WhatDoTheyKnow
|NSF Documents - Unformatted Document |
"RE: Request for advice"
|File Reference: |AWL/015 |
|File Title: | Allergies - Next Steps |
|Filed by: |/POLICY/DOH/GB on 24/11/2009 at 11:01 |
|Created by: |" @osha.nhs.uk> on 18/03/2008 at 16:26 |
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| |RE: Request for advice |
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I've just spoken with, Director of National Specialised Commissioning Group and it would seem that he might be your best next step. I would suggest you set up a meeting with him to discuss. Do call for further information.
Best wishes
Acting Director
@osha.nhs.uk
The Office of the SHAs, Southside, 105 Victoria Street, London SW1E 6QT
Direct Line: Mobile:
Fax
osha.nhs.uk
-----Original Message-----
From: @dh..uk [mailto: @dh..uk]
Sent: Monday 10 March 2008 13:56
To:
Subject: Request for advice
Dear,
As you may be aware, a House of Lords Science and Health Select
Committee into allergy recently recommended that: 'DH should establish a lead SHA, prefereably not in the South East of England, which would work with Primary Care Trusts to develop the first allergy centre'.
In response, the Government acknowledged that the establishment of a
Lead SHA merited 'careful consideration, in that it might provide a mechanism for increasing co-ordination and co-operation. We shall explore the feasibility of this approach with interested parties, including SHAs and specialised commissioning groups.'
I have been appointed to take forward this work and would be grateful
For any views you might have regarding this work. Also, has the OSHA issued any guidance regarding the process for establishing lead SHAs? If not, do you have any advice that you could offer. Are there any links that we could make through you to explore the feasibility of this approach with SHAs?
I would be grateful for the opportunity to speak to you in more detail
regarding this work, either in person or over the phone.
Thank you for the conversation earlier. The email below explains the
request. I have flagged this up to and, who are the two working with Bruce Keogh on the Clinical Executive Group, but in the meantime your expertise and input would be welcome.
|NSF Documents - Unformatted Document |
"Establishment of a lead SHA for allergy services - deadline 30 June"
|File Reference: |AWL/015 |
|File Title: | Allergies - Next Steps |
|Filed by: |/POLICY/DOH/GB on 24/11/2009 at 11:02 |
|Created by: |/POLICY/DOH/GB on 07/05/2008 at 12:10 |
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| |Establishment of a lead SHA for allergy services - deadline 30 June |
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Dear Chief Executive,
Please find attached a letter seeking calls of declarations of interest in the establishment of a lead SHA for allergy services.
I should be grateful if you could respond by the close of 30th June.
Private Office of Professor Sir Bruce Keogh
NHS Medical Director
Richmond House
79 Whitehall
London SW1A 2NS
Telephone: Letter:
[pic]
|7 May 2008 |
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|By e-mail. |
|(Hard copy to follow.) |
|Dear Chief Executive |
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Re: Establishment of a lead SHA to champion allergy services – call for declarations of interest
I am writing to all SHA Chief Executives to invite declarations of interest in being identified as the lead SHA for allergy and for setting up a pilot allergy centre.
In September last year the Report of the House of Lords Science and Technology Committee Inquiry into Allergies included the recommendation that we should establish a lead Strategic Health Authority, preferably not in the South of England, which would work with its Primary Care Trusts to develop the first allergy centre.
A full cost analysis should be integral to this to assess the efficacy of diagnosing and managing allergy using the “hub and spokes” model. The lessons learnt from the pilot allergy centre should then be used to inform the development of further allergy centres in other regions.
In the Government Response we said that we would consider this recommendation carefully as a mechanism for increasing co-ordination and co-operation. Since then officials have worked to explore the feasibility of this approach with interested parties.
We think the first step is for a nominated SHA and its PCTs to evaluate, in the light of local needs and priorities, whether the model suggested by the House of Lords report would be likely to be more beneficial to people suffering from allergies than other possible models for enhancing local services. We propose that a SHA be identified to champion allergy services and develop models of care that can help commissioners in all SHA regions to design services suited to the needs of their allergy patients.
I am writing to you to invite expressions of interest in taking on this role. The Department of Health is able to provide funding in the region of £60,000 in 2008/ 09 to support the Lead SHA in its work.
I would be grateful if you could contact, the Allergy Services Review Project Lead, within my Directorate by the 30th June 2008 to confirm if you would be interested in your SHA taking on this important role (contact details at the end of this letter. All declarations of interest will be evaluated to identify the best candidate, so please state why you would be suited to taking forward this work.
I look forward to hearing from you.
Yours sincerely
Professor Sir Bruce Keogh
NHS Medical Directo
Please respond to:
Allergy Services Review Project Lead
Wellington House
133-155 Waterloo Road
London SE1 8UG
email: @dh..uk
|NSF Documents - Unformatted Document |
"FW: SHA Lead for Allergy Services"
|File Reference: |AWL/015 |
|File Title: | Allergies - Next Steps |
|Filed by: |/POLICY/DOH/GB on 24/11/2009 at 11:02 |
|Created by: |" @nwsct.nhs.uk> on 16/06/2008 at 13:53 |
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| |FW: SHA Lead for Allergy Services |
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Hi
This is where I am up to. Not been an easy ride to get it to this point!
Regards
Senior Specialised Commissioning Manager
(Team Leader - Team 2)
North WestSpecialised Commissioning Team
Quayside, WilderspoolPark
Greenalls Avenue
StocktonHeath
Warrington
WA4 6HL
From:
Sent: 16 June 2008 13:53
To:
Cc:
Subject: SHA Lead for Allergy Services
Dear
I am responding to your e-mail of 16 May 2008 in regard to the above issue.
You may recall that I had contacted you in regard to the letter by Professor Sir Bruce Keogh asking for a lead SHA to develop allergy services. You responded that the SHA was not in a position to resource this work but would support the North West Specialised Commissioning Team (NWSCT) as lead agency for the work, subject to PCT agreement.
The issue was discussed at the North West Specialised Commissioning Group on 16th May 2008, where PCTs agreed to the NWSCT acting as lead agency for this work on behalf of the SHA and North West PCTs. The North West PCT Chief Executives also considered this matter on 23rd May 2008. The NW PCT Chief Executives supported the application for the North West to be the lead SHA for allergy services, although they stressed that such support did not represent a pre-commitment to providers to support the full implementation of the model of care being developed. The North West PCT Chief Executives highlighted that decisions to invest or not would be subject to prioritisation through the NWSCG. The North West PCT Chief Executives asked Manchester PCT, through their Director of Commissioning, , to work alongside the NWSCT in regard to the work on allergy services.
I hope that this is sufficient information for you to support your decision making within the SHA.
Regards
Senior Specialised Commissioning Manager
(Team Leader - Team 2)
North WestSpecialised Commissioning Team
Quayside, WilderspoolPark
Greenalls Avenue
StocktonHeath
Warrington
WA4 6HL
|NSF Documents - Unformatted Document |
"Re: FW: SHA Lead for Allergy Services"
|File Reference: |AWL/015 |
|File Title: | Allergies - Next Steps |
|Filed by: |/POLICY/DOH/GB on 10/03/2010 at 08:10 |
|Created by: |/POLICY/DOH/GB on 16/06/2008 at 15:05 |
|Recipients: |"" (SendTo, CopyTo & BlindCopyTo if applicable) |
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,
Thanks for letting me know where you are. The deadline is the 30th June and so far you are the only person who has let me know that they are thinking of sending something in (although of course other people might be beavering away in the background). I don't think that we will be particularly strict about the deadline, so if you need a bit more time then let me know.
Kind regards
Department of Health
Wellington House
133 - 155 Waterloo Road
London SE1 8UG
Tel: 020 7
From:
Sent: 16 June 2008 13:53
To:
Subject: SHA Lead for Allergy Services
Dear
I am responding to your e-mail of 16 May 2008 in regard to the above issue.
You may recall that I had contacted you in regard to the letter by Professor Sir Bruce Keogh asking for a lead SHA to develop allergy services. You responded that the SHA was not in a position to resource this work but would support the North West Specialised Commissioning Team (NWSCT) as lead agency for the work, subject to PCT agreement.
The issue was discussed at the North West Specialised Commissioning Group on 16th May 2008, where PCTs agreed to the NWSCT acting as lead agency for this work on behalf of the SHA and North West PCTs. The North West PCT Chief Executives also considered this matter on 23rd May 2008. The NW PCT Chief Executives supported the application for the North West to be the lead SHA for allergy services, although they stressed that such support did not represent a pre-commitment to providers to support the full implementation of the model of care being developed. The North West PCT Chief Executives highlighted that decisions to invest or not would be subject to prioritisation through the NWSCG. The North West PCT Chief Executives asked Manchester PCT, through their Director of Commissioning, Debbie Nixon, to work alongside the NWSCT in regard to the work on allergy services.
I hope that this is sufficient information for you to support your decision making within the SHA.
Regards
Senior Specialised Commissioning Manager
(Team Leader - Team 2)
North West Specialised Commissioning Team
Quayside, Wilderspool Park
Greenalls Avenue
Stockton Heath
Warrington
WA4 6HL
Tel
Fax: Blackberry:
|NSF Documents - Unformatted Document |
"FW: SHA Lead for Allergy Services"
|File Reference: |AWL/015 |
|File Title: | Allergies - Next Steps |
|Filed by: |/POLICY/DOH/GB on 24/11/2009 at 11:02 |
|Created by: |" @nwsct.nhs.uk> on 18/06/2008 at 16:48 |
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FYI - let me know if you do not receive the 'real' one.
