Presentation on theme: "Local Professional Networks Assembly"— Presentation transcript:
1 Local Professional Networks Assembly 17 September 2013
2 Opening of the LPN Assembly The Right Honourable Earl Howe Parliamentary Under-Secretary of State for QualityOpening of the LPN AssemblyNHS | Presentation to [XXXX Company] | [Type Date]
3 Ann Sutton Director of Commissioning (Corporate) NHS England National Ambition for the LPN’sNHS | Presentation to [XXXX Company] | [Type Date]
4 Mission Statement“High quality care for all, now and for future generations.”
5 The Commissioning Landscape Clinical Commissioning Groups151 - Local Authorities27 - NHS England Area TeamsImproving outcomes ● Delivering equality ● Improving experience
6 Commissioning together NHS England commissioningRelated commissioningEssential and additional primary medical services through GP contract and nationally commissioned enhanced servicesOut-of-hours primary medical services (where practices have retained the responsibility for providing OOH services)Out-of-hours primary medical services (where practices have opted out of providing OOH services under the GP contract)Community-based services that go beyond scope of GP contract (akin to current Local Enhanced Services) - CCGPharmaceutical services provided by community pharmacy services, dispensing doctors and appliance contractorsMeeting the costs of prescriptions written by member practices (but not the associated dispensing costs) - CCGPrimary ophthalmic services, NHS sight tests and optical vouchersAny other community-based eye care services and secondary ophthalmic services - CCGAll dental services, including primary, community and hospital services and including urgent and emergency dental careDental Public Health – Local AuthorityHealth services (excluding emergency care) and public health services for people in prisons and other custodial settings (adult prisons, young offender institutions, juvenile prisons, secure children’s homes, secure training centres, immigration removal centres, police custody suites)Emergency care, including 111, A&E and ambulance services, for prisoners and detainees present in geographic areaHealth services for adults and young offenders serving community sentences and those on probationHealth services for initial accommodation for asylum seekers - CCGHealth services for member of the armed forces and their families (those registered with DMS)Prosthetics services for veterans(Primary care for member of the armed forces will be commissioned by the Ministry of Defence)Health services for veterans or reservists (when not mobilised) for whom normal commissioning responsibilities applyEmergency care including A&E and ambulance services, for serving armed forces & families registered with DMS practice present in geographical area - CCGPublic health services for children from pregnancy to age 5 (Healthy Child Programme 0-5), including health visiting, family nurse partnership, responsibility for Child Health Information SystemsHealthy Child Programme for school-age children (5-19), including school nursing – Local AuthorityNational Screening & Immunisation programmesSexual Health programmes – Local AuthorityPublic health care for people in prison and other places of detentionSexual Assault Referral Services
7 A wealth of clinical resources to support commissioning LocalCCGsH&WB BoardsClinical SenatesStrategic Clinical networksArea Team CliniciansLocal Professional NetworksPublic Health EnglandAcademic Health Science NetworksNational Clinical Reference GroupsDomain LeadsNational Clinical DirectorsClinical DirectoratesClinical Priorities Advisory GroupChief Professional OfficersLPN AssemblyCommissioning Assembly
8 Dr David Geddes Head of Primary Care Commissioning NHS England National LPN UpdateNHS | Presentation to [XXXX Company] | [Type Date]
10 You said…we did from last LPN Assembly Essentials you said we must doWhat we’ve doneGet the right Chair in placeComprehensive job descriptionsRobust recruitment processesDraw up competence framework for Chairs and other LPN leadersDiscussion of the training & development toolkit are underwayPlanned development programme for Chairs & LPN leadersNHSIQ are here today and development work will continue following today’s AssemblyBuild on existing groups and networksPeople already involved encouraged to remain on the steering groupsNewsletterWebsiteClarity on governance & accountabilitySingle operating model published
11 Recruitment update 81 positions in total for LPN Chairs across England 18 have been confirmed as filled or interim63 are vacant (some are out to advert)
