (As per Greenwich Pilot Sites minus Conway Medical Centre) with diabetes over 10 years

Data on File MSD November 2012

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For more information

www.evidenceintopractice.co.uk

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