Senior Specialised Commissioning Manager
(Team Leader - Team 2)
North West Specialised Commissioning Team
Quayside, Wilderspool Park
Greenalls Avenue
Stockton Heath
Warrington
WA4 6HL
-----Original Message-----
From: Sent: 18 June 2008 12:40
To:
Cc:
Subject: RE: SHA Lead for Allergy Services
Dear
Further to the attached e-mail, I have drafted a response to Professor
Sir Bruce Keogh as requested. This response is attached, as is the
original letter from Professor Sir Bruce. I have added a list of people
to whom I suggest that the letter should be copied at the end.
I hope this is OK.
Regards
Senior Specialised Commissioning Manager
(Team Leader - Team 2)
North West Specialised Commissioning Team
Quayside, Wilderspool Park
Greenalls Avenue
Stockton Heath
Warrington
WA4 6HL
-----Original Message-----
From:
Sent: 16 June 2008 21:14
To:
Cc:
Subject: Re: SHA Lead for Allergy Services
Dear
Thank you for the update. It looks as if the NW needs to volunteer to be the lead!
Would you kindly draft the letter and pass to for to sign pls?
Thanks
[pic] - MFarrardraft18June08.doc[pic] - 080507 - Establishment of lead SHA for Allergy Services.doc
Date to be addded
Allergy Lead
Department of Health
Wellington House
133-135 Waterloo Road
London
SE1 8UG
Dear
Re: Establishment of a lead SHA to champion allergy services – call for
declarations of interest
I am writing in response to the letter from Professor Sir Bruce Keogh of 7th May 2008 inviting declarations of interest from Strategic Health Authorities to take a lead upon and set up a pilot allergy centre.
This invitation has been discussed with Primary Care Trusts (PCTs) through the North West Specialised Commissioning Group (NWSCG) on 16th May 2008 and the North West PCT Chief Executives meeting on 23rd May 2008. At these meetings PCTs agreed that NHS North West should declare an interest in leading this initiative. In supporting NHS North West in declaring an interest in leading this work, North West PCTs highlighted that the outcomes of the work in terms of service models and suggested provision would still be subject to the established mechanisms for the prioritisation of investment.
Given the positive outcome of these discussions, I wish to declare our interest in leading this work. Subject the acceptance of our expression of interest by the Department of Health, NHS North West and North West PCTs have agreed that the North West Specialised Commissioning Team (NWSCT) would act as the lead agency for this work on our behalf. The NWSCT would work alongside Manchester PCT, as lead PCT for this initiative, to ensure that the whole patient pathway was considered and all PCTs in the region we engaged in this work.
It is our view that we are best suited to taking forward this work as we already have strong working relationships between commissioners, clinicians and patients in regard to allergy services. Clinicians and commissioners from the North West have also been closely involved in the development of a number of reports from both Houses of Parliament and the Department of Health in recent years, which gives us an advantage in understanding the political significance of the proposed work and having in place the relationships with key players at a national level. The demography of the North West, with a large population that features large conurbations but also significant areas of rurality, areas of considerable deprivation but also of relative affluence and significant ethnic and cultural diversity, provides an ideal area to develop models of care that can help commissioners in all SHA regions to design services suited to the needs of their allergy patients. The NHS in the North West is also well advanced in respect of understanding the need for allergy services based upon demographic and epidemiological information and identifying how those needs are best met in terms of service models, specifications and standards. We feel that this work would allow us to explore and test further issues of access, equality, patient experience and patient outcomes. Finally, as indicated above, we have already given consideration to how we would wish to implement this initiative in terms of identifying a lead agency and PCT.
I hope that this is sufficient information to enable the Department of Health to make a decision in regard to the appointment of a lead SHA for this work. I look forward to hearing from you.
Your etc
Mike Farrar
cc. Professor Sir Bruce Keogh, NHS Medical Director
Dr Ruth Hussey, NHS North West
David Peat, Chief Executive, East Lancashire PCT and Chair, North West PCT Chief Executives
Dr Leigh Griffin, Chief Executive, Sefton PCT and Chair, North West Specialised Commissioning Group
|NSF Documents - Unformatted Document |
"Establishment of a lead SHA to champion allergy services - declaration of interest"
|File Reference: |AWL/015 |
|File Title: | Allergies - Next Steps |
|Filed by: |/POLICY/DOH/GB on 24/11/2009 at 11:02 |
|Created by: |" @northwest.nhs.uk> on 26/06/2008 at 18:09 |
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Enclosed please find a letter from Mike Farrar.
Regards
26 June 2008
Allergy Lead
Department of Health
Wellington House
133-135 Waterloo Road
London
SE1 8UG
Dear
Re: Establishment of a lead SHA to champion allergy services – call for
declarations of interest
I am writing in response to the letter from Professor Sir Bruce Keogh of 7th May 2008 inviting
declarations of interest from Strategic Health Authorities to take a lead upon and set up a pilot
allergy centre.
This invitation has been discussed with Primary Care Trusts (PCTs) through the North West
Specialised Commissioning Group (NWSCG) on 16th May 2008 and the North West PCT
Chief Executives meeting on 23rd May 2008. At these meetings PCTs agreed that NHS North
West should declare an interest in leading this initiative. In supporting NHS North West in
declaring an interest in leading this work, North West PCTs highlighted that the outcomes of
the work in terms of service models and suggested provision would still be subject to the
established mechanisms for the prioritisation of investment.
Given the positive outcome of these discussions, I wish to declare our interest in leading this
work. Subject the acceptance of our expression of interest by the Department of Health, NHS
North West and North West PCTs have agreed that the North West Specialised
Commissioning Team (NWSCT) would act as the lead agency for this work on our behalf.
The NWSCT would work alongside Manchester PCT, as lead PCT for this initiative, to ensure
that the whole patient pathway was considered and all PCTs in the region we engaged in this
work.
It is our view that we are best suited to taking forward this work as we already have strong
working relationships between commissioners, clinicians and patients in regard to allergy
services. Clinicians and commissioners from the North West have also been closely involved
in the development of a number of reports from both Houses of Parliament and the
Department of Health in recent years, which gives us an advantage in understanding the
political significance of the proposed work and having in place the relationships with key
players at a national level. The demography of the North West, with a large population that
features large conurbations but also significant areas of rurality, areas of considerable
deprivation but also of relative affluence and significant ethnic and cultural diversity, provides
an ideal area to develop models of care that can help commissioners in all SHA regions to
design services suited to the needs of their allergy patients. The NHS in the North West is
also well advanced in respect of understanding the need for allergy services based upon
demographic and epidemiological information and identifying how those needs are best met
in terms of service models, specifications and standards. We feel that this work would allow
us to explore and test further issues of access, equality, patient experience and patient
outcomes. Finally, as indicated above, we have already given consideration to how we would
wish to implement this initiative in terms of identifying a lead agency and PCT.
I hope that this is sufficient information to enable the Department of Health to make a decision
in regard to the appointment of a lead SHA for this work. I look forward to hearing from you.
Yours sincerely
Mike Farrar
Chief Executive
cc. Professor Sir Bruce Keogh, NHS Medical Director
Dr Ruth Hussey, NHS North West
David Peat, Chief Executive, East Lancashire PCT and Chair, North West PCT Chief
Executives
Dr Leigh Griffin, Chief Executive, Sefton PCT and Chair, North West Specialised
Commissioning Group
North West Specialised Commissioning Team
[pic] - Bruce letter to NW SHA Appointment of Allergy Lead 21.08.09.doc
|21 August 2008 |
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|Mike Farrar |
|Chief Executive, NHS North West |
|Gateway House |
|Piccadilly South |
|Manchester |
|M60 7LP |
|Dear Mr Farrar, |
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Re: Appointment of NHS North West as the Lead SHA for Allergy Services
Thank you for your letter of 26 June 2008 to my colleague, declaring the North West’s interest in becoming the Lead SHA for Allergy. I am pleased to be writing to invite you to take on this role.
Please find attached a summary of the scope of the work for the lead SHA for allergy, which I hope you will find acceptable. In taking this forward, we would expect you to engage with experts in the field of allergy and immunology, patient representatives and representatives from the other SHAs, so that successful models of care can be developed that will be suited to patients needs and can be rolled out across England.
I would request that you nominate someone to be the project lead for this work, who could meet with at an early stage to discuss the scope document in more detail and agree the arrangements for the transfer of the £60k funding for 2008/09.
We hope to announce this appointment next week. I would therefore be grateful if you could contact to confirm who in NW SHA can liaise with our press office to manage the announcement arrangements. can be contacted on.
I would like to take this opportunity to thank you once again for agreeing to take on this important role, which will play a vital part in driving up standards of care
…/
for allergy patients.
I look forward to working with you in the future.
Yours sincerely
Professor Sir Bruce Keogh
NHS Medical Director
Email: @dh..uk
Enc.
SCOPE FOR LEAD STRATEGIC HEALTH AUTHORITY FOR ALLERGY
1. Introduction
1. As part of its work around Allergy services, the Department of Health, considering the House of Lords Science and Technology Committee’s report on Allergy, wrote to all Strategic Health Authority (SHA) Chief Executives to invite declarations of interest in being identified as the lead SHA for allergy and for setting up a pilot allergy centre in England.
2. This agreement provides a framework for the lead SHA and sets out the Departments expectations in taking the project forward.
2. Background information
1. The House of Lords Science and Technology Committee published its Report on Allergy on 26 September 2007 and the Department of Health co-ordinated the Governments response, which it published in November 2007.
2. The Department welcomed the Committee’s report, which highlights allergy as an issue to be addressed by a range of stakeholders, including the Government.
3. One of the Committee’s recommendations is for the Department of Health to establish a lead SHA to work with its Primary Care Trusts (PCTs) to develop the first allergy centre.
