DR SIMON STOCKILL

M D NHS L W CCGMEDICAL DIRECTOR, NHS LEEDS WEST CCGCHAIR, LEEDS INSTITUTE FOR QUALITY HEALTHCARE

Improving quality across the health system in Leeds

WHAT IS LIQH?

A partnership between NHS organisations across the city, the University of Leeds and Leeds City Councily y

Leeds Community Healthcare NHS Trust Leeds and York Healthcare NHS Trust

The Leeds Teaching Hospitals NHS Trust

Partnerships NHS Foundation Trust

A brief history…y

Initiative of the LEEDS CLINICAL SENATES i l d d l t t t d i 2012Senior leaders development program started in 2012Medical at first then multi-professionalDeveloped as informal network of senior clinical leaderse e oped as o a et o o se o c ca eade sFormal role now as advisory board to new Leeds Academic Health PartnershipInformal role as “sponsor” of LIQHInformal role as “sponsor” of LIQH

International study tour to Intermountain Healthcare, Utahy ,

YEAR 1 METHODOLOGY AND LESSONS FROMINTERMOUNTAIN

LIQH Year 1 was based on lessons learnt by the Leeds Medical Senate from Intermountain Healthcare in Utah

OUR AIM

T i t i lit i L dTo secure improvement in quality care in Leeds.

We do this by providing an independent space where health f fand care professionals from all organisations across the city

can come together, share expertise and build relationships and networks to facilitate change across the whole system.

www.leedsqualityhealthcare.org.uk

OUR FOCUS IS TO:

Prioritise continuous improvement;

Use accurate, local data to inform evidence based decision making;

Enable collaborative conversations at system level through common language and approach;common language and approach;

Co-produce service improvement with partners, patientsCo produce service improvement with partners, patients /service users.

THE STRATEGY

Leeds is a high performing health system on the metrics of

IN 10 YEARS:Leeds is a high performing health system on the metrics of quality and cost, and international comparisons;The LIQH model is embedded in Leeds as a collaborative accountable care system with the network now a sustained andaccountable care system, with the network now a sustained and full part of every organisation’s practice, and the strategy of the city as a whole;Patients are partners in the decisions about their care across the itcity;

There is clear and authoritative professional leadership across the city; Th it i i b t l i h lthThe city is securing best value in health care;Knowledge generated through the LIQH model informs the development of our current and future professionals; There is ongoing learning and research on quality healthcareThere is ongoing learning and research on quality healthcare within a shared narrative for the city.

GOVERNANCE AND ORGANISATION

Delivery: University  Management

Systems Leadership Faculty CIHM Programme Management

Improvement / Change Faculty

g

Data Scientists / Informatics Faculty

Executive Group

The Leeds Clinical Senate

Faculty

Education FacultyEducation Faculty

OVERVIEW OF THE WHOLE APPROACH

Costing and quality data

Decisions with patients based on 

data

Varying Clinical Priorities per year across primary, 

secondary, health 

Better Quality Better Value 

through professional leadership of change i h i / i

and social care

with patients / service users

Communities of Practice across 

the city

System Accountability to enable change across the whole

Professional Leadership / Fellowship Programmes

across the whole

Programmes

HOW DO WE INSTIL CHANGE?

LIQH focuses on three major areas: Systems Context, Co-production and partnership, and Quality Improvement:p p p y p

2014: YEAR 1 – CLINICAL PRIORITIES

Three clinical priority areas were defined by the Leeds Health System: y

P ti i t t t d th i i t j tProgramme participants started their improvement projects which were focused on these areas.

YEAR 1 – CASE STUDY

Arrhythmia Angels

ProblemProblemThere was a large degree of failure demands in Cardiology clinic30% of newly referred patients did not have a y pcardiac-related diagnosis28% of people with symptoms relating to rhythm disorders showed no problem with their hearttheir heart

ImprovementThey redesigned a simplified pathway for the y g ycity that has cross-organisation consensusThey negotiated further development of a Primary Care Advice LineAnd are looking into future investment forAnd are looking into future investment for ECGs and training in Primary Care

YEAR 1 – WHAT WE LEARNED

While the Intermountain approachWhile the Intermountain approach worked for their local contexts, we needed an approach developed by L d i ti f L dLeeds organisations, for Leeds organisations.

