Risk Stratification and Medicines Optimisation Helen Liddell Leeds South East CCG.
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![Page 1: Risk Stratification and Medicines Optimisation Helen Liddell Leeds South East CCG.](https://reader035.fdocuments.net/reader035/viewer/2022062317/5a4d1b787f8b9ab0599b8288/html5/thumbnails/1.jpg)
Risk Stratification and Medicines Optimisation
Helen LiddellLeeds South & East CCG
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• Why Risk Stratification• What is Risk Strat?• Limitations of Risk Stratification• What implications for Medicines Optimisation
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Why? • People want to stay in their home as long as
possible• NHS funding requires reduction in unplanned
admissions• Reducing patient harm• New GP DES - Unplanned admissions Enhanced
Service
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4
The workload / cost distribution
Emergency admissions are draining resources. They account for the most cost and days
56% PBR budget is allocated to emergency care for
48%59%
84%
52%41%
16%
Spells Cost Days
Emergency Elective
160K £215M
Source: NHSIC. Data Leeds CCGs 11/12
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What?Risk profiling a population
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Risk profiling and case management• Individualised Care plans• Telehealth• Community Matrons• Case Managers – Elder Care Facilitators• Intensive support for LRCs• Third sector and voluntary organisations• Medicines Optimisation?
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Limitations of tools
• Medicines costings are inaccurate• Coding errors• Rare and spurious conditions • Expense and time
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Medicines Optimisation in targeted populations• In Care Homes• 4 or more medicines• with renal disease• Post discharge• Taking high risk medicines• Those identified by a risk prediction tool• Those with a particular condition• Those referred to a service
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A vision of care services in 5 years
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The House of Care model
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Performance Measures•A measure to evaluate how well a programme, agency or service system is working.
•Three questions:•How much did we do? (quantity)•How well did we do it? (quality)•Is anyone better off as a result? (quantity and quality of effect or customer/client outcomes)•Performance measures tell us how well service providers are working as opposed to the impact on whole populations
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From ends to means
ENDS
OUTCOMES“A condition of well-being for children, adults, families or communities”
PERFORMANCE MEASURES“A measure to evaluate how well a programme, agency or service system is working”
MEANS
INDICATORS“A measure which helps quantify the achievement of an outcome”
Popu
latio
n A
ccou
ntab
ility
Perf
orm
ance
Acc
ount
abili
ty
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Further opportunities?• More patient contact• Links with Community Pharmacies• Social Services• Intermediate Care Team• Hospital discharge pharmacists
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Where does Medicines Optimisation fit in?