“We recommend that the Department of Health should establish a lead Strategic Health Authority, preferably not in the South of England, which would work with its Primary Care Trusts to develop the first allergy centre. A full cost analysis should be integral to this to assess the efficacy of diagnosing and managing allergy using the “hub and spokes” model. Improved education of clinicians in allergy, with an accurate diagnosis recorded on the Systemised Nomenclature of Medicine (SNOMED) system, should assist a thorough cost analysis to be carried out. The lessons learnt from the pilot allergy centre should then be used to inform the development of further allergy centres in other regions.”
4. To take this recommendation forward, the Department of Health wrote to all SHA Chief Executives to invite declarations of interest in being identified as the lead SHA for allergy.
3. Scope of the Agreement
1. The lead SHA will champion innovation and improvements in allergy services in England.
2. The lead SHA will develop a model to pilot the first Allergy Centre. The lead SHA will evaluate, in the light of local needs and priorities, whether the ‘hub and spokes’ model suggested by the House of Lords report would be likely to be more beneficial to people suffering from allergies than other possible models for enhancing local services.
3. In evaluating the models, the lead SHA will work with key stakeholders, particularly patient representative groups, clinicians and representatives from all other SHAs, to ensure that the views and opinions of service users and other providers are well considered.
4. As part of developing that model, the lead SHA will continue to work with key stakeholder and will consider:
• how to draw on best national and international practice
• the geographical context i.e. the model will need to work equally well in rural and urban environments
• demographic data, including SNOMED
• equality issues
• training and education requirements for all professions involved in the care of allergy patients (e.g. primary care, emergency care, etc)
• how to engage with all clinicians/ professions involved in the care of allergy patients, including primary, secondary, tertiary and emergency care, school nurses, health visitors, occupational health
• including diagnostic and treatment services (including immunotherapy)
• provision for child and adult services
5. Any potential model should have an evaluation tool built in so that it is possible to assess transparently its success and viability. The evaluation criteria should be discussed with stakeholders and experts in allergy and immunology and agreed with all other SHAs.
6. Any potential model should be future proofed, in particular in line with Lord Darzi’s recommendations in his report “High Quality Care For All - NHS Next Stage Review final report” and should take into account wider policy change and review.
7. The lead SHA will pilot a model and building on the evaluation of the model, will develop a framework that could be used nationwide. In doing so, the lead SHA will consult and engage with NICE in the Pilot evaluation process and toolkit development.
8. The lead SHA will work with the Department of Health to provide support for baseline business, in particular in relation to parliamentary business, for example in providing contributions to Ministerial briefing and assisting with the answering of parliamentary questions.
9. As champions of innovation and improvement in Allergy services, the lead SHA will consider and explore how it could implement further recommendations from the House of Lords Science and Technology Committee Report on Allergy. In particular around the utilisation of existing services, clinical trials, academic links and the education of GPs and post-graduates etc. This could be taken forward as part of the pilot allergy centre work.
10. The lead SHA will ensure that the work is allocated sufficient administrative support, to enable it to work effectively, for example to manage media enquiries and take a pro-active approach to communicating with the media, healthcare professionals, patients etc about the work being undertaken.
4. Quality Requirements
1. The lead SHA will:
• Discuss with the Department of Health a project plan and timetable for:
o the identification of a project manager
o evaluating the different models for an Allergy centre
o piloting the first Allergy centre in England
o developing a framework and toolkit for any successful model that could be used nationwide.
• provide updates on progress by e-mail and telephone as appropriate
• attend an annual review meeting with Department of Health representatives.
2. The Department of Health will:
• establish a lead contact for the lead SHA
• keep the lead SHA informed of any relevant policy change
• attend update meetings as required
• attend annual meetings
5. Funding
1. The Department of Health is able to provide funding in the region of £60,000 in 2008/09 to support the lead SHA in its work.
2. The expectation is that the lead SHA will find the resources from within its existing budget for this work. If an application to the Department of Health for further funding were considered necessary, the lead SHA would need to alert the lead contact in the Department, for consideration as part of the Comprehensive Spending Review planning rounds.
6. Applicable Documents and Reference Material
1. The lead SHA will take into account existing documents and work programmes, including but not limited to:
• Allergy: House of Lords Science and Technology Committee Report on Allergy - 6th Report of Session 2006-07
• Government Response to the House of Lords Science and Technology Committee Report on Allergy
• Lord Darzi‘s report: High Quality Care For All - NHS Next Stage Review final report and associated documents
• Skills for Health National Occupational Standards for Allergy
7. Contacts
1. Until further notice, all correspondence to the Department shall be sent to the address given below for the attention of, the Allergy Services Review Project Lead.
Allergy Services Review Project Lead
Department of Health
Wellington House
133-155 Waterloo Road
London SE1 8UG
Tel:
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|NSF Documents - Unformatted Document |
"RE: Allergy Centres"
|File Reference: |AWL/015 |
|File Title: | Allergies - Next Steps |
|Filed by: |/POLICY/DOH/GB on 24/11/2009 at 11:03 |
|Created by: |" @imperial.ac.uk> on 30/06/2008 at 09:04 |
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Many thanks..happy to help
From: @dh..uk [@dh..uk]
Sent: 29 June 2008 19:54
To:
Subject: Re: Allergy Centres
Dear,
The NW put in a bid on Friday and I think that there will be one or two more tomorrow. I'll let you know about any others later next week. As we discussed when we met, it would be helpful if you were able to read any bids and assess them on a clinical basis. Would this still be OK?
Kind regards
Message sent from a Blackberry handheld device.
----- Original Message -----
From: @imperial.ac.uk]
Sent: 29/06/2008 11:20
To:
Subject: Allergy Centres
Dear ,
I hope you had a nice holiday.
I wonder if you could let me know if you have had bids for allergy centres and in particular whether there is one from the Northwest. I e-mailed some time ago asking him to contact you. I hope he did.
Regards
Sir Alexander Fleming Building,
Leukocyte Biology Section,
National Heart and Lung Institute,
Imperial College,
South Kensington Campus,
London, SW7 2AZ
|NSF Documents - Unformatted Document |
"Re: Allergy Info"
|File Reference: |AWL/015 |
|File Title: | Allergies - Next Steps |
|Filed by: |/POLICY/DOH/GB on 30/06/2009 at 16:07 |
|Created by: |/POLICY/DOH/GB on 30/06/2009 at 16:07 |
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Dear,
I attach the letter of 26th June. I don't think that there were any formal letters after the 21st August - they just became e-mails between myself and.[pic]
The Standards are on the Skills for Health website. The address for the interactive site is:
I also attach the accompanying pdf document (which is also on the Skills for Health website, in case you have trouble opening zip. files.)
Kind regards
[pic]
Department of Health
Wellington House
133 - 155 Waterloo Road
London SE1 8UG
Tel: Mob:
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Sorry to bother you but I am just trying to get up to speed on all the background to the project.
Sir Bruce wrote to Mike Farrar on 21 August 2008 in response to a letter from the NW SHA dated 26 June. I should be grateful for a copy of the June letter and of any communication in response to Sir Bruce's August letter, electronically if poss.
In the August letter there is reference to 'National Occupational Standards for Allergy'. I cannot find these on the DH website or more generally on the web. Please help.
Looking forward to meeting you.
Yours,
[Notional working days: Monday and Tuesday; Wednesday morning]
Associate Director (Strategy)
North West Specialised Commissioning Team
E-mail: @nwsct.nhs.uk
Office: MobileCar: (Sent from my Blackberry)
|NSF Documents - Unformatted Document |
"Re: Allergy Clinic & Mtg"
|File Reference: |AWL/015 |
|File Title: | Allergies - Next Steps |
|Filed by: |/POLICY/DOH/GB on 10/03/2010 at 08:29 |
|Created by: |" \(NWSCT\)" < @nwsct.nhs.uk> on 03/07/2009 at 09:42 |
|Recipients: |\(NWSCT\)" (SendTo, CopyTo & BlindCopyTo if applicable) |
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It was really good to meet you and. I hope you found the day both useful and enjoyable. I learnt a lot and came out of our meeting in a much more positive state of mind. Your offers of help were greatly appreciated.
You indicated in the meeting that you thought the SHA had responded to Sir Bruce's 'scoping' letter of 21 August 2008. I can't find a response and your e-mail (see below) suggests that there wasn't one. Could we be absolutely clear about this as it may have a bearing on the tenor and content of any chasing letter concerning his missive of 29 May 2009 to them. In respect of the latter, I don't think it was clear that a response was required as it is only the last sentence that has any implication to that effect. In respect of the earlier letter itself the only responses specifically required were essentially administrative and I'm sure those were actionned. However, the scope paper attached to that letter contained at least one action specifically for the SHA, namely para 3.5 and, probably, the final bullet point under 4.1. I should be grateful, in the light of the above, for clarification of exactly what it is that you are going to be chasing the NWSHA for a response before I contribute my sixpeneth.
Yours,
[Notional working days: Monday and Tuesday; Wednesday morning]
Associate Director (Strategy)
North West Specialised Commissioning Team
E-mail: @nwsct.nhs.uk
Office: Mobile:
Car:
(Sent from my Blackberry)
----- Original Message -----
From: @dh..uk < @dh..uk>
To: (NWSCT)
Cc: (NWSCT)
Sent: Tue Jun 30 16:07:18 2009
Subject: Re: Allergy Info
Dear,
I attach the letter of 26th June. I don't think that there were any formal
letters after the 21st August - they just became e-mails between myself and
.(See attached file: NW Lead SHA to champion allergy services.pdf)
The Standards are on the Skills for Health website. The address for the
interactive site is:
I also attach the accompanying pdf document (which is also on the Skills
for Health website, in case you have trouble opening zip. files.)
Kind regards
(See attached file: Skills for Health - AL - Allergy.zip)
Department of Health
Wellington House
133 - 155 Waterloo Road
London SE1 8UG
Tel: Mob:
|NSF Documents - Unformatted Document |
"Allergy Visit: 02.07.09 Notes from Informal Discussion"
|File Reference: |AWL/015 |
|File Title: | Allergies - Next Steps |
|Filed by: |/POLICY/DOH/GB on 08/12/2009 at 09:24 |
|Created by: |" \(NWSCT\)" < @NWSCT.nhs.uk> on 20/07/2009 at 16:31 |
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| |Allergy Visit: 02.07.09 Notes from Informal Discussion |
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Dear and ,
My apologies in getting the attached to you, I have attempted to summarise our pub-discussion in the attached. I have allocated actions as per our discussion.
Please let me know if there’s anything I have missed.
Kind regards
North West Allergy Project Manager
North WestSpecialised Commissioning Team
Quayside, WilderspoolPark
Greenalls Avenue
StocktonHeath
Warrington, WA4 6HL
T
E: @nwsct.nhs.uk
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[pic] - NW Allergy Network - Summary of Scope of Agreement key issues LS 20 07 09.doc
North West Allergy Pilot: Delivery of DH Requirements
Informal meeting in Manchester on 2 July 2009 to consider issues and how they might be addressed and subsequent actions
Present:
, Allergy Lead, DH
, Deputy Allergy Lead, DH
, Associate Director (Strategy), NWSCT
, NW Allergy Project Manager, NWSCT
|Scope from SLA |NW position/ability to deliver |
|3.1 the lead SHA will champion innovation and improvements in |Access to allergy services in NW is probably below access to other |
|allergy services in England |areas of the county. |
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| |The NW proposals focus on developing sustainable integrated |
| |services with common guidelines and operating procedures and |
| |improving access for NW patients. |
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| |Research and development within specialised which focus on improved|
| |diagnosis of allergic disease as well as the development of new |
| |therapies for children and adults with allergies. |
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| |The focus is on a patient-focussed, non-building-based ‘virtual |
| |centre’ utilising existing specialist expertise across the network.|
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| |Action: Determine whether NHS NW responded to BK’s letter of 08/08 |
| |(). Consider any response before drafting a letter to outlining |
| |the SHA role to work/share plan/communicate with other |
| |SHA’s re: the Pilot (). |
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|3.2 The lead SHA will develop a model to pilot the first |An option appraisal of whether a ‘hub and spokes model (HoL) would |
|Allergy Centre. The lead will evaluate, in the light of local |be more beneficial than other models was discussed at a stakeholder|
|needs and priorities, whether the ‘hub and spokes’ model |engagement event in November 2008. Given the size and distribution|
|suggested by the House of Lords Report would be likely to be |of the NW population, this was deemed to be the best approach to |
|more beneficial to people suffering form allergies than other |meet the needs of children and adults. |
|possible models for enhancing local services. | |
| |An in-depth, long-term evaluation of the NW model v.s ‘other |
| |possible models’ could not be achieved within the scope of the NW |
| |project alone and it is not clear what alternative models there may|
| |be. |
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| |Action: Further discussion required about how we might address |
| |metrics, determine evaluation criteria and a suitable comparator in|
| |the UK (with a similar geographical population) |
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| |The DoH agreed to the possibility of identifying a partner SHA |
| |(where an alternative model’ had been established). |
|3.3 Work with stakeholders to evaluate models |Engagement with stakeholders when evaluating models (clarity needed|
| |re: 3.2) |
| |A group of patients has been identified and NWSCT are in discussion|
| |with NASG regarding how they might contribute to this exercise. |
| | |
| |An engagement event for interested parties was held in November |
| |2008 event (limited representation from Primary and secondary care)|
| | |
| |NASG have been engaged throughout process, proposals have been |
| |shared etc. |
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| |Actions: |
| |Establish presence on NHS Networks () |
| |Progress plans to run an engagement/consultation exercise (Sept – |
| |Nov) () |
| |Draft possible cover letter from BK to support this exercise () |
| |Implement Communications Strategy (/NWSCT Comms Team) |
|3.4 Work with key stakeholders to consider: | |
| | |
|How to draw on best national and international practice. |Links between the Manchester and Liverpool centres and the national|
|Geographical Context (will model apply to urban and rural |and international allergy networks have been established are |
|environments |outlined in Working Group proposals. |
| | |
| |The proposals for a ‘virtual centre’ with specialist, tier 3 |
| |services being delivered from 4 adult and 2 child foci across the |
|Equality Issues |NW with the aim of ensuring that services are geographically |
| |accessible. The 6 locations will deliver training and provide |
|Training and Education Requirements |clinical support to secondary and primary services within agreed |
| |PCT areas. |
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| |Action: Work on Impact Assessment. to identify DoH contact to meet|
|Including diagnostic and treatment services (inc immunotherapy)|with to progress |
|Provision of Child and adult Services | |
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| |The proposals to improve allergy service in the NW place a large |
| |emphasis on increasing capability and capacity within primary and |
| |secondary care through training and production and distribution of |
| |regional guidelines. |
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| |The proposals address the need to improve the provision of |
| |specialist laboratory diagnostic tests in the NW. |
| | |
| |Network proposals cover children and young people and adults. |
|3.5 Any potential model should have an evaluation tool built in| |
|so that it is possible to assess transparently its success and |Proposal for clinical and patient-recorded outcome measures are in |
|viability. The evaluation criteria should be discussed with |the process of being established (working with the University of |
|stakeholders and experts in allergy and immunology and agreed |Liverpool). Clinicians to agree on best process and outcome |
|with all other SHA’s. |measures. |
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| |Need to share with stakeholders (presence on NHS networks) |
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| |Development and impact of tariff should feature in evaluation? |
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| |Action: learn from other DoH pilots’ evaluation criteria (where |
| |appropriate). to suggest where to look/provide info for NW Network|
|3.6 model to be future-proofed, in line with Darzi |NW proposals are in the spirit of Darzi – care closer to home…. |
| | |
| |Need to review documents, WG1 Need to address workforce issues and |
| |clarify the long-term ‘vision’ for the models of care for allergy |
| |in the NW. |
|3.7 Pilot a model and building on the evaluation of the model | |
|will develop a framework that could be used nationwide. |Need to define timescales for this. |
|Consult and engage with NICE in the pilot evaluation process |Need to include NICE in the development of evaluation criteria |
|and toolkit development. |(year 2: when we have baseline activity data.) |
| | |
| |DoH to define ‘Toolkit’ requirements and timescales. |
| |Action: suggested contact at NICE () |
| |
|NSF Documents - Unformatted Document |
"Re: North West Allergy Project: Diagnostic Questions from the DH"
|File Reference: |AWL/015 |
|File Title: | Allergies - Next Steps |
|Filed by: |/POLICY/DOH/GB on 10/03/2010 at 08:29 |
|Created by: |" \(NWSCT\)" < @nwsct.nhs.uk> on 29/07/2009 at 16:52 |
|Recipients: |\(NWSCT\)" (SendTo, CopyTo & BlindCopyTo if applicable) |
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| |Re: North West Allergy Project: Diagnostic Questions from the DH |
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, I tried to phone you and then but there was no response on either line.
I would have preferred not to have written this e-mail but rather to have spoken to you. However, your timetable for a response suggests this may be being actionned more generally which causes me some concern.
I found your e-mail/the Committee's request both baffling, as it was unclear in respect of which services we were being asked and the format of any possible response if the results are to be analysed, and frightening, in that going out to the NHS generally with such a set of vague, unfocussed questions is likely to generate derisive responses.
The Committee needs to be clear and more specific about what it is trying to understand and then to consider how best to collect the information. The range of people undertaking diagnostic tests/procedures of one kind or another includes the pathology disciplines, radiology using a wide range of equipment and including breast screening, ultrasonography, nuclear medicine, gastroenterology, ENT, cardiology, physiological measurement (including mental health and lung fuction) and genetics to name but a few.
Whilst it would be relatively easy to establish the presence of major equipment such as CT and MRI scanners, that would be only part of their story. You would also need to establish their availability both during the working day and 'out of hours' and the relevant training of those operating the equipment and those reading the results, in order to draw any conclusions about equity of access across the country.
I would strongly suggest that there should be no attempt to assess the relative availability of the common tests/procedures across the country as the effort involved would be out of all proportion to the likely benefits.
Perhaps you could phone me to discuss/clarify this matter. I will be at home most of tomorrow on.
Yours,
[Notional working days: Monday and Tuesday; Wednesday morning]
Associate Director (Strategy)
North West Specialised Commissioning Team
E-mail: @nwsct.nhs.uk
Office: Mobile:
(Sent from my Blackberry)
----- Original Message -----
From: @dh..uk < @dh..uk>
To: (NWSCT)
Cc: @dh..uk < @dh..uk>
Sent: Wed Jul 29 08:58:18 2009
Subject: Re: North West Allergy Project
Dear
As you may be aware, a new Diagnostics Clinical Committee is being
developed - led by Sue Hill (Chief Scientific Officer) and Mike Richards
(Cancer Czar) - to take a strategic look at the development of diagnostic services over the next five years particularly linked to the requirements of clinical pathways and new models of care. We will build on the excellent work that has been undertaken in the past few years to help achieve 18 weeks, cancer waiting times and other priorities.
At the first meeting, the committee agreed to undertake a stocktake from a range of different perspectives and want to establish:
1. what progress has been made on diagnostics in the past few years?
2. where are we now? e.g. what variation is there within England and how do we compare internationally?
3. what is needed to make services in this country world class?
4. what developments can be anticipated in the next five years which will need to be implemented across the NHS particularly linked to clinical
priorities and future visions?