Moving into year 2, we altered the programme in order to best fit the L d t tLeeds context

YEAR 2 CLINICAL PRIORITIES

With a new year came new clinical priorities:

This meant new improvement projects for our programme participants, most of whom continue to regularly meet to work on their projects with support from the LIQH University data scientist teamsupport from the LIQH University data scientist team.

2016: YEAR 3A REVISED APPROACH: THE IMPROVE CARE MODEL

The IMPROVE CARE Model, developed specifically for LIQH, provides a helical framework f f i l d ti d h lth i t It t k th h tfor professional education and healthcare improvement. It takes you through every stage of developing an improvement project from planning, designing and testing, through to 

implementation, evaluation, spread. 

THE IMPROVE JOURNEY

The IMPROVE journey is clear in its instruction with the CARE approach prompting the improver to ensure there is a

focus on people throughout every stage of the processfocus on people throughout every stage of the process.

THE LIQH FELLOWSHIP PROGRAMME 2016-2017

The LIQH Fellowship Programme is a nine‐month educational programme that incorporates theoretical teaching and practical application through the development of improvement projectsdevelopment of improvement projects.

It includes five educational workshops each designed around an area of the improvement process, fitting with the IMPROVE CARE model.

These educational sessions are then explored practically through five Project Support Clinics where faculty helpthrough five Project Support Clinics, where faculty help and support the improvement projects developed by LIQH Fellows.

The whole programme is supported by blended learning tools and learning workbooks. 

The LIQH Fellows are drawn from various healthcareThe LIQH Fellows are drawn from various healthcare professionals all with a focus on Primary Care.

THE LIQH LEADING IMPROVEMENT CORE CONCEPTSPROGRAMME 2017

The Core Concepts Programme is a three‐day short course that introduce participants to the major tenets of LIQH: Improvement Co‐production h k Systems Thinking

The course is specifically designed for health and social care professionals inhealth and social care professionals in Leeds to helps actively improve the quality of care. 

The programme is highly interactive and based on adult learning principles. 

THE LIQH IMPROVE CARE NETWORK

The IMPROVE CARE Network is a network open to anyone interested in improving quality p y p g q yof care across Leeds health and social care. 

We believe that quality improvement, finance, q y p , ,informatics, and engagement are interlinked and interdependent and that the best outcomes are achieved when professionalsoutcomes are achieved when professionals work together.

The Network meets regularly and welcomesThe Network meets regularly and welcomes anyone, with little or lots of experience of improvement.

WHAT DOES THIS MEAN FOR LEEDS HEALTHCARE?

LIQH aligns with the focus of Leeds CCGs with its emphasis of primaryCCGs with its emphasis of primary care and community.

LIQH links into the NHS Five Year Forward View by supporting NHS staff in their strive for improvementin their strive for improvement.

LIQH is also supporting the New Models of Care project by having locality based programs in Year 3

FEEDBACK RECEIVED

“Leeds is actually supporting innovation with relevant resource !”

“Certainly energised about working with such an able group of Leeds leaders on this project and humbled by the grounding that the co production piece gave to ourwith relevant resource…! that the co-production piece gave to our work.”

“We’re on a mission to spread the message “Excellent programme –very motivating and thought p g

about this ‘proper’ analytical approach to data. There is a lot more accountant capacity in this Trust than data analysts/scientists so even if we can only do the very basics we can improve the

provoking.”

“This is a fantastic opportunity can only do the very basics we can improve the spread.”

“The opportunity to meet, interact & explore

and provides learning and thinking in a whole new way which I’ve not encountered previously.” pp y , & p

with such a wide variety of peers from across so many organisations and perspectives is a real privilege. It is up to us to turn this opportunity into clear and significant

“Found the sessions very practical and a good way to h tl id tif i i

previously.

opportunity into clear and significant improvement for out fellow citizens.”

honestly identify issues in the way we work together.”