15 Local Ambition for LPN’s PharmacyDentalEye HealthNHS | Presentation to [XXXX Company] | [Type Date]
16 Dr Jill Loader Regional Pharmacist NHS England South Pharmacy LPNs
17 LPNs working as an integral part of NHS England Area Teams, developing close local working relationshipsHWB/Local AuthoritiesClinical Commissioning GroupsHEE/LETBsInforming needs, demand, supply in primary, community and secondary carePeer support, peer review and benchmarkingLocal professionalnetworksArea TeamsLocal intelligence, clinical expertise, innovation and development of integrated care pathwaysMaximising performanceLPN AssemblyNHS England regional/ centralImplementation and development plans to reflect local circumstancesAggregation of need and assurance of performanceStrategy, policy, contract, procedure and assurance of achievement of outcomes
18 Pre April 2013Commissioning essential, advances and enhanced Pharmaceutical servicesMedicines optimisationPharmaceutical Needs AssessmentAccess to medicines out of hoursMedicines safetyContract monitoringClinical leadership and engagementComplaintsPatient engagementTransfers of carePCTConsultation with LPCMedicines strategyAccountable officer for Controlled Drugs and LINPoor performersFraudPublic HealthAccreditationPharmaceutical ApplicationsMedicines QIPPWaste medicinesCare Homes
19 Post April 2013 CCGs NHS England LAs Commissioning essential, advanced and enhanced Pharmaceutical servicesMedicines QIPPMedicines optimisationMedicines strategyPrimary care prescribingCCGsQuality improvementContract monitoringClinical leadership and engagementPatient engagementPoor performersTransfers of careCommissioning services direct from pharmacy e.g. minor ailments, palliative care medicinesNHS EnglandMedicines safetyAccess to medicines out of hoursFraudWaste medicinesSafe use of controlled drugsAccreditationPatient pathwaysNetworksComplaintsPublic HealthAccountable officer for Controlled DrugsConsultation with LPCCare HomesLAsContract monitoringPharmaceutical ApplicationsPharmaceutical Needs Assessment (H&W Boards)Direct commissioning of public health services from pharmacy
20 Local Professional Networks for Pharmacy Clinically-led commissioning ensuring a coherent offer for public from multiple commissioners of services from community pharmacy informed by patient and public engagementQuality improvement support continuous improvement in quality of pharmaceutical services provision locally.Pharmaceutical Needs Assessment advise H&W Boards in producing a robust local PNAOutcomes Framework contribute to every domain through effective joined up work on medicines optimisation and support for healthy living through community pharmacy – CCGs, NHS England, Local Authorities, Public Health England, Health Education England
23 Pharmacy LPN Steering Group Chair: Clare HowardSupporting the development of Local Professional Networks and sharing best practiceSupporting the development and implementation of national strategy and policyWorking with key stakeholders on the development and delivery of national prioritiesProviding clinical leadershipEnsure contribution of LPNs in each AT is maximised to improve outcomes and reduce inequalities
24 Getting Medicines Right at Discharge Integrated care around the patientCross sector working - NMS, tMURsImprove safety, reduce readmissionsEffective communicationOn-going monitoringUnderstanding which medicines have been stopped and started and why.Support for medicines-takingJoint decision making – plan when to take, when to stop, when monitoring needed, when to review, outcomes, side effects
25 Effective Patient Involvement Clearly define remit of each member of groupWhat is needed and why and what they will get out of itMake sure patient reps are properly preparedappropriate background to LPNs,a good pre-brief (include roles, jargon, expectations, behaviours)opportunity to ask questions in a non threatening environmentEnsure support available from both an NHS buddy and another patient repBe clear about training provided, claiming expenses etc.Keep engaged and give regular feedback re the difference their contribution is making
27 Serbjit Kaur Deputy Chief Dental Officer NHS England LPN (Dental) Steering Group Chair Dental LPNs
28 Key Aims and Objectives for Dentistry Implementation of SEICDTo improve oral health and reduce inequalitiesTo improve access to high quality dental servicesTo Improve the outcomes for patientsTo provide seamless delivery of care across alldental specialtiesTo integrate dental services within wider NHSTo develop meaningful quality metricsGetting value for money without compromising clinicalquality.
29 The big issuesTo reduce oral health inequalities with respect to access to services and outcomes for patientsTo develop patient pathways to ensure patients can access appropriate care, dependent on need, regardless of the setting within which this care is developedTo develop a service with a greater focus on preventionTo develop a service that meets patients expectations
30 National Dental Commissioning Group Relationships Directly Commissioned Services CommitteePrimary CareOversight GroupNational Dental Commissioning GroupNational LDN Steering groupOral and maxillofacial surgeryVulnerable peopleClinical Priority Advisory GroupReport toAdvisoryReport to
31 National Dental Commissioning Group Aims:To ensure a holistic approach to commissioningTo work with all key stakeholders to lead the transformation of dental services required to deliver SEICDKey Objectives:To develop a comprehensive dental commissioning strategyTo oversee the delivery of a single operating modelTo encourage innovation and creativity and identify best practiceTo encourage active dialogue on issues and challenges relating to dental services
32 National Dental Commissioning Group Chief Dental OfficerHead of Primary Care Commissioning, NHS EnglandAssistant Head of Primary Care Commissioning, NHS EnglandHead of Primary Care and Commissioning Outcomes, NHS EnglandDental Policy DHDeputy Chief Dental OfficerDental Commissioning lead for Public Health England2 Dental Commissioners for each region nominated by the regional leadHealth Education England - Post Graduate Dental Dean
33 LPN Dental Steering Group Draft Terms of ReferenceInvitations for nominations for membership have been sentWill play a key role as a conduit between the NDCG andLocal Dental NetworksInformation needs to flow in both directions to achieve theaspirations of SEICDFunction is to support the LDNs in the development andImplementation of national strategy and policy
34 Membership of the Dental Steering Group Chair: Deputy Chief Dental OfficerHead of Primary Care CommissioningAssistant Head of Primary Care Commissioning/National LPN Lead4 LDN Chairs (one from each region)4 Commissioners (one from each region)4 Dental Public Health Consultants (one from each region)Regional Consultant in Dental Public Health - NHS England liaisonRepresentative from Health Education England
35 NHS England needs you! LDN are essential to: To provide clinical advice to Area teamsTo ensure sufficient local flexibility in the implementationof national strategies and policiesAchieving the aspirations of SEICDLink across all Area Teams and the centre support structures
36 Dr David Geddes Head of Primary Care NHS England Local Eye Health Professional Networks
37 LEHN – An opportunity for clinical leadership. Four specific functions for LEHN to considerEye Health Needs AssessmentRedesigning services for quality improvementWorking in PartnershipImprove access for sight tests for seldom heard groupsThe SOM LPN has 4 specific functions and priorities for LEHNS to consider in addition to their local prioritiesThe functions were consistent from the 16 cluster of PCTs that tested eye health LEHNs between 2011 and 2012
39 National priorities and LEHN focus LPNCCGLAHealth and Wellbeing Board
40 Facing blindness alone Almost half of blind and partially sighted people feel “moderately” or “completely” cut off from people and things around them.Older people with sight loss are almost three times more likely to experience depression than people with good vision.Approaching one in 10 falls that result in hospital admissions occur in individuals with visual impairment.Facing blindness aloneRNIB 2013Facing blindness aloneWhat Government needs to do now to stop theisolation of blind peopleRNIB 2013
42 RehabilitationRehabilitation is the structured support put in place, over a defined period of time, with the overall aim of maximising a person’s independence and quality of life.It is a cost effective approach which aims to help blind and partially sighted people “do things for themselves”, rather than “having things done for them”.Taking part in social and leisure activitiesMany people with little or no sight need social support to engage socially. Not beingable to see when you enter unfamiliar environments obviously affects your ability tointeract with others and establish relationships. Blind and partially sighted peoplesometimes need personal assistance or a carer to accompany them on trips, for exampleso they can find a rail station ticket attendant to seek help with getting through theticket barriers.
46 Support for LPNs Eye Health Steering Group Getting Started and Building RelationshipsClinical Council for Eye Care CommissioningNational Primary Care Strategy and Area Team Primary Care PlansMillie’s mum. I hope you can see that the old “normal” glasses slide down but the Erin’s world stay where they are supposed to.
47 Leading purpose & possibility Dr Robert Varnam PhD RCGP Clinical Lead NHS ImprovingLeading purpose & possibilityNHS | Presentation to [XXXX Company] | [Type Date]
53 What is the performance management framework? Who’s paid them?What’s the plan?Large scale actionNot requiring large leadership teamor compliance framework
54 “We have a list of measurable objectives” versus“We have a list of measurable objectives”“I have a dream”
55 Compliance and commitment States a minimum performance standard that everyone must achieveStates a collective goal that everyone can aspire toUses hierarchy, systems and standard procedures for coordination and controlBased on shared goals, values and sense of purpose for co-ordination and controlThreat of penalties/sanctions/shame creates momentum for deliveryCommitment to a common purpose creates energy for delivery
56 expect them to be committed to it” “You can’t imposeanything on anyone andexpect them to be committed to it”Edgar Schein, Professor Emeritus MITSloan School
57 “You don’t need an engine when you have wind in your sails” Paul Bate
58 Using intrinsic motivation Often, change need not becajoled or coerced.Instead, it can be unleashed.Kelman, S. (2005) Unleashing change.A study of organizational renewal in government.Brookings Institution Press; Washington, D.C.
