Winner: Barts and the London trust
This project set out to improve cardiovascular care in north east London, an area with some of the worst figures for coronary disease outcome
The UK’s first fully operational primary angioplasty pilot project is now the largest acute cardiology service in the NHS, treating 600 heart attack patients each year.
Early discharge of patients (45 per cent of the entire cohort) at 48 hours is routine and compares with the national average of six days.
Mortality and morbidity in some of the most deprived wards of east London - and across the UK - has been halved.
The headline figures are an overall hospital mortality of 4.5 per cent, a 30-day mortality of 5.9 per cent and a one-year mortality of 8 per cent.
Close collaboration across the organisations, including the London Ambulance Service, the local primary care trusts and emergency physicians, has meant a high uptake of cardiac rehabilitation and secondary prevention and is reducing the risk of future heart attacks. Furthermore, this collaboration is beginning to make improvements in other areas of cardiovascular care.
The project has transformed the London Ambulance Service into acute gatekeepers, with skills that enable them to diagnose heart attacks effectively and independently. In the face of such a challenge, a number of features made the project stand out.
These included the scale of the evidence of the benefit to patients and the decrease in secondary incidence, the integration of activities across a large geographical area and with the acute and primary care trusts and the London Ambulance service, and the work on the infrastructure to ensure reliability.
The heart attack project, contact firstname.lastname@example.org
Highly Commended: Tameside and Glossop PCT
This project involved the establishment of a completely new community-based service for people suffering from lymphoedema, a chronic and incurable condition affecting about 1 per cent of the population. Its aim is to enable patients to manage their own condition through skin care, massage, exercise and the use of pressure garments.
The service is led by a lymphoedema specialist nurse, supported by lymphoedema key workers and is transforming the lives of patients previously experiencing severe symptoms. Set up as a pilot study early in 2008, the service saw a total of 40 new patients during its first three months. Recurrent funding has now been agreed.
Community lymphoedema service, contact email@example.com
Finalist: City and Hackney teaching PCT
In line with the new community pharmacy contractual framework, requirements identified in the pharmaceutical needs assessment and the need to improve access for all its communities, City and Hackney has commissioned what it believes is the widest range of community pharmacy-enhanced services in England. These include: Pharmacy First, a minor ailments service; sexual health services; flu treatment using oseltamivir; and CHARM (City and Hackney Asthma Review and Management) service.
A recent white paper recognises the potential for pharmacy and community pharmacy to promote health and deliver personalised care; it highlights City and Hackney as a beacon.
Community pharmacy services, contact firstname.lastname@example.org
Finalist: Nottingham City PCT and the Association of the British Pharmaceutical Industry
Happy Hearts is a unique collaboration between Nottingham City PCT, the pharmaceutical industry and primary care, to identify people at risk of developing cardiovascular disease and help them make healthier lifestyle choices. This enhances the PCT’s project monitoring, in line with world-class commissioning requirements, while targeting deprived areas.
Patients are prioritised by risk and the project is integrated within the PCT’s wider cardiovascular disease improvement programme. In its first eight weeks, 260 high-risk patients received full CVD assessments.
Happy Hearts, contact email@example.com
Finalist: Oldham Community Health Services
A redesign of primary dental care provision means Oldham has become the first site in England to gain accreditation for a course to train dental nurses to deliver preventive techniques previously permitted only to dentists.
Starting in 2008, the clinic now provides patient-centred prevention advice and fluoride varnish treatments to children and their immediate families, to support sustainable health improvement.
The initiative targets those children most likely to experience poor dental health and offers them and their families lifestyle guidance and preventive treatment. More than 500 families have attended the clinic, with clinicians reporting improved oral hygiene in children.
Dental nurses, contact firstname.lastname@example.org
Finalist: Wolverhampton City PCT
Traditionally only available in an acute hospital setting, Wolverhampton City PCT provider services have been working closely with Royal Wolverhampton trust to develop an integrated pathway service for people with multiple sclerosis suffering relapses, which offers them the chance to be treated with symptom control at home.
Developed and delivered in partnership, the nurse-led service offers patient choice, improved patient outcomes and experience and value for money.
More than 25 patients have accessed the service. An audit of the pilot scheme showed they are pleased with receiving treatment in the comfort of their homes and find the service convenient and effective.
Home MS service, contact email@example.com