QIPP – Sip feedsWaltham Forest PCT

Summary

Spend and potential savings Plan implemented in WF Barriers Progress so far

Savings for east of England

Trend in spending on ONS in WF

2005/6 2006/7 2007/8 2008/9 2009/10 Total

ONS Spend £ % Increase

294,764 341,041(16%)

362,892 (6%)

443,022 (22%)

532,005 (20%)

1,973,723(64%)

ONS expenditure in WFPotential ONS Expenditure in Waltham Forest to 2014

£0

£200,000

£400,000

£600,000

£800,000

£1,000,000

£1,200,000

2005/6 2006/7 2007/8 2008/9 2009/10 2010/11 2011/12 2012/13 2013/14

Year

Exp

end

itu

re £

Current Trend

London Average

Potential Savings

Savings in Waltham Forest

Reduce inappropriate prescribing ONS policy Scriptswitch Increase GP awareness (newsletter & meetings)

Complan switch First line where apporpriate Starter packs Educate care homes

PoA Alter policy to promote Complan before other

nutritional on hospital discharge and in community

Scriptswitch messages Complan starter packs in hospital Dietician to review all patients discharged from

hospital on ONS if not referred while in hospital Audit current practice Dietician to review patients Recommendations to GP GP informs own practice Better referral levels to dieticians in future

Barriers

GP – relationship with PSPs, defensive of current practice

Access to practices – time and computer facilities

Need for dietician to carry out reviews Insufficient medicines management team

support to carry out audit

Audit

Top ten spending practices in WF Patient ID & age, recent BMI, indication, sip

feed prescribed and duration, goals recorded, food first advice given, involvement of dietician

Contact details of patients for dietician Confidential treatment of information

Dietician support

Dietician seconded for a year Sits with dieticians but under MMT Reviews by telephone, face-to-face or at a

clinic Recommendations to GP Patient and MMT copied into communications Weekly excel progress update

Progress so far

Early days but encouraging Discontinued or switched Informs other dieticians to be vigilant and

use Complan first-line Appointments with patients set-up initially

Potential for savings across east of England

PCT 2009 SpendSavings using Complan Shake

     Suffolk £753,664 £401,040Norfolk £734,238 £390,957Cambridgeshire £719,621 £384,756West Hertfordshire £701,356 £363,687East and North Hertfordshire £651,934 £338,606South West Essex £512,532 £270,752North East Essex £506,843 £261,996Bedfordshire £495,700 £235,441South East Essex £471,104 £244,867West Essex £375,590 £200,132Luton Teaching £329,341 £173,415Mid Essex £317,738 £164,999Great Yarmouth and Waveney £271,461 £144,682Peterborough £225,225 £119,539     TOTALS £7,066,347 £3,694,869

Thank you for your time