59 build energy and creativity Intrinsicmotivatorsbuild energy and creativity
60 Intrinsic motivators build energy and creativity connecting to shared purposeengaging, mobilising and calling to actionmotivational leadershipbuild energy and creativity
61 Intrinsic motivators build energy and creativity Drivers of extrinsic motivationIntrinsicmotivatorsconnecting to shared purposeengaging, mobilising and calling to actionmotivational leadershipbuild energy and creativitycreate focus &momentum for delivery
62 Intrinsic motivators build energy and creativity Drivers of extrinsic motivationIntrinsicmotivatorsconnecting to shared purposeengaging, mobilising and calling to actionmotivational leadershipregulationpayment & incentive systemsperformance managementmeasurement for accountabilitybuild energy and creativitycreate focus &momentum for delivery
63 Drivers of extrinsic motivation create & focus momentum for delivery Internalmotivatorsconnecting toshared purposeengaging, mobilising and calling to actionmotivational leadershipSystem drivers & incentivesPerformance managementMeasurement for accountabilitycreate & focusmomentum fordeliverybuild energy and creativity
66 Invest more in people than plans Create massively distributed leadershipLead through the sense of purpose and possibility you createTalk fearlessly about valuesInvest in your first followers
67 Case StudiesNHS | Presentation to [XXXX Company] | [Type Date]
68 Stephen Gough Lancashire LPN Lead NHS England Lancashire Local Professional Networks
69 ObjectiveTo describe the governance structures and framework by which the Lancashire Area Team will ensure the integration of LPNs within the health system, specifically the primary care strategy and clinical strategy, and hold LPNs to account for the delivery of their work plans.It is important to recognise and acknowledge that the appointed LPN chairs working one day a week will not have sufficient resource to influence the health system especially if the local health economy does not understand their role and position within the local health systemTherefore the Area Team through its multiple contacts with stakeholders needs to not only fully understand the role of LPNs but keep a grip on their priorities to ensure alignment with primary care strategies etc.The mechanism by which Lancashire will ensure that the Area Team understands the direction and development of LPN work plans and ensure their alingment within the AT strategy and primary care strategy is through the LPN executive and supporting framework.> The governance and integration is managed through the establishment of the LPN Executive and the supporting framework consists of a suite of locally developed documents, using NHS England templates so other ATs can adopt / amend, consistently applied across all 3 LPNs and include:>> TOR> LPN Structures> LPN Matrix of stakeholders> Summary Work Plan> Detailed Work Plan with milestones and outcomes Conflict of InterestPolicy Commercial Sponsorship Policy
70 LPN Executive Commissioning Director & Medical Director LPN Chair LEHN ChairLDN ChairLPN ManagerHead of Primary CareAssistant Director Clinical StrategyLPN Single Operating Framework accountability MD and DOC.To ensure LPNs are fit for purpose and delivering contributions to the NHS and Public Health outcomes framework.•To receive, review and approve, in collaboration with the three Health and Well Being Boards, each Local Professional Network work plan.•Ensure integration of the work plans with the primary care strategy and overarching Lancashire strategy.•Support LPN chairs and their respective networks in the delivery of the work plans, but equally hold LPN chairs and LPNs to account for the delivery of the work plans•To facilitate engagement and collaboration of the LPNs with the local health economy•To support the development of clinical leaders within LPNs and the wider workforce including secondary care•Acting as a conduit to share learning and experiences between LPNs.•Acting as a conduit to share learning and experiences between different professional LPNs.•Support for measuring and monitoring, collating and sharing LPN outputs.•Support the development of the national primary care strategy•Support the delivery of national policy and strategy•To encourage creativity and innovation and the identification of best practice and excellence in LPNs and corresponding services they advise upon
71 FrameworkThe supporting framework consists of a suite of locally developed documents, using NHS England templates, applied across all 3 LPNs and include:> LPN Matrix of stakeholders> LPN TOR> LPN Structures> Summary Work Plan> Detailed Work Plan with milestones and outcomes> Conflict of Interest> Policy Commercial Sponsorship PolicyTOR, there are national templates for TOR which will be hosted on the LPN portal to be established on 17th Sept at LPN AssemblyLPN structures all set up in accordance with the LPN single operating framework.
