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Demand and threshold management

NW examples of demand and threshold management initiatives

Referral Management for Dental Referrals – a pilot & NIHR research programme

The School of Dentistry was successful in bidding for the National Institute for Health and Research Service Delivery Organisation demand management call and this webex will describe the current referral management system, its application in all health care systems including GP medical referrals, and the protocol by which this system will be evaluated in the North West using a three year, staged implementation model.  Anticipated savings for the Greater Manchester Network are £250,000 a month. Professor Iain Pretty from the University of Manchester led a discussion on the project and the lessons learnt so far.

 For  more information, use the links below:

 Are You SDM Positive? An Introduction to Shared Decision Making and the National SDM Programme

Over the last couple of years, the concept of Shared Decision Making as a way to increase patient involvement and autonomy has become more popular across the NHS and has been gaining traction across a range of specialties and clinical professions.  It uses evidence-based information about options, outcomes and uncertainties, and not only improves patient outcomes, but reduces healthcare costs.

 AQuA have been leading on a national piece of work with over 20 teams in the North West on training clinical teams, engaging patients and trying to embed SDM into the curricula of education providers.

 Use the links below for more information:

Elective demand management; how to improve quality and manage demand in elective services

As part of demand management and quality improvement work across Pennine Lancashire a plan has been developed to improve the quality of referrals and reduce elective demand on secondary care. Pennine Lancashire is a partnership arrangement between NHS East Lancashire and NHS Blackburn with Darwen which is continuing with the advent of CCGs. This plan has been co-produced and agreed by the two Clinical Commissioning Group. It has been presented and refined at various workshops, CCG and stakeholder meetings.  The objective of the plan is to improve the quality of care and if needed, referral of patients to other services (in the main secondary care). The process has been led by the Pennine Lancashire Demand Management Group. 

 We were fortunate to be able to work with AQUA (Advancing Quality Alliance – a North West SHA improvement organisation) and also the SHA itself in further developing our ideas and plans.

 The evidence base was first reviewed to develop the overarching strategy, with the various processes and tools created as an on-going piece of work. The scheme was “soft” launched earlier this year with the basic ideas and principles agreed, with the various methods, tools and enablers being launched and refined over a period of time. These are being monitored to assess effectiveness and will be added to or withdrawn depending on the results. A key principle is that clinicians can choose, in the main, from a menu of options that best suit the way that they work. None are mandated apart from some pre-existing triage schemes.


Engaging Patients to Reduce Variation and Improve Outcomes – the North West COPD Patient Passport

People with a long term condition such as COPD can improve their health and have a better quality of life by taking a more active role in their own care. But to do this, people need self-management skills and access to information about their condition. They also need skilled support and motivation from their clinicians, and access to high quality, evidence based care.  The North West respiratory leads worked with patients and carers to develop the COPD passport. The passport informs patients of the markers of a quality service and empowers them to engage in self-care interventions that can release value.

 Use the links below for more information: