Integrating care throughout the patient’s surgical journey: How can we harness multidisciplinary working, reduce variation and improve patient outcomes?

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About this event

10 million patients undergo surgery every year, with more than 250,000 people falling into the high-risk category.

Establishing efficient patient-centred care pathways, led by a multidisciplinary team, has the potential to reduce variation, improve patient outcomes, and deliver more efficient health care for patients undergoing major surgery.

This one-day conference explored how to embed a co-ordinated and collaborative way of working between health and care professionals who are responsible for patients' care before, during and after major surgery, so that they can deliver the best possible outcomes.

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Session one: Opening plenary

Welcome and introduction

Vijaya Nath, Director, Leadership Development, The King's Fund

Delivering integrated models of care to improve patient outcomes from surgery: achieving the ambitions set out in NHS five year forward view

Celia Ingham Clark MBE, National Director for Reducing Premature Deaths, NHS England

Patient perspectives

Dr Kate Granger MBE, Patient leader, and Consultant in Elderly Medicine, Mid Yorkshire Hospitals Trust (Expert by Experience)

Fiona Carey, Co-Chair, Coalition for Collaborative Care (Expert by Experience)

How do we develop a co-ordinated and collaborative approach to improve the care patients receive before, during and after surgery?

  • Dr Frank Joseph, Future Hospital Officer, Royal College of Physicians, and Consultant Physician in Diabetes and Endocrinology, Countess of Chester Hospital NHS Foundation Trust
  • Grainne Siggins, Director of Adult Social Care, London Borough of Newham, and Policy and Urgent Care Lead, Association of Directors of Adult Social Services
  • Professor Monty Mythen, Consultant in Anaesthesia and Critical Care, University College London, and University College Hospital, and Chair, Peri-operative Medicine Programme, Royal College of Anaesthetists
  • Mr John Abercrombie, Consultant Surgeon, Nottingham University Hospitals NHS Trust and Member of Council, Royal College of Surgeons of England
  • Dr Ravali Goriparthi, GP, Clinical Director, Barking and Dagenham Clinical Commissioning Group, and Clinical Adviser, Royal College of General Practitioners

11.45am: Session two: Breakouts

Delegates will have the choice of attending one of the following four breakout sessions.

A: Measuring and improving surgical outcomes

Welcome and introduction

Professor Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton

Peri-operative Quality Improvement Programme (PQIP)

Dr Ramani Moonesinghe, Consultant, Anaesthetics and Critical Care Medicine, University College London Hospitals NHS Foundation Trust

Measuring outcome and using this to drive improvement is a fundamental tenet of high quality patient care. The Perioperative Quality Improvement Programme is an innovative system which will measure complications and patient reported outcome, and test novel quality improvement methods in pilot hospitals. This session will discuss the importance of understanding complications (rather than just mortality) and the challenges of quality improvement in a complex multidisciplinary setting.

Case study: The Emergency Laparotomy Pathway Quality Improvement Care (ELPQuiC) experience

Dr Nial Quiney, Clinical Director, Anaesthesia, Intensive Care and Pain Management, Royal Surrey County Hospital NHS Foundation Trust

Questions and discussion

B: Pre-operative optimisation

Welcome and introduction

Dr Teik Goh, Clinical Director, North East Community Health Network (NECHN), and Clinical Lead, Care Closer to Home Workstream, NHS South Tees Clinical Commissioning Group

Developing a complex preoperative intervention in the primary care setting

  • Working with primary care staff on knowledge sharing and addressing unhealthy patient behaviours and co-morbidities at an early stage in the pathway.

Professor Gerry Danjoux, Consultant Anaesthetist, South Tees Hospitals NHS Foundation Trust

Making every contact count for physical activity

  • Communicating the benefits of moderate physical activity before and after many types of operation – improving surgical outcomes, aid the recovery process and enhance the patient's own psychological wellbeing.

Mr Jon Dearing, Consultant Orthopaedic Surgeon, NHS Kilmarnock, and Regional Surgical Advisor, The Royal College of Surgeons of Edinburgh

Questions and discussion

Panel joined by Mr Simon Roberts, Fellow, The Faculty of Sport and Exercise Medicine, and Consultant Orthopaedic and Sports Injury Surgeon, Robert Jones and Agnes Hunt Orthopaedic Hospital

C: Making surgery safer for older people

Welcome and introduction

Professor David Oliver, President, British Geriatrics Society, and Visiting Fellow, The King’s Fund

Pro-active care for older people undergoing surgery (POPs)

  • Delivering a geriatrician-led and patient-centred service tailored to improve the health of patients before and after surgery.

Dr Jugdeep Dhesi, Consultant Physician and POPS Lead, Guy's and St Thomas' NHS Foundation Trust

Jason Cross, Advanced Nurse Practitioner, POPS Team, Guy's and St Thomas' NHS Foundation Trust

Co-ordinating care through multidisciplinary working

  • A holistic approach to delivering tailored care for older people with cancer.
  • Empowering patients to take more control over their treatment and other services they need.

Dr Shane O'Hanlon, Consultant in Elderly Care Medicine (Surgical Liaison and Comprehensive Care of People with Cancer), Royal Berkshire NHS Foundation Trust

Kay Hargreaves, Occupational Therapist, Royal Berkshire NHS Foundation Trust

Questions and discussion

Speakers joined by Brenda Thompson-Murray, Trustee, Carers UK (Expert by Experience)

D: Implementing integrated care pathways

Welcome and introduction

Ben Collins, Project Director, The King's Fund

Commissioning for true integration of primary and secondary care services

  • Joining up care so that patients have a smooth transition from hospital to home post-surgery.
  • Ensuring more care is delivered in community settings, and joint commissioning responsibility across the whole health economy.

Dr Alistair Blair, Chief Clinical Officer, NHS Northumberland Clinical Commissioning Group

A joined-up health and care community

  • Integrated Care Organisation– part of a health and care system
  • Ensuring effective recovery and enabling patients to maintain independence

Caroline Taylor, Director of Adult Social Services, Torbay Council

Questions and discussion

Session three: Lessons from national and international examples of integrated care

Welcome back

Tony Delamothe, Deputy Editor, The BMJ

Opportunities and challenges in the implementation of integrated care: drawing a parallel with mental health crisis care

Dr Steven Reid, Consultant Psychiatrist, Psychological Medicine, Central North West London NHS Foundation Trust

International perspective: Peri-operative Enhancement Team, (POET) US experience

Professor Soloman Aronson,Professor of Anesthesiology, Duke University School of Medicine, and Executive Vice Chair, Department of Anesthesiology, Duke University Health System

Professor Charles S. Brudney, Associate Professor of Anesthesiology and Critical Care Specialist, Duke University School of Medicine

Panel response: how can we apply these lessons to perioperative care in England?

Speakers from the day joined by Robert Thompson, Lay Committee Chair, Royal College of Anaesthetists

Questions and discussion