Lorenzo: A Clinicians Perspective

Lorenzo: A Clinicians PerspectiveNeil NevittPodiatry Team LeaderLiverpool PCT

Who we are?Community Podiatry serviceClinic based sessionsHome visitsNail surgeryHigh risk patients diabetes, PVD, RABiomechanicsSelf referral system open to all residents of LiverpoolCurrently- approx 500 clinic/ 180 dom sessions a month

Areas for Improvement: Before LorenzoAccurate understanding of current patients vs total caseloadImproved booking and clinic managementWaiting list managementScheduling system for home visitsChoiceEquityImproved accuracy of demographic details

As a Team LeaderStaff and rota management Availability of Clinic sessionsManaging demandUnderstanding productivity DNAsIdentifying opportunities

What the Podiatry Service wanted to deliver?Flexibility and choice to patientsAn accessible, equitable service for allA service that responded to patient needTeam that understands its achievements is run effectively.A service with fewer patient complaints

Reporting and Information GatheringThenManual countsMonthly talliesDependent on individual clinic staff

NowMonthly reportsInformation TeamData quality programmeCitywide vs clinic view

Chart1

766

602

741

573

685

641

584

504

Referrals

Month

No of Referrals

Liverpool PCT Podiatry Service Referrals

Sheet1

LIVERPOOL PCT COMMUNITY PODIATRY SERVICE

MonthReferrals

Jan-07766

Feb-07602

Mar-07741

Apr-07573

May-07685

Jun-07641

Jul-07584

Aug-07504

Total5096

MonthContacts

Jan-073599

Feb-073720

Mar-073825

Apr-073101

May-074058

Jun-074100

Jul-073782

Aug-073924

Total30109

Data Source: NCRS Lorenzo database as at 17/09/2007

Sheet1

Referrals

Month

No of Referrals


Sheet2

Contacts

Month

Number of Contacts

Liverpool PCT Podiatry Service Total Contacts

Sheet3

Chart2

3599

3720

3825

3101

4058

4100

3782

3924

Contacts

Month

Number of Contacts


Sheet1

LIVERPOOL PCT COMMUNITY PODIATRY SERVICE

MonthReferrals

Jan-07766

Feb-07602

Mar-07741

Apr-07573

May-07685

Jun-07641

Jul-07584

Aug-07504

Total5096

MonthContacts

Jan-073599

Feb-073720

Mar-073825

Apr-073101

May-074058

Jun-074100

Jul-073782

Aug-073924

Total30109

Data Source: NCRS Lorenzo database as at 17/09/2007

Sheet1

Referrals

Month

No of Referrals


Sheet2

Contacts

Month

Number of Contacts


Sheet3

Offering Choice and Managing Demand

Chart1

370

1499

659

751

670

389

565

492

425

1325

1534

262

1514

543

114

775

1174

655

582

905

73

3687

2

Patients Seen by Location

Location

No of Contacts

Index

Information & Analysis

Provider Services

AHP MONTHLY REPORT

20th September 2007

COMMENTARY

DIETETICS

PHYSIOTHERAPY

PODIATRY

SPEECH THERAPY - ADULT

SPEECH THERAPY - CHILD

OCCUPATIONAL THERAPY

FALLS TEAM

CASE MANAGERS

WAITING TIMES

Commentary

Allied Health Professionals Monthly Report

COMMUNITY PODIATRY SERVICE COMMENTARY:

Referrals to the Podiatry service remain steady at 500 - 600 per month. The service aims

to offer assessment appointments to all patients within 12 weeks of referral (4 weeks for

high risk patients) and waiting times are currently within this.

Contacts for 07/08 are marginally down on the previous year, this is due to the increased

number of patients failing to attend booked appointments (DNA's).

The service is looking to determine and address the reasons behind the increase in DNA's.

COMMUNITY NUTRITION & DIETETICS SERVICE COMMENTARY:

1) The fall off in activity links to staff holidays and maternity leave within the team.

2) The service will now have fewer DNA's as it is operating an opt in system with fewer

wasted appointments.

COMMUNITY OCCUPATIONAL THERAPY ADULT REHAB TEAM COMMENTARY:

1) Referrals prior to Jan 07 include falls referrals from BGH. In Jan 07 the service

sent an OT support worker to BGH and subsequently stopped taking these referrals.