Would you be able to use your advisory network to seek some views from clinicains on the first three and provide a response on the final question yourself. A response by Thursday next week would be greatly
appreciated. Please let me know if this would be a problem.
Kind regards
Department of Health
Wellington House
133 - 155 Waterloo Road
London SE1 8UG
Tel:
Mob:
|NSF Documents - Unformatted Document |
"RE: Royal College of Physicians - Allergy review"
|File Reference: |AWL/015 |
|File Title: | Allergies - Next Steps |
|Filed by: |/POLICY/DOH/GB on 08/12/2009 at 09:24 |
|Created by: |" \(NWSCT\)" < @NWSCT.nhs.uk> on 06/08/2009 at 16:10 |
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Dear,
I attach our draft position statement on the North West Network's implementation of the HofL recommendations.
Please don't hesitate to get in touch should you need any clarification. (FYI I shall be on Annual Leave from tomorrow until 17 Aug).
Kind regards,
North West Allergy Project Manager
North West Specialised Commissioning Team
T:
E:@nwsct.nhs.uk
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-----Original Message-----
From: @dh..uk [mailto: @dh..uk]
Sent: 17 July 2009 12:03
To: (NWSCT)
Cc: (NWSCT)
Subject: Royal College of Physicians - Allergy review
Dear
and I have gone through the attached update request from the RCP and
I have highlighted in red the areas where we feel you might be able to make a contribution, hopefully you will agree! I have done the same for various other Government Depts (or will be!) and in this way I will be able to keep track of which questions I will be getting updates on.
With regard to timescale, I think that if we could get something from you by 4 September that would give me time to collate everything.
Please let me know if you are happy with this, and of course both
and I are happy to discuss.
Many thanks.
(See attached file: NWSHA request for contribution.doc)
Department of Health
Wellington House
London SE1 8UG
[pic] - HoL Implementation of Key Recommendations Position Statement (DRAFT) 06.08.09.doc
In 2007 the House of Lords Science and Technology Committee published a report on allergy. The Government published a response to that report in November 2007.
The report contained a number of recommendations, the key ones covering:
• The setting up of allergy centres in each SHA
• Professional education
• Research and product development
• Food
• Schoolchildren
This question concerns the setting up of allergy centres. Recommendation 8 stated:
“We recommend that the Department of Health should establish a lead Strategic Health Authority, preferably not in the South of England, which would work with its Primary Care Trusts to develop the first allergy centre. A full cost analysis should be integral to this to assess the efficacy of diagnosing and managing allergy using the “hub and spokes” to model. Improved education of clinicians in allergy, with an accurate diagnosis recorded on the Systemised Nomenclature of Medicine (SNOMED) system, should assist a thorough cost analysis to be carried out. The lessons learnt from the pilot allergy centre should then be used to inform the development of further allergy centres in other regions”.
In response, the Government appointed NHS North West as a lead Strategic Health Authority for allergy in August 2008 and is the hub pilot referred to in the question. The pilot centre is currently exploring and developing a detailed model for delivering network-based integrated allergy services for children and adults, which we anticipate will be launched by the end of 2009. Once this model has been successfully implemented and tested in the North West of England, the intention is to roll this model out across the rest of England, to provide a more thorough, coherent and consistent pattern of specialist allergy services.
This pilot seeks to address long standing inequalities in access to care for people who suffer from allergic conditions that are often life long and life limiting and it is somewhat early to make an assessment of the outcomes as it was only announced in late August 2008.
However, significant progress is being made by this specialist allergy hub. An assessment of the healthcare needs of the local population in regard to allergic conditions has been undertaken, existing service provision mapped, specifications for future service development scoped and business cases for these developments are being presented to the Primary Care Trusts (PCTs) that will be required to support these improvements through local resources.
|NSF Documents - Unformatted Document |
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|File Reference: |AWL/021 Vol 2 |
|File Title: | Allergies - Government Response to House of Lords Science and Technology Report |
|Filed by: |/POLICY/DOH/GB on at 17:19 |
|Created by: | on 12/10/2009 at 09:23 |
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Dear
As requested on Friday, please see attached supplementary information.
Hope this helps.
North West Allergy Project Manager
North WestSpecialised Commissioning Team
Quayside, WilderspoolPark
Greenalls Avenue
StocktonHeath
Warrington, WA4 6HL
T:
[pic] - 20091011allergypqsuppl.doc
NORTH WEST SPECIALISED COMMISSIONING TEAM
Allergy PQ Supplement
The Minister is likely ask us to describe allergy services in the North West could you give me a brief note where services are located and how the patient pathway works and what individual patients can expect to receive?
Proposals have been developed for a network-based approach to allergy care in the North West for adults and children and young people. The proposal is to create linked paediatric and adult services, delivered from a number of locations across the region:
The vision is to create Consultant Allergist-led foci acting as ’hubs’, leading the managed clinical network, recognising the significant contribution to this work of organ-based specialists and immunologists. These allergy foci across the region will be linked to form a ‘Virtual Allergy Centre’. This plan envisages the development of an integrated regional clinical allergy service bringing together a group of health professionals and organisations from primary, secondary and tertiary care, working in a co-ordinated manner to ensure the equitable provision of high-quality, clinically effective services in allergy across the North West.
The North West Allergy and Clinical Immunology Network is proposing a three-tier network of care for patients with allergy in which:
- primary care will handle the majority of straightforward allergy problems,
- secondary care will deal with some anaphylactic reactions (particularly those occurring in children) and more difficult allergic issues including those managed in dermatology, ENT and respiratory medicine
- tertiary units will pick up the most difficult cases from the above and will offer more detailed investigations and will share expertise across the region through education, training and outreach.
Tertiary adult allergy services are currently provided from:
• Central Manchester Hospitals NHS Foundation Trust
• Lancashire Teaching Hospitals NHS Foundation Trust
• The Royal Liverpool and Broadgreen University Hospitals NHS Trust
• Salford Royal NHS Foundation Trust
• University Hospital of South Manchester NHS Foundation Trust
Tertiary paediatric allergy services are currently provided from:
• Alder Hey Children’s Hospital NHS Foundation Trust
• Central Manchester Hospitals NHS Foundation Trust
• Lancashire Teaching Hospitals NHS Foundation Trust
Do you have any information about waiting times or backlog of patients waiting for treatment?
Currently, Trusts are meeting the 18 week out-patient target but in many cases are having to run additional allergy clinics to achieve this. Some services are unable to participate in Choose and Book initiative because they could not hope to meet the increased demand.
Could you also advise us of the amount of expenditure on allergy services in the North West?
Costs associated with services for allergy patients in the NW are proving difficult to un-pick. Many allergy patients are seen in secondary and tertiary care under the labels of other specialties, such as immunology, dermatology, respiratory medicine and ENT surgery. They are not coded as 'allergy' and, therefore, not readily separately identifiable. Allergy activity is not coded as such by GPs and is not a target within QOF.
In 2008/09 and 2009/10, North West PCT committed £485,000 to 'pump-prime' a limited development of specialised allergy services in the region.
Service costs for allergy need to be identified which should then enable appropriate tariffs to be developed, assessed, approved and introduced through standard and accepted funding models, such as Payment by Results.
LS/RMDS/20091011allergypqsuppl
|NSF Documents - Unformatted Document |
"What learning has there been in developing a fully-funded network model in the North West?"
|File Reference: |AWL/021 Vol 2 |
|File Title: | Allergies - Government Response to House of Lords Science and Technology Report |
|Filed by: |/POLICY/DOH/GB on 16/03/2011 at 17:19 |
|Created by: |@NWSCT.nhs.uk> on 13/11/2009 at 14:55 |
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| |What learning has there been in developing a fully-funded network model in |
| |the North West? |
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Dear
Further to your request, I have drafted my thoughts in the attached; I do hope this is helpful. The NW Allergy and clinical network is funded from a variety of sources (not from a single ‘network pot’ i.e. NHS Trusts, NWSCG pump priming, DH for project management and metrics, service income is also generated through activity, that in some cases, is paid for directly by the patient’s PCT.
I shall be in touch re: the 24th and with clarification for 25th as soon as possible.
Kind regards,
North West Allergy Project Manager
North WestSpecialised Commissioning Team
Quayside, WilderspoolPark
Greenalls Avenue
StocktonHeath
Warrington, WA4 6HL
What learning has there been in developing a fully-funded network model in the North West?
Inclusive representation at scoping stage:
• The North West Network started with a membership drawn from clinicians, service managers, commissioners, public health professionals and third sector organisations, to develop service models that: current pattern of specialised allergy service provision in the region, looking at historical and prospective activity trends, access, capacity, capability, payment mechanisms and performance.
• From the outset, the North West work also set out to address the area of clinical immunology as, overall, there are issues of capacity and sustainability in that service and, in many hospitals currently, consultant immunologists are responsible for many patients with allergic disease.
Agreement on an end result:
• The NW vision is to create specialist-led foci acting as ’hubs’, leading the managed clinical network, recognising the significant contribution to this work of organ-based specialists and immunologists. These allergy foci across the region will be linked to form a ‘Virtual Allergy Centre’. This plan envisages the development of an integrated regional clinical allergy service bringing together a group of health professionals and organisations from primary, secondary and tertiary care, working in a co-ordinated manner to ensure the equitable provision of high-quality, clinically effective services in allergy across the North West.
• A workshop was held by the NWSCT in November 2008 to share the work of the TFG with interested parties in the region. The outcomes from this event demonstrated considerable support for the direction of travel set by the TFG, specifically with regard to the development of integrated allergy provision focused around and led by specialised foci in Liverpool, Manchester and Preston.
Cohesion with World Class Commissioning:
• Service improvements concentrate on increasing capacity and capability in primary and secondary care - improving the patient pathway. Reduction of inappropriate referrals to tertiary centres, patients managed in closer to home.
