With the next stage review promoting quality over cost, now is the time to develop better ways of sharing best practice. As the closing date for the annual NICE awards nears, HSJ talks to last year's winners
The Darzi review's aim of shifting our national obsession with the financial performance of the NHS to an obsession with quality of care is based on a commitment to patient and professional empowerment. Quality, says Lord Darzi, is at the heart of everything we do.
True to this socially progressive ideal, the National Institute for Health and Clinical Excellence is encouraging NHS workers to be creative in implementing its guidance through its shared learning programme. Last year's inaugural Shared Learning Awards recognised the efforts of a broad spectrum of organisations that had used NICE guidance to create innovative, effective local programmes.
One of the four finalists was Michael Smith, a consultant psychiatrist for NHS Greater Glasgow and Clyde and winner of the 2006 HSJ Improving Health with NICE Guidance category.
As the clinical lead for the Doing Well initiative, which aims to improve the quality of care for patients with depression, Mr Smith knows the value of sharing good practice. "It's the scourge of the NHS that there are people doing great work nationally and we don't learn enough from each other," he says. "People just keep starting from scratch again and again. We need to pool what we're doing and collaborate with each other."
Alun Davies, of the Multiple Sclerosis Society, is just as vocal in his support of shared learning. Having developed an audit tool to evaluate multiple sclerosis services against NICE guidance, the society has seen real benefits through its participation in the Shared Learning Awards. As a result, it is now working with three other charities, the Department of Health and the Healthcare Commission looking at developing an audit tool for the national service framework for long-term conditions.
"It just showed how the society wants to work with the NHS to look at innovative ways of developing services," he said. "To not be beating trusts over the head for the problems they've got, but looking at realistic solutions on how to overcome them. It's a true partnership."
Partnership is the true essence of NICE shared learning. At the 2007 awards, the panel was so impressed by the standard of entries that the top prize went to two very different initiatives.
One was a community-based service for women with heavy menstrual bleeding devised by Anne Connolly, a GP working for Bradford and Airedale Teaching primary care trust. "NICE guidance talks about keeping women at the centre of treatment choices. Often when women come to us, their GP has told them they need a hysterectomy," she says. "And we can say, 'actually, you don't. Look, there's this treatment or this treatment. There's the evidence, go away and read about it. You choose, we'll do it.' It's very empowering for these women. They often come back and say, 'thank you very much, you've transformed my life'; I don't think you can ask for better really!"
In her winning submission, clinical co-ordinator Pam Hancock took the idea of involving service users one step further. Hired by North East Lincolnshire PCT to oversee the implementation of the NICE guidance on chronic obstructive pulmonary disease, she established a scheme in which patients undergoing pulmonary rehabilitation were paired with "buddies", volunteers who had already completed the programme.
"We entered the Shared Learning Awards because I think it's very important for us to be shouting about what we're doing, especially in terms of the results we've got and the patient feedback we've been getting," she says. "It's important to tell other people that a patient-led NHS programme can work, that the results can be good, and that it can be very cost-effective."
The buddy programme has massively reduced hospital admissions and, exceeding expectations, resulted in fewer emergency GP and nurse consultant visits. Ms Hancock expects more than 300 people each year to enter the programme, potentially saving£2,500 per person.
NICE is now accepting submissions for the 2008 Shared Learning Awards. The closing date for entries is 30 September.