2) The service has had 1 WTE qualified therapist on long term sick (6 months) & 1

WTE assistant practitioner also on long term sick.

3) The service currently has 1 WTE assistant practitioner post vacant (since Sept 06).

DIETETICS

COMMUNITY NUTRITION & DIETETICS

Referrals Received*Apr-07May-07Jun-07Jul-07Aug-07Sep-07Oct-07Nov-07Dec-07Jan-08Feb-08Mar-08TotalF/C Outturn

Urgentn/a000113

Routinen/a1471361331185341602

Total014713613311900000005351605

Referrals Closed by reason*Apr-07May-07Jun-07Jul-07Aug-07Sep-07Oct-07Nov-07Dec-07Jan-08Feb-08Mar-08Total

Dependent c/load entry closedn/a11104126

Discharged with possible recalln/a10001

Inappropriate Referraln/a10001

Othern/a11002

Deceasedn/a11136

Patient Diedn/a9123226

Self Disch/Treatm't refusedn/a00011

Treatment Completedn/a61108

Total0302597000000071

Referrals RejectedApr-07May-07Jun-07Jul-07Aug-07Sep-07Oct-07Nov-07Dec-07Jan-08Feb-08Mar-08Total

Rejectedn/a23207

TSA Rejectedn/a1521121866

Note: Rejected TSA referrals are not specific to any AHP team

DOMICILIARY/HOME CONTACTS ONLY

Total Contacts**Apr-07May-07Jun-07Jul-07Aug-07Sep-07Oct-07Nov-07Dec-07Jan-08Feb-08Mar-08TotalF/C Outturn

2007/2008n/a501012662526692007

2006/2007n/an/an/an/an/an/an/an/an/an/an/an/an/an/a

% Diffn/an/an/an/an/an/an/an/an/an/an/an/an/an/a

DNA 2007/2008**n/a33201743129

Canc 2007/2008**n/a001239

Total DNA/Canc 2007/2008n/a332119000000046138

Total DNA/Canc 2006/2007n/an/an/an/an/an/an/an/an/an/an/an/an/an/a


Unreconciled Contactsn/a15563395

Notes:

* Where referred to Prof Carer is 5NL_DIET_0000001 to 25 (Rejected Referrals NOT included)

** Where referred to Prof Carer is 5NL_DIET_0000001 to 25 and contacts have been actualised.

actualised = contact has been recorded as attended, CANC or DNA for clinic/dom appointment

Data Sources:

NCRS Lorenzo database as at 17/09/2007

Patients Seen by LocationAprMayJunJulAugSepOctNovDecJanFebMarTotal

aa_nk__Health Clinic (NHS)n/a00202

aa_nk__Nursing Home (non-NHS)n/a00101

aa_nk__Other Locationn/a0010212

aa_nk__Patient's Homen/a00123

aa_nk__Res. Care Home (Local Auth)n/a00011

Lancaster Centren/a00101

Patient's Homen/a50101249246646

Telephonen/a00213

Total0501012662520000000669

&L&8&Z&FDavid O'GradySpecialist Information Analyst0151 296 7016David.O'[email protected]

DIETETICS

1129.235294117667.30045369210

3729.235294117667.30045369210

2529.235294117667.30045369210

4429.235294117667.30045369210

3029.235294117667.30045369210

4429.235294117667.30045369210

1729.235294117667.30045369210

4829.235294117667.30045369210

2729.235294117667.30045369210

2929.235294117667.30045369210

2529.235294117667.30045369210

4029.235294117667.30045369210

3429.235294117667.30045369210

2429.235294117667.30045369210

2129.235294117667.30045369210

2929.235294117667.30045369210

1229.235294117667.30045369210

Referrals

Average

UCL

LCL

No. of Referrals

Dietetics Weekly Referrals SPC chart

PHYSIO

0

0

0

0

0

0

0

0


Location

No of Contacts

PODIATRY

COMMUNITY PHYSIOTHERAPY


Urgentn/a000000

Routinen/a2332332531738922676

Total023323325317300000008922676


Clinical Assessment Completedn/a00101


Discharged - Other Providern/a12003


Othern/a532010

Deceasedn/a01113



Transfer to hospitaln/a015511

Transfer to residential accomn/a10001


Treatment unnecessaryn/a10012

Unable to contact patientn/a10001

Total0875545150000000202


Rejectedn/a111771247




2007/200845763865777491734438263

2006/200762077590677889357463973554269763955583538353

% Diff-26.3%-17.7%-27.5%-0.5%2.7%-1.1%

DNA 2007/2008**46468872173

Canc 2007/2008**2314912765156

Total DNA/Canc 2007/200869181520150000000137329

Total DNA/Canc 2006/20075992659771667594531006885925925

% Diff16.9%-80.4%-76.9%-79.4%-78.9%-85.2%-64.5%


Notes:

* Where referred to Prof Carer is 5NL_PHYSIO_0000001 to 24 (Rejected Referrals NOT included)

** Where referred to Prof Carer is 5NL_PHYSIO_0000001 to 24 and contacts have been actualised.


Data Sources:

Peak Physiotherapy database as at 31/07/2007



43 Whitehedge Road, Garston, L19 1RZ000112

aa_nk__Health Centre000101

aa_nk__Health Clinic (NHS)014101025

aa_nk__Nursing Home (NHS)382743072

aa_nk__Nursing Home (non-NHS)0511191146

aa_nk__Other GMP Premises001001

aa_nk__Other Location1941414758

aa_nk__Patient's Home001001

aa_nk__Public Place011002

aa_nk__Res. Care Home (Local Auth)010001

aa_nk__Res. Care Home (non-NHS/LA)000011

aa_nk__Resource Centre (Local Auth)001001

aa_nk__Ward013123187271594

DLL GYM001001

KENT LODGE010139187165

Patient's Home4004814565196082464

Patient's Visiting Address041207

Telephone000011

Total45763865777491700000003443


PODIATRY

3751.058823529487.627972465614.4896745932

5151.058823529487.627972465614.4896745932

6651.058823529487.627972465614.4896745932

4851.058823529487.627972465614.4896745932

4051.058823529487.627972465614.4896745932

5851.058823529487.627972465614.4896745932

5951.058823529487.627972465614.4896745932

7151.058823529487.627972465614.4896745932

3551.058823529487.627972465614.4896745932

6151.058823529487.627972465614.4896745932

6151.058823529487.627972465614.4896745932

5251.058823529487.627972465614.4896745932

5751.058823529487.627972465614.4896745932

5551.058823529487.627972465614.4896745932

3251.058823529487.627972465614.4896745932

5051.058823529487.627972465614.4896745932

3551.058823529487.627972465614.4896745932

Referrals

Average

UCL

LCL

No. of Referrals

Physiotherapy Weekly Referrals SPC chart

SPEECH ADULT

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0


Location

No of Contacts

SPEECH CHILD

COMMUNITY PODIATRY


Urgent9498274939307737

Routine47958761453546526806432

Total573685641584504000000029877169


Clinical Assessment Completed210003

Dependent c/load entry closed18252312280

Discharged with possible recall110002

Other010416

Patient Died4651117

Treatment Completed11244829

Inappropriate Referral020002

Unable to contact patient002002

Referred back GP000011

Treatment unnecessary000022

Total36383421150000000144

Referrals Rejected/CancelledApr-07May-07Jun-07Jul-07Aug-07Sep-07Oct-07Nov-07Dec-07Jan-08Feb-08Mar-08Total

Rejected96518139

Cancelled013206

Total Contacts**AprMayJunJulAugSepOctNovDecJanFebMarTotalF/C Outturn

2007/2008310140584100378239241896545516

2006/20073425461744593854405839814180374329553599372038254641646416

% Diff-9.5%-12.1%-8.1%-1.9%-3.3%-1.9%

DNA 2007/2008**25128029834037715463710

Canc 2007/2008**46549249360750425616146

Total DNA/Canc 2007/2008716772791947881000000041079857

Total DNA/Canc 2006/200737353662454558555061156250768467875070057005

% Diff92.0%44.0%26.8%73.8%50.6%40.7%

Unreconciled Contacts6573140140145563

Notes:

* Where referred to Prof Carer is 5HA_MA_0000001 to 46 (Rejected Referrals NOT included)

** Where referred to Prof Carer is 5HA_MA_0000001 to 46 and contacts have been actualised.


Data Source:



Aintree HC7483727566370

Belle Vale HC2283862943372541499

Bousfield HC135122152146104659

Croxteth Clinic150176137145143751

Dovecot HC142133146115134670

Edge Hill HC8676688079389

Everton Rd1471139497114565

Hartington Rd120821019792492

Livingston Drive FHC586112110184425

Norris Green FHC2672482842842421325

Old Swan HC3003513402313121534

Princes Park HC5465455543262

Queens Drive FHC2933253122673171514

Riverside HC108114107100114543

Sandringham MC2320193022114

Sheil Park HC172145143169146775

Sir Alfred Jones2072532272332541174

Speke HC135118140128134655

Vauxhall HC11314499103123582

Wavertree HC178186201159181905

KENT LODGE56980073

Patient's Home/Domiciliary558489908289663687

Telephone000202

Total31014058410037823924000000018965


SPEECH CHILD

128138.5238095238216.848277608960.1993414387

97138.5238095238216.848277608960.1993414387

167138.5238095238216.848277608960.1993414387

152138.5238095238216.848277608960.1993414387

153138.5238095238216.848277608960.1993414387

123138.5238095238216.848277608960.1993414387

169138.5238095238216.848277608960.1993414387

150138.5238095238216.848277608960.1993414387

145138.5238095238216.848277608960.1993414387

165138.5238095238216.848277608960.1993414387

152138.5238095238216.848277608960.1993414387

132138.5238095238216.848277608960.1993414387

166138.5238095238216.848277608960.1993414387

184138.5238095238216.848277608960.1993414387

109138.5238095238216.848277608960.1993414387

158138.5238095238216.848277608960.1993414387

95138.5238095238216.848277608960.1993414387

113138.5238095238216.848277608960.1993414387

139138.5238095238216.848277608960.1993414387

105138.5238095238216.848277608960.1993414387

107138.5238095238216.848277608960.1993414387

Referrals

Average

UCL

LCL

No. of Referrals

Podiatry Weekly Referrals SPC chart

OT


Location

No of Contacts

FALLS

COMMUNITY SPEECH THERAPY - ADULT (17+)


Urgentn/a000226

Routinen/a37444226149447

Total0374442280000000151453




Othern/a01001

Deceasedn/a11002


Recoveryn/a10001


Total09951000000024


Rejectedn/a211131339



COMMUNITY SPEECH THERAPY - ADULT (17+)



2007/2008n/a64410767224896



DNA 2007/2008**n/a081142392

Canc 2007/2008**n/a000000

Total DNA/Canc 2007/2008n/a0811400000002392




Willy Russell Centre Speech Therapy

Referrals into service

MonthADULT

Apr-2007n/a

May-20076

Jun-200714

Jul-20074

Aug-20074

Total28

Notes:

* Where referred to Prof Carer is 5NL_SALT_0000001 to 6 (Rejected Referrals NOT included)

** Where referred to Prof Carer is 5NL_SALT_0000001 to 6 and contacts have been actualised.


Data Sources:



aa_nk__Health Centren/a019502897

aa_nk__Health Clinic (NHS)n/a00011

aa_nk__Nursing Home (NHS)n/a00303

aa_nk__Nursing Home (non-NHS)n/a03121126


aa_nk__Public Placen/a00303

aa_nk__School (Public/Private)n/a01001

aa_nk__School (State)n/a01001

aa_nk__Wardn/a01001


Patient's Visiting Addressn/a00101

Telephonen/a00011

Total0644107670000000224


FALLS

58.294117647121.42576658320

168.294117647121.42576658320

88.294117647121.42576658320

48.294117647121.42576658320

58.294117647121.42576658320

118.294117647121.42576658320

128.294117647121.42576658320

148.294117647121.42576658320

58.294117647121.42576658320

108.294117647121.42576658320

168.294117647121.42576658320

58.294117647121.42576658320

48.294117647121.42576658320

98.294117647121.42576658320

48.294117647121.42576658320

78.294117647121.42576658320

68.294117647121.42576658320

Referrals

Average

UCL

LCL

No. of Referrals

Adult Speech & Language Therapy Weekly Referrals SPC chart

CASE MANAGERS

0

0

0

0

0

0

0

0

0

0

0

0


Location

No of Contacts

Waiting Times

COMMUNITY SPEECH THERAPY - CHILD (0-16)