Securing support from PCTs in the region:
• Specialised Allergy services fall within the remit of the North West Specialised Commissioning Group (NWSCG) that is represented by all 24 PCTs in the North West. NWSCG recognised the opportunity the DH pilot presented: to give a dedicated focus on these services (In 2003 the previous NWSCG had given ‘in principle’ agreement to a strategy under the heading “A Framework for an Adult Allergy Network in the North West: The North West Integrated Clinical Allergy Service”. This document stimulated discussion nationally but was not implemented in the North West. )
• The plans build upon the previous investment by the NWSCG in allergy services, in addition to the costs of service provision through contract prices. The NWSCG has also committed resources to adult and paediatric clinical immunology in support of business cases to increase capacity in the Liverpool and Manchester centres.
• A PCT Chief Executive Lead has recently been identified to support the NW work in this aread, in particular:
o Oversee the work plan
o Provide additional assurances through NWSCG
o Provide assurances through the PCT Alliance
o To sponsor recommendations in the wider Chief Executive community
o Provide political cover in dealing with difficult circumstances
Dedicated Project Management (DH Funded for 2 years)
A Project Manager was appointed to take forward the implementation of the proposals (I have included my main activities to support service development):
Support leadership and direction for the work of NW Allergy and Clinical Immunology Strategy Board and wider NW Allergy and Clinical Network (develop a Network Establishment Agreement).
Develop commissioning strategies for allergy and immunology services for children, young people and adults in the region, working with PCTs and Secondary Care Providers.
Support service providers with implementing service improvement proposals (pilot tier 2 allergy nurses, GP with Special Interest in allergy, Designation of Tier 2b Paediatric Allergy Clinics)
Facilitate communication across professional and organisation boundaries, both clinical and non-clinical, and to facilitate multidisciplinary working. (Oversee University of Liverpool Allergy activity analysis, translate results in to action plan to improve communication between specialisms and reinforce patient pathways.
• Working with NWSCT Finance and providers, lead the development of a locally agreed tariff for implementation/evaluation in 2011/12.
• Oversee collection of robust baseline data. Work with DoH to establish the identification of a national comparator.
Organise events (GP and specialist nurse training, education, possible national network launch) and meetings, prepare progress reports, updates and key issues.
Produce reports for the NWSCG, CRG, Zonal DoCs/DoFs, SHA and others as and when required.
Working with national stakeholders (allergy UK, Anaphylaxis campaign, Asthma UK etc) ensure appropriate mechanisms are established actively implemented to engage with patients, their carers and appropriate support agencies.
Maintain credibility and share information with local and national links within allergy and immunology services and to act as an interface with other relevant groups and Networks (Presentations to patient groups/writing for newsletters: National Allergy Strategy Group, Primary Immunodeficiency Association).
Representation of NWSCT at National Meetings and Working Groups developing Allergy and Immunology care pathways and guidelines (RCPCH)
Produce new guideline documents following discussion and consultation with key stakeholders (Point of Care Testing, Grazax Guidelines and Immunoglobulin Replacement Home Therapy Funding.)
• Development, publicity and establishment of regional allergy patient pathways, working with Map of Medicine.
• Support the development of clinical guidelines and protocols; best evidence based, shared across allergy and immunology service providers.
• Respond to Parliamentary Questions relating to the DoH pilot and provide information for Health Minister Briefings.
• Support the monitoring of contracts with providers.
Allergy Service Analysis (DH Funded 7 month project with University of Liverpool’s Clinical Evaluation Unit)
• The North West network will benefit from Separate analysis of adult and children’s services throughout the pathway (primary, secondary and tertiary services) outlined below.
|Objective |Expected outcome |
|Tertiary services for allergy: data collection (survey) of a |A picture of the referral pathways, workload and outcome |
|minimum data set on ALL patients attending tertiary allergy |measures from tertiary clinics. |
|clinics across the NW SHA. | |
| |Separation of allergy and immunology activity within the |
| |service. |
| | |
| |Prelude to the introduction of locally agreed tariff and |
| |improved data recording in specialist centres |
|Speciality-based Allergy Services outside the NW Tertiary |An understanding of: |
|Centres: To establish a baseline of current level of service |Which NW hospitals are providing allergy services and to what |
|provision and referral pathways in Dermatology, ENT, |standard. |
|Gastroenterology, Dermatology, Chest Medicine and Occupational |Number of patients seen in secondary care for their allergy. |
|Medicine. |Understanding of consultant to consultant referrals in |
| |secondary care. |
| |Who refers to tertiary services and what criteria are used for |
| |the referral. |
|Patient recorded outcome measures for allergy: To devise a tool|An understanding of the impact of services on the Quality of |
|and try out PROMs for the tertiary services (pre-and post-first|Life of patients, initially those referred to tertiary |
|outpatient appointment). |services. |
|Primary Care-based Allergy Services: sample current level of |An understanding of: |
|primary care service provision and referral criteria and |GP competence to manage mild/moderate allergy (scenario |
|pathways to more specialist (secondary and tertiary) services. |approach) |
| |Where a patient would be referred to with common conditions. |
| |Criteria used for referral. |
| |Number of referrals to secondary/tertiary care |
| |Understanding of consultant to consultant referrals in |
| |secondary care. |
| |Who refers to tertiary services and what criteria is used for |
| |the referral. |
| | |
| | |
|Emergency services for severe allergic reactions: Minimal data |Understanding of acute presentation of severe allergy. |
|extraction project to gather data from (i) ambulance services | |
|and (ii) emergency depts on aimed at recording the extent of | |
|the workload and outcome. | |
|NSF Documents - Unformatted Document |
"DH/NHS North West Service Level Agreement"
|File Reference: |AWL/015 Vol 2 |
|File Title: | Allergies - Next Steps |
|Filed by: |/POLICY/DOH/GB on 22/06/2010 at 11:58 |
|Created by: |@NWSCT.nhs.uk> on 16/04/2010 at 14:40 |
|Recipients: |\(NWSCT\)"; \(NWSCT\)" (SendTo, CopyTo & BlindCopyTo if applicable) |
| | |
[pic]
|@NWSCT.nhs.uk> | |
|16/04/2010 14:41 |To |
| |/POLICY/DOH/GB@DOH, /ES/DOH/GB@DOH |
| | |
| |cc |
| |" uk>, " @nwsct.nhs.uk> |
| | |
| |bcc |
| | |
| | |
| |Subject |
| |DH/NHS North West Service Level Agreement |
| | |
| | |
| | |
| | |
| | |
Dear and,
To assist with discussions at our meeting on 28th I attach Sir Bruce Keogh's letter of 21 August 2008 that invites NHS North West to take on the role of lead SHA for Allergy.
You will see that appended to the letter is the 'Scope' for the project.
Given that the DH funding to support the pilot ends at the end of this year (January 2011), I suggest that we prioritise and agree next steps for delivery of the agreement within this timescale.
In particular, we still do not have any clarity on areas that require mutual agreement such as determining evaluation criteria and a suitable comparator in the UK (with a similar geographical population). I fear that any retrospective evaluation without (agreed) adequate baseline data for assessment will be very difficult. In this context, DH pilot evaluation criteria for previous initiatives will be essential.
I look forward to progressing this and related matters with you.
Kind regards,
North West Allergy Project Manager
North West Specialised Commissioning Group
T: E: @nwsct.nhs.uk
M: nwscg.nhs.uk
-----Original Message-----
From: (NWSCT)
Sent: 02 March 2010 11:08
To: @dh..uk
Subject: FW: Allergy Pilot: Issue outstanding for 2010
Dear
It would be good to catch up on the attached and points raised below tomorrow (likely to be after 1pm - hope this suits).
Look forward to speaking to you.
North West Allergy Project Manager
North West Specialised Commissioning Group
T:
E
-----Original Message-----
From: (NWSCT)
Sent: 02 February 2010 11:03
To: @dh..uk
Cc: (NWSCT)
Subject: Allergy Pilot: Issue outstanding for 2010
Dear and
A belated Happy New Year to you both.
We have reviewed progress of the first year of the NW pilot project and have established objectives for the forthcoming 12 months. There are some issues still outstanding:
I am still progressing impact assessment of the pilot with your colleagues - it appears that an enquiry and information I submitted in December may have gone astray, I have re-submitted and am awaiting a response from your colleagues.
I recall that asked to look into the letter Bruce Keogh sent to the SHA in August - I wonder whether there is any progress on this?
We were promised help and further discussion about how we might address metrics, determine evaluation criteria and a suitable comparator in the UK (with a similar geographical population). We (, and I)briefly discussed the possibility of joining forces with the service based at Imperial College, but did not reach any conclusion. We were also offered information about previous DH pilot evaluation criteria but this has not been forthcoming.
Perhaps it might be useful for us to establish quarterly meetings for 2010? If you agree, I would be happy to work to identify some mutually convenient dates? We will need to consider the continuation of this initiative beyond 2010 and the Baroness Finlay's imminent report in this context.
I look forward to hearing from you.
Regards,
North West Allergy Project Manager
North West Specialised Commissioning Group
-----Original Message-----
From: @dh..uk [mailto: @dh..uk]
Sent: 30 November 2009 13:47
To: (NWSCT)
Cc: @dh..uk
Subject: Impact Assessments
,
asked me find an official who can help you with Impact Assessments
(IA).
As a first step, read the Department for Business, Enterprise and
Regulatory Reform (BERR) Better Regulation Executive guidance and then talk to will be happy to discuss the IA process with you. You must also engage Departmental Analysts/Economic Advisers at the earliest stage in the process.
I attach a link to the Better Regulation Website.
I also attach the DH Impact Assessments made easy guide.
