What is the challenge your project is going to address and how does it connect to your chosen theme?

Current outpatient models provide a structure for regular clinical review, regardless of clinical need at the time of the review.

Outpatient cancellation and Did Not Attend rates of up to 20% in England are indicative of problems associated with the current system which does not support patients who need urgent attention e.g. during an IBD flare, from timely advise and review in the most appropriate setting. This adversely impacts on the patient’s quality of life, ability to work and functionality and results in higher costs to the wider health care system including primary care, and increases surgical/pharmaceutical intervention.

In addition to sharing information PHRs can also be utilised to improve the flexibility of access and the overall quality of outpatient services; reduce negative consequences to the wider health care system by preventing complications as a result of delays in access to the most appropriate care; and improve the quality of life of patients who live with IBD.

What does your project aim to achieve?

We will evaluate the impact of IBD patients accessing expert healthcare as clinically needed through a PHR, rather than via the current out patient model. We expect this to improve patient experience and outcomes, and more effective use of professional time.

We will deliver this by adopting/adapting an existing PHR IBD out patient model to spread to a new Trust, learning from previous evaluation, and focusing on gaps in evidence.

Working with patients, clinical, and digital teams, we will support a local IBD team transforming their outpatient service using PHR, to optimise local pathway and evaluation opportunities.

To deliver on resource, evaluation will focus on the impact of demand to the service and the effect on staff and patients. We will provide a case study and aim to calculate the value this change has had to service.

This project will contribute towards the body of evidence/toolkit supporting replicability in outpatient transformation for specific patient populations and need.

How will the project be delivered?

Katherine Sykes, Q member, will lead this project working with local clinical and digital teams, patients, the Q community, and KSSAHSN Programme and Analytics support.

The project will be tightly managed with project management through the AHSN, who will hold a live risk register. We know from similar projects that expected risks can include lack of engagement from senior management and pressure on clinical time. We have mitigated against this by allocating funds for clinical backfill as detailed. We will keep senior management cited on all work to ensure we have their full support and any barriers/risks are recognised and mitigated including avoiding any loss/pressure to the system.

We will actively seek Q insights and support especially when looking at techniques to engage stakeholders, and suggestions for focus of evaluation that support the wider objectives of this programme. We will collaborate and share our learning and outcomes with the community.

What and how is your project going to share learning throughout?

A core remit of the AHSN is to disseminate learning. We will use this project to engage stakeholders within our region and across the AHSN network.

During the projects initiation workshop we will map out needs, opportunities, challenges, and barriers for this project, share learning from stakeholders, including patients, and from show casing a local example of this type of model in IBD out patients.

A steering group will meet at least quarterly once the project is established to evaluate progress and address any risk.

We will collaborate and share our learning and outcomes with the Q community as required and at least quarterly on the project.

At the end of the project we will produce a free toolkit to showcase our learning and will host at least one webinar that will be shared with the Q community.

We will also write a case study to illustrate our findings and the impact of transforming access to expert healthcare when needed on this patient population.