Testing the Directory of Services (DoS)

Testing the Directory of Services (DoS)

Gavin Reader – CMS Regional LeadRoss Hamilton – BNSSG DoS Project Manager

Gavin Reader – CMS Regional LeadRoss Hamilton – BNSSG DoS Project Manager

Event scheduleEvent schedule

09:00 Welcome / Scene setting

• The role of the DoS in 111• Service profiling• QDoS testing

10:00 Testing

• Guided example• Testing expected scenarios (90 minutes)• Testing rarer scenarios (30 minutes)

12:30 Close

ObjectivesObjectives

1. Ensure the expected services are returned for normally expected scenarios

2. Test rarer scenarios, to identify where appropriate existing services are not returned

3. Reinforce stakeholder confidence and commitment

1. Ensure the expected services are returned for normally expected scenarios

2. Test rarer scenarios, to identify where appropriate existing services are not returned

3. Reinforce stakeholder confidence and commitment

Building the DoS and how it works!

Building the DoS and how it works!

Building the DoSBuilding the DoS How 111 works with the DoS

NHS Pathways – outputs a disposition

or ‘DX’ code (NOT WHAT WE ARE TESTING)

Project Board – approves which DX codes

go to one of four locations1)999

2)111 i.e. stays in house3)DoS

4)Self-care

Commissioners – decided what services

would meet those needs

Providers – completed supplied profiles of

what their services do, these are then uploaded to the DoS

Building the DoSBuilding the DoS

Process involved in building the DoS:

Commissioners asked to identify services that are likely to be required through the 111 system.

DX Mapping. Outcomes from NHS Pathways vs local healthcare services Urgent Care Services able to respond to the patients needs within 2,6,12,24 hours Patient facing – does not require another healthcare professional to access the service

Commissioners or Providers to provide:

Demographics of the services. (Address, contact details, Opening hours) Clinical Details. (Profiling) Restrictions around GP registered patients

Worth Remembering that not every service within the Health Community is currently on the system.

Process involved in building the DoS:

Commissioners asked to identify services that are likely to be required through the 111 system.

DX Mapping. Outcomes from NHS Pathways vs local healthcare services Urgent Care Services able to respond to the patients needs within 2,6,12,24 hours Patient facing – does not require another healthcare professional to access the service

Commissioners or Providers to provide:

Demographics of the services. (Address, contact details, Opening hours) Clinical Details. (Profiling) Restrictions around GP registered patients

Worth Remembering that not every service within the Health Community is currently on the system.

DoS ProfilesDoS Profiles

Profiling is vital to ensure the DoS provides the appropriate services to the 111 call advisors.

The process to ensure this has been completed correctly is:

Type 1 Services have been profiled using the National Template Type 2 Services have been profiled by the providers

Commissioners / CAC asked to verify demographics of each and every service

(Address, contact number, opening hours).

Commissioners / CAC ask to verify profiling for every service

QDoS testing (explained later)

End to End Testing

‘Break the system Event’

Profiling is vital to ensure the DoS provides the appropriate services to the 111 call advisors.

The process to ensure this has been completed correctly is:

Type 1 Services have been profiled using the National Template Type 2 Services have been profiled by the providers

Commissioners / CAC asked to verify demographics of each and every service

(Address, contact number, opening hours).

Commissioners / CAC ask to verify profiling for every service

QDoS testing (explained later)

End to End Testing

‘Break the system Event’

QDoSQDoS

Automated test to ensure the correct services return for a set of pre-defined scenarios.

Can only be run by the CMS Regional DoS Lead.

The scenarios are produced by Connecting for Health – based on calls received by the 111 pilot sites around the country.

Works on returning the top two services from each team type that are appropriate, irrespective of the time of day the test is run.

Works on GP restricted services and the patients postcode (37 mile radius)

We will use the test to identify the ‘type’ of service returned is correct – Not every service entered onto the DoS!!

NB: This is a requirement for ‘DoS readiness’ that is signed off by the DH

Automated test to ensure the correct services return for a set of pre-defined scenarios.

Can only be run by the CMS Regional DoS Lead.

The scenarios are produced by Connecting for Health – based on calls received by the 111 pilot sites around the country.

Works on returning the top two services from each team type that are appropriate, irrespective of the time of day the test is run.

Works on GP restricted services and the patients postcode (37 mile radius)

We will use the test to identify the ‘type’ of service returned is correct – Not every service entered onto the DoS!!

NB: This is a requirement for ‘DoS readiness’ that is signed off by the DH

QDoS ExampleQDoS Example

Vomiting Scenario: Dx05 : The individual needs to be seen by the GP practice or other local service

within 2 hours. If the practice is not open within this period they need to be seen by the out of hours service.

Symptom Group:  VomitingSymptom Discriminators:  non-trauma full Primary Care assessment and prescribing capability

Call Report Patient: Joe Bloggs, Age Gender Selected: Adult, MaleSignificant blood loss was not described.Fighting for breath was not described.A heart attack, chest/upper back pain, recent probable stroke, recent fit/seizure or suicide attempt was not described as the main call reason.New confusion, a diabetic hypo, a probable allergic reaction was not described as being the main call reason.The individual was not described as feeling cold to touch.Pathway Selected: PW939, VomitingDiarrhoea as well as vomiting was not described.Vomiting blood was not described.Vomiting after drinking alcohol was not described.A head injury in the previous 3 days was not described.Abdominal pain was not described.Vertigo was described.

