1. “The essence of our approach to managed care” Surrey and Sussex Transforming Chronic Care Programme September 17 2004

2. Patients at all levels of the pyramid need some level of assistance to help them to achieve the best possible outcomes Self Management Level 1 70-80% of a CDM pop Level 2 High risk patients Care Management Level 3 Highly complex patients Case Mgt The majority of patients do not care for themselves effectively The key to an effective systematic approach is to support patients down the pyramid rather than allow them to drift up to highest levels Intensive case management is not cost effective beyond the highly complex Self careAssisted (‘managed’) care

3. Serum works with PCTs to deliver a fully integrated local care management programme Proactive telephone follow up ­Disease specific risk prevention and self- management education (Currently asthma, COPD, Diabetes and CHD) ­Inbound telephone facility GP practice/clinician support ­Patient referral and coordination ­Practice nurse support Local integration into care pathways Detailed reporting and measurement Project management and delivery

4. Proactive telephone support is both clinically and cost-effective at keeping patients well and out of hospital Asthma example - 1 year national case study Utilization outcomes ­Estimated 64% reduction in unplanned asthma admissions ­Reduction in emergency primary care visits and use of additional resources Quality of life outcomes ­86% of patients feel that they have a better understanding of their asthma ­Extensive patient feedback on improved motivation, quality of life and functional ability Clinical outcomes ­69% improvement in patients self reported asthma status ­40% reduction in reliever medication use ­39% improvement in self reported preventer medication compliance GP - Blackwater Valley and Hart PCT: "Very positive feedback. The advice is first class and on one occasion prompt intervention prevented an admission. “

5. The additional telephone care improves the patient experience Patients respond better when given… Education on complex conditions and medication Support at a time and place that suits their needs. Confidential advice from a qualified nurse Time to respond to their questions and concerns. Additional support outside of their GP practice Follow up to see if they have managed to do what was agreed Male, 66 - "'It's been a very, very good service. My understanding of asthma and the treatment that I'm on has improved by 100%, since you started making the calls'"

6. We work to a structured process which manages a programme from initiation to delivery Step 1. Nominated PCT leads Step 2. Agreed support variables ­Patient population ­Recruitment ­PCT/GP practice integration and engagement ­Reporting and measurement Step 3. PEC/CDM group/Board sign off Step 4. Project plan and Serum delivery Typical steps from contact to delivery

7. Our goal is to help you and your patients to achieve the best possible outcomes Reduce the burden on secondary care Help patients to better care for themselves Achieve a direct financial return on investment Improve the quality of care delivered to your patients Improve patients functional status and quality of life Ensure best use of medicines and reduce medicines wastage About Serum Benefits of a telephone care management programme Serum is a leading independent UK provider of healthcare support and information The calling protocols were developed by the Serum Intervention Committee whose membership includes Professor Mike Pringle, Professor Stephen Chapman and Professor Rob Horne. The operation runs from custom built decision support software, SCCM (the Serum Call Centre Manager), which is based on US decision support tools. The service is delivered to a detailed process of Clinical Governance, in which all calls are recorded, risks reviewed monthly and calling processes managed to an agreed service level agreement.

8. Perry Blacher Serum 100 Union St London SE1 ONL Tel: 020 7261 9256 Perry@serumgroup.com