74 Lancashire Pharmacy Network As a practising clinician I have daily experience of patients accessing NHS and Social Care services. The opportunity to provide clinical leadership to the development of a Lancashire Pharmacy Network I welcome.Our LPN has foundations within established working relationships across Lancashire .Examples of innovative and quality assured patient focussed service developments have demonstrated effective joint working between legacy pct’s, LPC and secondary care pharmacy. During transition the formation of a Pharmacy Transformation Board proved invaluable. Establishing the Lancashire Pharmacy Network was a natural progression within this environment.
75 A good example of how this has supported innovation in patient care is demonstrated in the primary/secondary care interface work now on the verge of “Go Live” in East Lancashire Hospital Trust.
76 Electronic referral for post-discharge pharmaceutical care Including community pharmacy based :Targeted MURs (discharge medication review)New Medicine ServiceThe journey to Refer to Pharmacy started within PCT hosted interface discussions acknowledging the need to support patients seamlessly as they move between home and hospital and back again. Initial developments of a paper-based refer to community pharmacy system aimed to encourage patients to benefit from a pharmacy based Medicines Use Review or New Medicines Service at a time when changes to medication can increase risk for vulnerable patients. This paper-based scheme was subsequently adopted across Lancashire through the Lancashire Chief Pharmacists group and Lancashire Local Pharmaceutical Committees and existing pharmacy networks. Most significantly the Hospital Discharge Letters from all our hospital trusts were reviewed to include signposting patients to their community pharmacy for and MUR or NMS as appropriate. Refer to Pharmacy progresses this further using an electronic referral mechanism. Presented most recently at our July LPN this excellent video was reviewed very positively by our patient group member and the whole board. As a board we look forward to supporting this work .
77 Alistair Gray GP Hospital Pharmacy Community pharmacy East Lancashire Hospitals NHS Trust (ELHT)
79 Elaine Hawthorn GM LPN (Dentistry) Chair Baby Teeth Do MatterThe first project of the GM LPN for dentistry
80 The first project of the GM LPN for dentistry Baby Teeth DO MatterThe first project of the GM LPN for dentistryQuality and AccessNHS | Presentation to [XXXX Company] | [Type Date]
81 In this case study you will hear about: The first problem we tackled as a LPNI will share the outline of what we did and whywhat we produced and achievedLater in the workshop you will be considering whether our formula could be useful in your LPNIf any of you have addressed other issues and started projects our LPN would be pleased to receive your learning
82 GM LPN Early days….. Establishing the network NHS | Presentation to [XXXX Company] | [Type Date]
83 Steering Group formed in Jan 2012 Core group - 3 X Dentists (from the outset) 2 X Commissioners, 1 X Dental Public HealthWe considered how the LPN could function across 10 PCT localities with helpful advice (CCG Chair and Director of Public Health)Following consideration on structure - rather than sit around talking about ToRs etc and the dentists losing the will to live - we decided to take action and do something positiveThe first task would test whether this collaborative approach, led by dentists, could work
84 Baby Teeth DO Matter The task NHS | Presentation to [XXXX Company] | [Type Date]
85 What did we do and why?One problem in GM is high decay levels in the very young – it starts before age 3Leading to far too many children having pain, dentists struggling to treat them and too frequent GAs for extractions5 year old decay rates had not changed despite all our (separate) best efforts for many yearsWe learned from PH that the best way to influence behavioural change is a quality 1 to 1 contact with a health care professional
86 Getting the message out there Dental decay is largely preventable with a healthy diet and use of fluorideTask:to encourage attendance of all under 5s in GM especially those who had not seen a dentist ever or in last two years – find the missing thousandsand when they got there - make the contact countwith simple achievable message (bedtime routine), fluoride varnish application and given free TB & TPDentists wanted something lasting not a quick access fix to year end – more on that later ….
