chronic disease management why is this an important issue? high numbers of patients affected...

Chronic Disease Chronic Disease Management Management Why is this an important issue? High numbers of patients affected Effective interventions may be available Concern that there is variation in standards of care across the country In response to this the Government/DoH has set up some National Service Frameworks

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Page 1: Chronic Disease Management Why is this an important issue? High numbers of patients affected Effective interventions may be available Concern that there

Chronic Disease ManagementChronic Disease Management

Why is this an important issue?High numbers of patients affectedEffective interventions may be availableConcern that there is variation in standards

of care across the countryIn response to this the Government/DoH

has set up some National Service Frameworks

Page 2: Chronic Disease Management Why is this an important issue? High numbers of patients affected Effective interventions may be available Concern that there

National Service FrameworksNational Service Frameworks

What are National Service Frameworks?DoH documents/plans but with expert

inputPart of modernisation of NHSProvide standards & service modelsAim to disseminate good practice

Page 3: Chronic Disease Management Why is this an important issue? High numbers of patients affected Effective interventions may be available Concern that there

National Service FrameworksNational Service Frameworks

Aim to ensure nationwide access to consistent, good standards of care

Evidence-basedE.g. CHD, Elderly, Mental HealthMore to come

Page 4: Chronic Disease Management Why is this an important issue? High numbers of patients affected Effective interventions may be available Concern that there

National Service Framework National Service Framework for Coronary Heart Diseasefor Coronary Heart Disease

10 year programme published by the government in 2000

Sets out 12 national standards for prevention and treatment of CHD

Page 5: Chronic Disease Management Why is this an important issue? High numbers of patients affected Effective interventions may be available Concern that there

National Service Framework National Service Framework for Coronary Heart Diseasefor Coronary Heart Disease

Recommends service delivery modelsGives milestones to mark progressLays down audit requirements

Page 6: Chronic Disease Management Why is this an important issue? High numbers of patients affected Effective interventions may be available Concern that there

The 12 standardsThe 12 standards

1 & 2: Reducing heart disease in the population, reducing smoking

3 & 4: Preventing CHD in high-risk groups5,6 & 7: Heart attacks and other acute

coronary symptoms

Page 7: Chronic Disease Management Why is this an important issue? High numbers of patients affected Effective interventions may be available Concern that there

The 12 standardsThe 12 standards

8: Stable angina9 & 10: Revascularisation11: Heart failure12: Cardiac rehabilitation

Page 8: Chronic Disease Management Why is this an important issue? High numbers of patients affected Effective interventions may be available Concern that there

NSF requirements forNSF requirements for primary care primary care

All relevant but perhaps especially -Standards 1 & 2: Reducing heart disease in the

population, reducing smokingStandards 3 & 4: Preventing CHD in high risk

patientsStandard 11: Management of heart failure

Page 9: Chronic Disease Management Why is this an important issue? High numbers of patients affected Effective interventions may be available Concern that there

What is required to make it What is required to make it happen?happen?

A systematic approach to preventive cardiac careClinical protocols for dealing with established

heart diseaseA robust system for identification, management

& recall of patients

Page 10: Chronic Disease Management Why is this an important issue? High numbers of patients affected Effective interventions may be available Concern that there

Ensuring qualityEnsuring quality

Structure and process elements of any system

easier to monitor than outcomeOutcome may be years in the futureWill morbidity/mortality be improved?

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