(See attached file: DH Impact Assessments made easy Guide.doc)
Background
On 14 May 2007, a new Impact Assessment (IA) format was introduced; from
November 2007, all IAs must use the new format. This replaces the
Regulatory Impact Assessment framework, which helps departments deliver
their priorities better.
The Department for Business, Enterprise and Regulatory Reform (BERR),
Better Regulation Executive (BRE) with support from all Government
Departments developed the IA framework. Like the RIA, the new IA will serve
as both: a continuous process to help policy-makers fully think through and
understand the consequences of proposed DH interventions (whether
domestic or internationally based) in the public, private and third sectors, against a range of alternative options (including the no-change option); and
a tool to enable policy makers to engage and, work with analysts,
early in the policy development cycle and to weigh up relevant
evidence of the costs and the benefits of such options for
intervention on different sectors over time, against their budgetary
costs.
An Impact Assessment is an ideal place for evidencing data, creating better regulations and policies that are coherent, consistent and easily
understood.
Impact Assessments are an integral part of the policy making process the
purpose of an IA is to focus the policy maker's attention on scrutiny of
the policy, why intervention is necessary, what impact the policy change is
likely to have; highlighting costs, benefits and risks.
The key features of the revised IA are:
A revised template
Revised guidance
A comprehensive toolkit
A strengthened Ministerial declaration at consultation and
final/implementation stage
Increased emphasis on post-implementation review
.
===========================================
Policy Manager
Liver Disease and Allergy Policy
Clinical Policy and Strategies Division
NHS Medical Directorate
Department of Health
Tel:
===========================================
- - Disclaimer - -
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[pic] - Bruce letter to NW SHA Appointment of Allergy Lead 21.08.09.doc
North West Allergy and Clinical Immunology Network
House of Lords, Science and Technology sub-committee, 6th Report on Allergy:
Implementation of Key Recommendations Position Statement
|HoL, Science and Technology sub-committee |North West Position (August 2009) |Status/Risk |
|Appendix A: KEY RECOMMENDATIONS FOR EVALUATION | | |
|ALLERGY CENTRES |In August 2008, the Department of Health appointed North West Strategic Health Authority (SHA) to pilot improvements in allergy |Planned |
|10.1. Creation of new centres/New clusters of |services. |Implementation phase hindered |
|expertise |Key Features of NW Plans for implementation by January 2011: |by lack of resources |
| |A network-based approach to allergy care in the North West. |Focus on tariff development |
| |Linked paediatric and adult services, delivered from a number of locations across the region. | |
| |Agreed regional protocols for referral, management and Standard Operating Procedures. | |
| |Developing diagnostic and treatment skills in primary and secondary care largely through training initiatives | |
| |Re-enforcement of existing specialist services to meet all service standards and build sustainability. | |
| |Develop a network approach to clinical governance including audit. | |
|10.2. Improved diagnostic facilities necessary to |Services to meet the needs and investigate very specialised/complex allergy problems will be provided by a restricted number of |Planned |
|investigate complex allergies with accredited |specified Trusts in the NW. | |
|allergy training for practitioners. |Examples include Contact Dermatitis, Refractory Chronic Idiopathic Urticaria, Injection Immunotherapy for multiple allergens, | |
|Regular multi-disciplinary team meetings |anaesthetic reactions, Vaccine reactions etc | |
|Service places needs of the patient first |Consideration will be given to the best care of patients with multi-system allergic disease. | |
|Involvement of paediatric allergists | | |
|Improved transition from paediatric to adult | | |
|allergy care | | |
| | | |
| | | |
| | | |
| | | |
| | | |
|10.3. Improved patient pathways to support primary|The network has identified and developed initial ‘model patient pathways’ with a view to publishing agreed pathways for patients |In development. |
|and general secondary care and patient |with mild, moderate and complex allergies on the SHA Map of Medicine to support primary and secondary care and self-management |Publishing NW pathways may be |
|self-management |(where appropriate) |hindered by the lack of a |
|Appropriate provision of Allergen immunotherapy by|The development of regional pathways and policies for referral (into and within the network) and patient diagnosis and care. |governance process for |
|specialists |There is a need to improve clinical governance at all levels across the network. |publishing Map of Medicine |
| |Immunotherapy services are patchy and underprovided in the NW. CMFT receives 150 requests for pollen immunotherapy per year but |Pathways on a regional basis. |
| |because of staffing shortages is only able to provide a minority of these. In Cumbria and Lancashire immunotherapy is difficult |Risk: PCTs do not support |
| |to provide because of the distances involved for patients travelling to the service. |proposals for resources in the |
| |The network has made recommendations to improve the currently inadequate staff numbers and resources within the NW services and |‘Virtual Centre’ to facilitate |
| |increase the number of patients being treated with to venom, pollen, drug desensitisation using standard approaches |venom, pollen and drug |
| |The Network has developed guidelines to ensure best clinical practice for Grazax® treatment and ensure equity of access to |desensitisation using standard |
| |Grazax® treatment across the NW. |approaches. |
| |(none of these relate to patient self-care) |Immunotherapy – Grazax® |
| | |guideline |
|10.4. New centres should enhance and build, |Paediatric Allergy Services |Job descriptions for Paediatric|
|develop and expand upon the services already |Funding for two new Paediatric Allergists has been agreed. |Consultant Allergists are |
|offered. |NW proposals are for two tertiary paediatric services (Liverpool and Manchester) with a remit to: |currently being developed. |
| |Educate and train primary and secondary care clinicians in the diagnosis and treatment of patients with allergies. | |
|New posts established? |Work with the media and voluntary organisations to ensure the public and patients are informed with evidence-based information. | |
| |Clinical management of complex cases. | |
| |Database and Audit and Research | |
| | | |
| |The two paediatric allergy services will be based with the two tertiary children’s services in the North West at Alder Hey | |
| |Hospital and the new Royal Manchester Children’s Hospital to take advantage of the current allergy infrastructure and workload | |
| |and facilitate close liaison with other tertiary paediatric services (e.g. dermatology, ENT, respiratory, gastroenterology, | |
| |immunology and infectious diseases, PIC). | |
| | | |
| | | |
| | | |
| |Adult Allergy | |
| |A full time (adult) Consultant Allergist has appointed at the University Hospital of South Manchester NHS Foundation Trust | |
| |(UHSM). | |
| | | |
| |NW proposals for Adult Allergy Services are: | |
| |Recommending training for community pharmacists in symptomatic treatment for conditions such as hay fever and the encouragement | |
| |of appropriate Quality Assurance measures for pharmacists undertaking point-of-care allergy testing. | |
| |Training and support for GPs who will continue to diagnose and treat the bulk of allergy using agreed Map of Medicine pathways | |
| |that will detail when to refer on. | |
| |More relatively complex cases will be seen closer to home by Specialist Nurses and GPwSIs. | |
| |The Trusts providing GP access referrals (SMUHT, SRFT, CMFT, LTHT and RLUBHT) will continue to see moderately complex cases which| |
| |cannot be managed in primary care. | |
| |Several Trusts will continue to provide moderately specialised services such as drug challenges and injection immunotherapy for | |
| |single allergens (typically grass pollen or insect venom). This will require referral from one allergist to another, within the | |
| |NW Allergy Service. | |
| |A few Trusts will continue to provide very specialised allergy services within the NW Allergy Service to build a cadre of | |
| |practitioners with experience. Examples include Contact Dermatitis, Refractory Chronic Idiopathic Urticaria, Injection | |
| |Immunotherapy for multiple allergens, anaesthetic reactions, Vaccine reactions and so on. This will require referral from one | |
| |clinician to another, within the NW Allergy Service. | |
| | | |
|10.5. Equitable geographical distribution/access |Paediatric services have larger referral populations. Paediatric Allergy Specialists in the NW Network will run joint paediatric|Planned |
|to services |allergy clinics with general paediatricians with an interest in allergy at a number of locations across the area to bring | |
| |specialist care closer to home | |
| |The development of protocols and quality standards across the NW is in the early stages. | |
| |Increasing capacity and capability in Primary Care. | |
| | | |
| | | |
| | | |
| | | |
| |To take this forward clarity would be needed nationally re: what is done on a supra-regional level and who decides which centre | |
| |would lead on each specialist service. As such centres are not equitably distributed across the country, it is assumed that some| |
|National reference centres and supporting referral|of these decisions would be temporary until expertise could be developed elsewhere to reflect population needs. |National clarity needed |
|pathways for super-specialist allergy | | |
|10.6. Improved educational activities for local |The NW is exploring the development/improvement of allergy CPD for GPs. |Planned |
|GPs and other healthcare workers in allergy. |A GPwSI is currently training in Manchester | |
| |The Network plans to develop agreed policies across provider Trusts regarding access to clinics and use of Choose and Book. |Risks: |
|Development of GPwSI in allergy |Plans exist to develop primary/secondary care interface posts in PCTs. These services may possibly focus on areas of high |Allergy is not a PCT priority. |
| |prevalence of allergic disease if these can be identified. |Data does not exist to provide |
| |The place of complementary allergy therapy and its funding need to be explored. |evidence for service redesign |
| | |in primary care. |
|Public information and advice. |The network has started an early exploration into the possible development of a lead consultant with a responsibility for |Early discussions |
| |‘Involvement’ who could be the ‘voice of the network’ and have a significant role in the provision of information to the public. | |
|Centres should provide education and training | | |
|courses for allergy patients, their families, | | |