Total ContactsAprMayJunJulAugSepOctNovDecJanFebMarTotalF/C Outturn

2007/20085951111102667136537689043

2006/2007n/an/an/an/an/an/an/an/an/a73863668920638252

% Diffn/an/an/an/an/an/an/an/an/an/an/an/an/a9.6%

Total DNA/CANCAprMayJunJulAugSepOctNovDecJanFebMarTotalF/C Outturn

2007/200879821051091034781147

2006/2007n/an/an/an/an/an/an/an/an/a918061232928

% Diffn/an/an/an/an/an/an/an/an/an/an/an/an/a23.6%

Willy Russell Centre Speech Therapy

Referrals into service

MonthCHILD

Apr-2007n/a

May-200715

Jun-20072

Jul-200710

Aug-200715

Total42


SPC data

COMMUNITY OCCUPATIONAL THERAPY ADULT REHAB TEAM


Urgentn/a000113

Routinen/a88921431094321296

Total0889214311000000004331299


Clinical Assessment Completedn/a00101




Transfer to hospitaln/a00112


Total0302234200000000106


Rejectedn/a10150328





2007/2008n/a1921842371998122436



DNA 2007/2008**n/a102039

Canc 2007/2008**n/a000113

Total DNA/Canc 2007/2008n/a10210000000412




Notes:

* Where referred to Prof Carer is 5NL_OT_0000001 to 12 (Rejected Referrals NOT included)

** Where referred to Prof Carer is 5NL_OT_0000001 to 12 and contacts have been actualised.


Data Sources:



aa_nk__Not Specifiedn/a00112


aa_nk__Patient's Homen/a20002

aa_nk__Wardn/a0001

aa_nk__Workn/a01001

Livingston Driven/a10001



Telephonen/a7211424

Total01921842371990000000811


SPC data

1424.37538.559397163110.1906028369

2524.37538.559397163110.1906028369

1924.37538.559397163110.1906028369

1624.37538.559397163110.1906028369

1924.37538.559397163110.1906028369

2124.37538.559397163110.1906028369

2524.37538.559397163110.1906028369

2424.37538.559397163110.1906028369

1724.37538.559397163110.1906028369

3124.37538.559397163110.1906028369

3724.37538.559397163110.1906028369

2624.37538.559397163110.1906028369

3124.37538.559397163110.1906028369

3124.37538.559397163110.1906028369

2624.37538.559397163110.1906028369

2824.37538.559397163110.1906028369

Referrals

Average

UCL

LCL

No. of Referrals

Occpational Therapy Weekly Referrals SPC chart

raw data

0

0

0

0

0

0

0

0

0


Location

No of Contacts

FALLS TEAM


Urgentn/a000000

Routinen/a352029589267

Total03520295000000089267




Recoveryn/a10001

Total0300000000003


Rejectedn/a20002





2007/2008n/a66415761225675



DNA 2007/2008**n/a000339

Canc 2007/2008**n/a020026

Total DNA/Canc 2007/2008n/a02030000000515




Notes:

* Where referred to Prof Carer is 5NL_FALLS_0000001 (Rejected Referrals NOT included)

** Where referred to Prof Carer is 5NL_FALLS_0000001 and contacts have been actualised.


Data Sources:






Total0664157610000000225


115.235294117611.88423028790

65.235294117611.88423028790

65.235294117611.88423028790

65.235294117611.88423028790

75.235294117611.88423028790

65.235294117611.88423028790

45.235294117611.88423028790

75.235294117611.88423028790

25.235294117611.88423028790

95.235294117611.88423028790

65.235294117611.88423028790

95.235294117611.88423028790

35.235294117611.88423028790

25.235294117611.88423028790

15.235294117611.88423028790

15.235294117611.88423028790

35.235294117611.88423028790

Referrals

Average

UCL

LCL

No. of Referrals

Falls Team Weekly Referrals SPC chart

0

0

0


Location

No of Contacts

CASE MANAGERS


Urgentn/a000000

Routinen/a20531030

Total0205300000001030


n/a00000

Total0000000000000


Rejectedn/a00000





2007/2008n/a29116468172516



DNA 2007/2008**n/a001013

Canc 2007/2008**n/a3051927

Total DNA/Canc 2007/2008n/a306100000001030




Notes:

* Where referred to Prof Carer is 5NL_AHP_0000002 to 4 (Rejected Referrals NOT included)

** Where referred to Prof Carer is 5NL_AHP_0000002 to 4 and contacts have been actualised.


Data Sources:



AHP Waiting Times

Occupational Therapy Adult Rehab team

MonthNew ReferralsShortest wait in weeksLongest wait in weeksAverage wait in weeksNo. waiting for 1st contact/assessNo. waiting for ongoing treatmentNo. Discharged

Apr-200738115n/a106239

May-200785118n/a21889

Jun-200786118n/a5814055

Jul-2007120n/an/a221565858

Aug-2007n/an/an/an/an/an/an/a

Speech & Language Therapy - Adults


Apr-200720n/an/an/a149n/a49

May-2007n/an/an/an/an/an/an/a

Jun-200740n/an/a38n/a75n/a

Jul-200738n/an/a48n/an/a16

Aug-200738n/an/a48n/an/a16

Speech & Language Therapy - Children


Apr-20073521605237016834


Jun-200736n/an/a5226519656

Jul-200735n/an/a5224722628

Aug-200723n/an/a5218722793

Podiatry


Apr-2007565n/a20n/a3920000**93***

May-2007390n/a20n/a3220000**93***

Jun-2007437n/a20n/a3020000**93***

Jul-2007n/an/an/an/an/an/an/a


* = Waiting list for new assessments increasing due to staff shortages (currently 5 WTE short) ** = Approximate Active Caseload

*** = not a reflective figure due to problems with discharging patients on Lorenzo

Nutrition & Dietetics - Adult


Apr-2007n/an/an/an/an/an/an/a


Jun-2007n/an/an/an/an/an/an/a



Nutrition & Dietetics - Children


Apr-2007n/an/an/an/an/an/an/a


Jun-2007n/an/an/an/an/an/an/a



Physiotherapy


Apr-200714814221322n/a121

May-200718314623327n/a98

Jun-200719315025368n/a81

Jul-2007n/an/a54n/a450n/an/a



PODIATRY REFERRALS SPC DATAPHYSIOTHERAPY REFERRALS SPC DATADIETETICS REFERRALS SPC DATAADULT SPEECH & LANGUAGE THERAPY REFERRALS SPC DATAOCCUPATIONAL THERAPY REFERRALS SPC DATAFALLS TEAM REFERRALS SPC DATA

Week endingReferralsAveragemoving rangeAv moving rangeSigmaUCLLCLweek noWeek endingReferralsAveragemoving rangeAv moving rangeSigmaUCLLCLweek noWeek endingReferralsAveragemoving rangeAv moving rangeSigmaUCLLCLweek noWeek endingReferralsAveragemoving rangeAv moving rangeSigmaUCLLCLweek noWeek endingReferralsAveragemoving rangeAv moving rangeSigmaUCLLCLweek noWeek endingReferralsAveragemoving rangeAv moving rangeSigmaUCLLCLweek no

8-Apr-07128139292621760146-May-07375114128814186-May-0711291413670186-May-075854210186-May-071424553910186-May-071153212018

15-Apr-079713931-41.52217601513-May-07515114-0.0688141913-May-073729267.766701913-May-07168117.712101913-May-072524110.6339101913-May-076550.7612019

22-Apr-071671397028.48217601620-May-0766511514.9488142020-May-07252912-4.246702020-May-07888-0.292102020-May-0719246-5.3839102020-May-076500.7612020

29-Apr-071521391513.48217601727-May-07485118-3.0688142127-May-0744291914.766702127-May-07484-4.292102127-May-0716243-8.3839102127-May-076500.7612021

6-May-07153139114.4821760183-Jun-0740518-11.068814223-Jun-073029140.76670223-Jun-07581-3.29210223-Jun-0719243-5.383910223-Jun-077511.7612022

13-May-0712313930-15.52217601910-Jun-075851186.9488142310-Jun-0744291414.766702310-Jun-0711862.712102310-Jun-0721242-3.3839102310-Jun-076510.7612023

20-May-071691394630.48217601917-Jun-07595117.9488142417-Jun-07172927-12.246702417-Jun-0712813.712102417-Jun-07252440.6339102417-Jun-07452-1.2412024

27-May-071501391911.48217602124-Jun-0771511219.9488142524-Jun-0748293118.766702524-Jun-0714825.712102524-Jun-0724241-0.3839102524-Jun-077531.7612025

3-Jun-0714513956.4821760221-Jul-07355136-16.068814261-Jul-07272921-2.24670261-Jul-07589-3.29210261-Jul-0717247-7.383910261-Jul-07255-3.2412026

