Winner Oxleas Foundation trust

The project implements NICE guidance on Schizophrenia across a London based mental health trust. An audit measured trust practice against the guidelines and against a technology appraisal for the use of atypical antipsychotic prescribed to service users.

The scheme concentrated on focusing on what clinicians need at ground level. The relevance of the tool to clinicians, including an accompanying database that was developed for them to monitor their own practice, helped capture their interest. Ongoing changes to practice could be made and teams could make changes that they specifically needed to implement. Depot clinics and clinic caseloads have been reviewed and clopazine clinics set up in each area of the trust, with a dedicated clopazine nurse. A checklist to monitor physical symptoms of service users had been developed and was now used across the trust.

A group has now been set up to establish advanced directives, including a crisis card distributed to service users and the crisis planning section of electronic records have been promoted in training. Service users were involved in developing easy to read versions of the guidance and patient leaflets are available on the staff intranet.

Further work is planned to audit trust work around depression and long term outcomes for service users.

Judges said the project had included comprehensive involvement of service users, had gained board support and been one of the board's top priorities and produced a model which gained clinical engagement and was replicable across a geographically diverse site.

Schizophrenia implementation support tool

Contacts:

Head of clinical audit Jane Moore jane.moore@oxleas.nhs.uk

Clinical director Geraldine Strathdee Geraldine.strathdee@oxleas.nhs.uk

NICE implementation support officer Stuart Pack stuart.pack@oxleas.nhs.uk

Highly commended Bradford and Airedale Teaching PCT

After being informed by the local histopathology department that there were wide variations in the removal of suspected skin cancer lesions by GPs, the PCT, local lead clinician and skin cancer team supported a skin cancer review.

After results showed not all GPs were following NICE cancer guidance on improving local outcomes for people with skin tumours - GPs were inappropriately removing suspected skin cancers - an implementation package was developed.

This included a local skin cancer pathway and guideline and comprehensive education package for primary care clinicians, including multi professional educational events developed and delivered by local experts which over 75 per cent of local GP practices have now attended. A routine data monitoring system has been established.

The work was developed in line with the PCT's policy for clinical guidelines, with the final document published in a style familiar to primary care clinicians.

Judges said the scheme was an opportunity to educate GPs, had strong links across primary and secondary care and had established an effective monitoring system.

Improving local outcomes for people with skin cancer

Contacts:

Bradford and Airedale Teaching PCT medical director Dr Peter Dickson Peter.Dickson@bradford.nhs.uk

Bradford Teaching Hospitals Foundation trust consultant dermatologist Dr Andrew Wright Andrew.wright@bradfordhospitals.nhs.uk

Bradford Teaching Hospitals Foundation trust skin cancer clinical nurse specialist Catherine Wheelhouse Catherine.wheelhouse@bradfordhospitals.nhs.uk

Bradford and Airedale Teaching PCT head of quality development Claire Seymour Claire.seymour@bradford.nhs.uk

North East Lincolnshire PCT

Provision of services for people with COPD and at risk of falls were limited and disjointed in the area, which is largely served by small GP practices. The Health Optimisation, Prevention and Education (Hope) service aims to provide a one stop shop for these service users.

An exercise led pulmonary rehab plus programme, including Thai Chi and chair based exercise instructors and exercise sessions in community settings was developed. Work with the local authority is underway to develop a functional rehabilitation zone that will help people at risk of falls learn to cope with outside obstacles.

Hope for the Future

Contacts:

Falls co-ordinator Kylie Farbrace kylie.farbrace@nelpct.nhs.uk

COPD clinical co-ordinator Pam Hancock pam.hancock@nelpct.nhs.uk

Nottingham University Hospitals trust

The project implemented a bone and falls risk assessment service for all patients aged 50 years and over presenting to an outpatient fracture clinic or as an inpatient following low trauma fractures in a bid to reduce the number of fractures suffered. Day to day implementation of the service is conducted by a fracture liaison clerk and patients are referred on to a primary care falls service for home based falls and environment assessment. Those aged over 70 are offered a bone density scan and high risk patients referred to a metabolic clinic.

The Nottingham Fracture Liaison Project

Contacts:

Consultant physician Dr Opinder Sahota opinder.sahota@nuh.nhs.uk

Specialist nurse Lindsey Marshall Lindsey.marshall@nuh.nhs.uk

Sandwell Mental Health and Social Care trust

Patients and carers from a learning disability service had their epilepsy care needs addressed by a doctor and epilepsy nurse specialist at a specialised epilepsy clinic. The nurse specialist had previously made home visits to gather information from patients with complex needs or identified as not likely to attend. Previously people were seen as outpatients along with those attending mental health diagnoses and was a generic clinic without time to focus on epilepsy needs.

Implementing NICE epilepsy guidelines in a learning disability service

Contacts:

Epilepsy specialist nurse Esther Whitten esther.whitten@smhsct.nhs.uk

Clinical governance manager Eva Madsen eva.madsen@smhsct.nhs.uk