87 Not seen by dentist in past 24 months The missing thousandsTotal numberSeen by dentistNot seen by dentist in past 24 monthsChildren under three years of age108,78044,60064,180Children aged three and four years of age75,52051,35424,166TOTAL88,346We were then told by PH how many children in GM had not visited a dentist
88 How did we pay for it?£200,000 allocated from the collective PCT dental underspend CsDPH had to fight hard for this - less than 1%This was to pay for TB & TP, literature and to secure the time of 10 clinical champions - one for each PCT locality to encourage practices to participateThe dentists had to be prepared to use their currently contracted UDAs to prioritise this group and actively seek them out UDA allocationSLA agreed (with difficulty) across 10 PCTsThe incentive (3 UDAs subtracted from annual total) was allowed if the child returned 3/12
90 Launched in November 2012 400+ practices in GM, almost half signed up This is credited to the leadership of the clinical champions within the localities – one rang every single practice to encourage participation!They involved the media running stories in local press and used radio to let parents know that dentists were keen to see their children even though they “only” had baby teethIn the finite time we had almost 4000 very young children some of whom had never been before attended the dentist and the majority returned within three months for further advice & FV
91 Using the mediaDentists used the media to get message out to the community radio and news papers
92 The add on for the long term….. Dentists seeing these young children wanted support in best practice treatment and decision makingAnd for BTDM to continueSo….We established a sub group to take this forwardIt included specialists, GDPs, public health and commissioning leads and was Chaired by one of the clinical championsClinical pathways booklet and training produced to assist dentists and their teams provide better quality care and reduce the GAs
95 Things we struggled with… Commissioners adapting from previous PCT approach, to really listen and act upon what the dentists were saying – some found relinquishing power to the clinicians difficultLooking back the SLA was too complicated and the specialists found it hard to be pragmatic – they had not always taken on board the “keep it simple” message and the pace neededInvolving the champions and engaging practices was variable across GMGetting funding
96 What worked well….Dentists were very enthusiastic and LDCs gave positive input and supportIn a very short time we achieved far more working collaboratively on the same goal than we had working separately 4000 in and quality pathwaysMeeting the CCG Chair and other leaders outside of dentistry was inspiring for the dentists and it made sure that they knew about us and what we were trying to achieveAlmost 500 dentists from across GM attended the launch of the pathway booklet and the Area Team Director of Commissioning looked at the audience and said “ I can’t ignore this” he was impressed they had given up an evening of their free time
97 Baby Teeth DO Matter Best of all….. 4000 young children and their families have been given the opportunity to have a future free of decayNHS | Presentation to [XXXX Company] | [Type Date]
98 The Solihull and Birmingham LEHN story so far Debbie Graham Interim LEHN Chair of Birmingham, Black Country and Solihull The Solihull and Birmingham LEHN story so far
99 Commercial break www.visionmatters.org.uk Follow National Eye Health Week on twitter @myvisionmatters
100 LEHN membership Optometrists Health & Well Being Board Ophthalmologist [2e care]Patient representativeLOCCCG clinical leadsClinical advisorCommunity paediatric care [orthoptist]Low vision service providersHealth & Well Being BoardVision 2020 [regional]Public HealthLocal AuthorityAston University optometryPrimary care commissionerAdmin. Support
101 The first meeting… Wide stakeholder input Invitation of workplan ideas and opportunitiesOrganisational developmentCore lead groupTask and finish groupsCommunicationsBuilding on existing workstreams…..
102 Systems & processes Constituting the network: Workplan agreement: core group identifiedterms of reference agreedaccountability agreementconflict of interest addressedprioritisation criteriasign-off by BSol cluster
103 Measures of Success for the LEPN Secure Public Health engagement (at Health and Well Being Board level) in the eyecare needs assessmentSecure Public Health attendance/membership at the LEPN meetingsCommunicate to Clinical Commissioning Groups and Primary Care Optometrists, the evidence base in relation to handling referrals between primary and secondary careProvide a report on the outcomes of the intra-ocular pressures local enhanced service to aid future commissioning decisionsDevelop and recommend a complete, evidence-based age-related macular degeneration pathwayDevelop and recommend a complete cataract pathway in line with the Map of Medicine evidence-based approachProduce and implement an effective Communications Strategy and Plan to ensure the LEPN’s accessibility to stakeholders and vice versaToo Ambitious?
104 Next steps Event to establish single LPNs including LEHN across AT Appointment of chairsSteering group to prioritise workplan suggestionsCommissioner and medical director sign-offQuick second LEHN meetingTask and finish group approachSingle LEHN acrossBirmingham Solihull and Black Country