Vomiting Scenario: Dx05 : The individual needs to be seen by the GP practice or other local service

within 2 hours. If the practice is not open within this period they need to be seen by the out of hours service.

Symptom Group:  VomitingSymptom Discriminators:  non-trauma full Primary Care assessment and prescribing capability

Call Report Patient: Joe Bloggs, Age Gender Selected: Adult, MaleSignificant blood loss was not described.Fighting for breath was not described.A heart attack, chest/upper back pain, recent probable stroke, recent fit/seizure or suicide attempt was not described as the main call reason.New confusion, a diabetic hypo, a probable allergic reaction was not described as being the main call reason.The individual was not described as feeling cold to touch.Pathway Selected: PW939, VomitingDiarrhoea as well as vomiting was not described.Vomiting blood was not described.Vomiting after drinking alcohol was not described.A head injury in the previous 3 days was not described.Abdominal pain was not described.Vertigo was described.

QDoS Example Cont….QDoS Example Cont….

Dx05 : The individual needs to be seen by the GP practice or other local service within 2 hours. If the practice is not open within this period they need to be seen by the out of hours service.

GP - Yeo Vale Medical Practice (Yatton) - North Somerset (Home GP) PostCode: BS49 4ERDisposition Instructions: Out of hours provided by Harmoni - 0845 121 0235 **GWAS Contact number only** - 01934 839820

Community Team - Strawberry Line - North Somerset PostCode: BS40 5JDDisposition Instructions: 111 Call Advisor must phone prior to the service accepting the referral Phone numbers 8am-5pm, then Carelink number 5pm-10pm Carelink number all weekend. Will Only accept patients over the age of 18

GP in Urgent Care - (Harmoni) - North Somerset PostCode: BS23 4TQDisposition Instructions:

GP - Yeo Vale Medical Practice (Congresbury) - North Somerset PostCode: BS49 5DXDisposition Instructions: Out of hours provided by Harmoni - 0845 121 0235 **GWAS Contact number only** - 01934 839820

WIC - Harmoni (Weston Healthcare Centre) - North Somerset PostCode: BS23 1NADisposition Instructions:

WIC - Harmoni (Weston General Hospital) - North Somerset PostCode: BS23 4TQDisposition Instructions:

Dx05 : The individual needs to be seen by the GP practice or other local service within 2 hours. If the practice is not open within this period they need to be seen by the out of hours service.

GP - Yeo Vale Medical Practice (Yatton) - North Somerset (Home GP) PostCode: BS49 4ERDisposition Instructions: Out of hours provided by Harmoni - 0845 121 0235 **GWAS Contact number only** - 01934 839820

Community Team - Strawberry Line - North Somerset PostCode: BS40 5JDDisposition Instructions: 111 Call Advisor must phone prior to the service accepting the referral Phone numbers 8am-5pm, then Carelink number 5pm-10pm Carelink number all weekend. Will Only accept patients over the age of 18

GP in Urgent Care - (Harmoni) - North Somerset PostCode: BS23 4TQDisposition Instructions:

GP - Yeo Vale Medical Practice (Congresbury) - North Somerset PostCode: BS49 5DXDisposition Instructions: Out of hours provided by Harmoni - 0845 121 0235 **GWAS Contact number only** - 01934 839820

WIC - Harmoni (Weston Healthcare Centre) - North Somerset PostCode: BS23 1NADisposition Instructions:

WIC - Harmoni (Weston General Hospital) - North Somerset PostCode: BS23 4TQDisposition Instructions:

‘Break the System Event’‘Break the System Event’

A few key aspects to remember:

Urgent Care / patient facing services currently in the system

System is ‘Time of Day’ dependant – No OOHs services returning

We are trying to mimic the NHS pathways algorithm. Think about the profiling terminology.

We are looking to enter scenarios that we expect our service to return for or ones that we know our services should not return for.

Only Use 6.4 / 6.5 Symptom Groups – Ignore AMB Symptom Discriminators

Ranking is based on National Ranking – Mileage

If you identify an issue PLEASE let us know.

A few key aspects to remember:

Urgent Care / patient facing services currently in the system

System is ‘Time of Day’ dependant – No OOHs services returning

We are trying to mimic the NHS pathways algorithm. Think about the profiling terminology.

We are looking to enter scenarios that we expect our service to return for or ones that we know our services should not return for.

Only Use 6.4 / 6.5 Symptom Groups – Ignore AMB Symptom Discriminators

Ranking is based on National Ranking – Mileage

If you identify an issue PLEASE let us know.

ExampleExample

How to use the system demonstration:

CMS DoS - www.pathwaysdos.nhs.uk

Account Username and Password: gwtestaccount

How to use the system demonstration:

CMS DoS - www.pathwaysdos.nhs.uk

Account Username and Password: gwtestaccount

Example Cont……Example Cont……

Leave this box as it is.

Patients Postcode. Format xxx xxx

Leave for Open Access PatientsFor services restricted to GP surgeries:Un-tick the ‘Unknown Box’Enter first 3-4 letters of GP SurgeryClick on required surgery from the pop up list

Enter first 3-4 letters of a symptom until drop down list appearsSelect required Symptom GroupSelect required Symptom Discriminators

Enter Urgency of the Patients condition