10-Jun-071651392026.4821760238-Jul-076151269.948814278-Jul-0729292-0.24670278-Jul-0710851.71210278-Jul-073124146.633910278-Jul-079573.7612027

17-Jun-071521391313.48217602415-Jul-07615109.9488142815-Jul-0725294-4.246702815-Jul-0716867.712102815-Jul-073724612.6339102815-Jul-076530.7612028

24-Jun-0713213920-6.52217602522-Jul-07525190.9488142922-Jul-0740291510.766702922-Jul-075811-3.292102922-Jul-072624111.6339102922-Jul-079533.7612029

1-Jul-071661393427.48217602629-Jul-07575155.9488143029-Jul-07342964.766703029-Jul-07481-4.292103029-Jul-07312456.6339103029-Jul-07356-2.2412030

8-Jul-071841391845.4821760275-Aug-07555123.948814315-Aug-07242910-5.24670315-Aug-079850.71210315-Aug-07312406.633910315-Aug-07251-3.2412031

15-Jul-0710913975-29.52217602812-Aug-07325123-19.0688143212-Aug-0721293-8.246703212-Aug-07485-4.292103212-Aug-07262451.6339103212-Aug-07151-4.2412032

22-Jul-071581394919.48217602919-Aug-07505118-1.0688143319-Aug-0729298-0.246703319-Aug-07783-1.292103319-Aug-07282423.6339103319-Aug-07150-4.2412033

29-Jul-079513963-43.52217603026-Aug-07355115-16.0688143426-Aug-07122917-17.246703426-Aug-07681-2.292103426-Aug-07262600003426-Aug-07352-2.2412034

5-Aug-0711313918-25.5221760312-Sep-07352-Sep-07352-Sep-07352-Sep-07352-Sep-0735

12-Aug-07139139260.4821760329-Sep-07369-Sep-07369-Sep-07369-Sep-07369-Sep-0736

19-Aug-0710513934-33.52217603316-Sep-073716-Sep-073716-Sep-073716-Sep-073716-Sep-0737

26-Aug-071071392-31.522176034

2-Sep-0735

9-Sep-0736

16-Sep-0737

Every little helps!Reviewing real time clinic management-know what kind of day the team are having- DNAs, walk ins etc! Rota and clinic set upLetter production

Clinical Coding: Snomed CTNorth West Regional Podiatrist DatasetCodes now availableStart to record clinical informationDiabetics, high risk, nail surgery, orthotics

Liverpool PCT Podiatry ServiceRecording Items for Podiatry Service on Lorenzo

CodeTermDescriptionSnomedReleaseReason for ReferralTo be completed at initial appointment for patients with the following conditions onlyCCRFRPeripheral vascular diseasePatients with PVDCCRFRPeripheral NeuropathyAll patients with peripheral neuropathyCCRFRConnective tissue diseaseEg patients with rheumatoid arthritis105969002MR2CCRFRHigh risk diabeticHigh risk following assessment394672002FLEMCCRFRIncreased risk diabeticIncreased risk following assessmentCCRFRLow risk diabeticLow risk following assessment394671009FLEMCCRFRFoot UlcerAny foot ulcer95345008FLEM

Assessment codesTo be used to record assessments during initial & follow up appointmentsCCASSDiabetic foot risk assessmentFor minimum assessments & annual review394683006FLEMCCASSBiomechanical assessmentFull/ simple biomechanical assessmentCC00030FLEM

Treatment & InvestigationsTo be used to note treatment activity at each contactCCTRENail Care ProcedureNails cut and filed313026002FLEMCCTRESharp debridementCallus / corn removal with scalpelCCTREPartial nail avulsionPNA20781004FLEMCCTRETotal nail avulsionTNA183668008FLEMCCTREWound care debridementDebridement of ulcerCCTREWound careSwab, dressing etc of wound225358003FLEMCCTREBiomechanical therapeutic activityManufacture and fitting of bespoke / adjusted orthotic device & exercise advice16361000000102MR2CCTREProvision of orthoticProvision of simple insole or simple orthotic

Next StepsSharing record with Dermatology servicesTreatment room nursesCompare and share outcome measures

SummaryTaken 2 years Information Team supporting DQJust starting to codeLooking forward to Summary Record

Questions?Contact Details:

Neil Nevitt: 07795 370150

Claire Jones: 0151 234 5093

Documents

Lorenzo: A Clinicians Perspective