|school staff and employers, in how to prevent and | | |
|treat allergic conditions | | |
|work in collaboration with | | |
|allergy charities | | |
|schools |Work has stared to develop PROMS. Members of the RCP House of Lords Allergy Report Implementation Working Group have agreed to | |
|local businesses. |share existing metrics/patient questionnaires on Quality of Life to support the NW work in this area. |In development |
|Patient engagement: Better feedback between | | |
|patient groups and allergy centres | | |
| | | |
| | | |
|10.8 Establishment of lead Strategic Health |A full cost analysis |In progress |
|Authority to work with its Primary Care Trusts to |Implementation of the proposals is dependent upon North West PCTs resources being allocated to support this work. This is | |
|develop the first allergy centre |becoming increasingly problematic. | |
|A full cost analysis |Development of allergy services is in competition with other priority areas in a context of increasing fiscal restraint to reduce| |
|Assess the efficacy of diagnosing and managing |public expenditure and the still emerging impact of the introduction of HRG4 as a basis for assessing financial contributions | |
|allergy using the "hub and spokes" model. |under PbR. | |
|Improved education of clinicians in allergy, with |Exploration of opportunities for tariff-based funding of the services delivered by the networks (self-financing), requiring the | |
|an accurate diagnosis recorded on the Systemised |development of tariff bands for the different activities that take place, particularly in out-patient settings, and of a means of| |
|Nomenclature of Medicine (SNOMED) system |funding outreach training by specialists who would otherwise be generating income by treating patients. | |
|The lessons learnt from the pilot allergy centre | | |
|used to inform the development of further allergy |Assess the efficacy of diagnosing and managing allergy using the "hub and spokes" model. | |
|centres in other regions. |The vision is to create Consultant Allergist-led foci acting as ’hubs’, leading the managed clinical network, recognising the | |
| |significant contribution to this work of organ-based specialists and immunologists. These allergy foci across the region will be| |
| |linked to form a ‘Virtual Allergy Centre’. This plan envisages the development of an integrated regional clinical allergy | |
| |service bringing together a group of health professionals and organisations from primary, secondary and tertiary care, working in| |
| |a co-ordinated manner to ensure the equitable provision of high-quality, clinically effective services in allergy across the | |
| |North West. The ‘spokes’ might be organ-based specialist with an interest in allergy and/or the relatively few locations at | |
| |which the allergy specialists advised and assisted secondary care colleagues in more general, joint clinics. | |
| | | |
| |Improved education of clinicians in allergy, with an accurate diagnosis recorded on the Systemised Nomenclature of Medicine | |
| |The Network is exploring: | |
| |The development of identified lead consultant roles in clinical governance, outcome measures educational and Involvement | |
| |(patients and public) for the entire network. | |
| |Possible funding arrangements for the ‘network’ (education/training/non-direct patient role i.e. non-income generating) element | |
| |of clinical activity are currently being explored. | |
| |Educational resources focussed on primary care (early referral stages) will be developed to clarify diagnostic and treatment | |
| |pathways and clarify referral processes. | |
| | | |
| | | |
| | | |
| | | |
| |Initially, the Network plans to engage in audit and patient-recorded outcome assessment to determine the effectiveness of the | |
| |model of care for patients with acute allergy in secondary and tertiary services and to provide a NW view of trends in referral | |
| |patterns (numbers and types of conditions treated) | |
| | | |
| | | |
| | |Planned |
|10.9. Sharing of resources - such as standard |Each Trust providing specialist Allergy Services in the NW has agreed to develop standard operating procedures and clinical |In progress |
|operating procedures, clinical guidelines and |guidelines across the North West. ‘Skin Prick Testing’ is the first protocol to be addressed. | |
|patient information. | | |
|The lead Strategic Health Authority should ensure | | |
|that there are national reference centres for | | |
|rarer allergic conditions such as some | | |
|occupational disorders or adverse drug reactions. | | |
|10.10. A patient database to support clinical |Proposal |Outcome measures: |
|research within each region. |To set up four parallel linked projects concentrating on: |In progress |
| |Tertiary services for allergy: a data collection of a minimum data set on ALL patients attending tertiary allergy clinics across | |
|The Office for Strategic Coordination of Health |the NW SHA. This will give a picture of referral pathways and workload and outcome measures for the tertiary clinics. |Clinical Research: To be |
|Research and the Translational Medicine Funding |Speciality-based Allergy Services outside the NW Tertiary Centres: establish a baseline of current level of service provision and|explored |
|Board should work with the lead Strategic Health |referral pathways in Dermatology, ENT, Gastroenterology, Dermatology, Respiratory Medicine and Occupational Medicine. Patient | |
|Authority to support clinical research in the |recorded outcome measures for allergy: To establish a routine follow up at 3 months of those attending the tertiary clinics and | |
|allergy centres and co-ordinate national research |from it develop a PROM (patient recorded outcome measure) index of success. | |
|projects. |Primary Care-based Allergy Services: consider ways of establishing a baseline of current level of services provision and referral| |
| |criteria and pathways to more specialist services and to use cost/benefit analysis to determine whether to attempt this (perhaps | |
| |when we have an idea of what is happening at DGH level we could use those contacts to point us in the right direction to what is | |
| |happening in their PCT area). | |
| | | |
| | | |
| | | |
| | | |
| |Emergency services for anaphylaxis: Set up a limited data extraction project to gather data from (i) ambulance services and (ii) | |
| |emergency depts on anaphylaxis/angioedema aimed at recording the extent of the workload and outcome (on hold pending clarity | |
| |around the NICE anaphylaxis guideline and subject to a cost/benefit assessment) | |
|PROFESSIONAL EDUCATION (10.11 – 10.13) |National Issue (HSE, DoH) – Out of NW project scope |N/A |
|RESEARCH AND PRODUCT DEVELOPMENT |National Issue (Office for Strategic Co-ordination of Health Research) – Out of NW project scope |N/A |
|(10.14-10.16) | | |
|FOOD |Food Standards Agency Issue – Out of NW project scope |N/A |
|(10.17 – 10.18) | | |
|SCHOOLCHILDREN |The Department for Children, Schools and Families Issue – Out of NW project scope |N/A |
|(10.19) | | |
|FURTHER RECOMMENDATIONS |We are working towards improved coding etc, but think the bullets fall outside the scope of the project. | |
|MONITORING ALLERGY | | |
|10.20. Department of Health should ensure the | | |
|Systemized Nomenclature of Medicine (SNOMED) | | |
|system is supported by appropriate training, to | | |
|ensure its efficacy as a simple consistent | | |
|classification system to record allergic disease, | | |
|monitor its prevalence and inform the | | |
|commissioning of allergy services. | | |
|Progress with standardising the collection of data| | |
|on occupational illness via the Health and Safety | | |
|Executive in EU working groups. | | |
|Health and Safety Executive should fund the Health| | |
|and Occupation Reporting Network with the full | | |
|economic cost of its surveillance programmes | | |
|Government to ensure support for this work in the | | |
|future. | | |
| | | |
|THE AIR WE BREATHE (10.23-10.24) | | |
|SCHOOLCHILDREN (10.24-10.25) | | |
|WORKFORCE | | |
|(10.27-10.28) | | |
|INFORMATION FOR CONSUMERS | | |
|(10.29-10.31) | | |
| | | |
|ADVICE FOR ALLERGY SUFFERERS | | |
|(10.32 – 10.35) | | |
|10.34. Consistent, evidence-based policies and | | |
|public advice are provided with close | | |
|collaborative working with allergy | | |
|charities/patient support groups and allergy |See response to 10.7 | |
|services | | |
|EVALUATION OF COMPLEMENTARY TECHNIQUES (10.36) | |In progress |
| | | |
|10.37 Near patient testing. | | |
|Improved interpretive support for self testing | | |
|kits available to the public are by appropriately |Near patient testing. | |
|trained healthcare personnel- Evidence of good and|The network has defined key issues arising from patients purchasing near patient tests for allergy outside the NHS and is | |
|bad practice |considering how best to encourage the appropriate training of staff in community pharmacies. | |
|Avoidance of IgG food antibody test is being used | | |
|to diagnose food intolerance in the absence of | | |
|stringent scientific evidence. | | |
| | | |
|Further research into the relevance of IgG | | |
|antibodies in food intolerance by controlled | | |
|clinical trials | | |
|General practitioners, pharmacists and charities | | |
|not to endorse the use of these products until | | |
|conclusive proof of their efficacy has been | | |
|established. | | |
20090804Dnwpstnholrecs
6 August 2009
[pic] - Bruce letter to NW SHA Appointment of Allergy Lead 21.08.09.doc
|21 August 2008 |
| |
|Mike Farrar |
|Chief Executive, NHS North West |
|Gateway House |
|Piccadilly South |
|Manchester |
|M60 7LP |
|Dear Mr Farrar, |
| |
Re: Appointment of NHS North West as the Lead SHA for Allergy Services
Thank you for your letter of 26 June 2008 to my colleague, declaring the North West’s interest in becoming the Lead SHA for Allergy. I am pleased to be writing to invite you to take on this role.
Please find attached a summary of the scope of the work for the lead SHA for allergy, which I hope you will find acceptable. In taking this forward, we would expect you to engage with experts in the field of allergy and immunology, patient representatives and representatives from the other SHAs, so that successful models of care can be developed that will be suited to patients needs and can be rolled out across England.
I would request that you nominate someone to be the project lead for this work, who could meet with at an early stage to discuss the scope document in more detail and agree the arrangements for the transfer of the £60k funding for 2008/09.
We hope to announce this appointment next week. I would therefore be grateful if you could contact to confirm who in NW SHA can liaise with our press office to manage the announcement arrangements. can be contacted on.
I would like to take this opportunity to thank you once again for agreeing to take on this important role, which will play a vital part in driving up standards of care
…/
for allergy patients.
I look forward to working with you in the future.
Yours sincerely
Professor Sir Bruce Keogh
NHS Medical Director
Email: @dh..uk
Enc.
SCOPE FOR LEAD STRATEGIC HEALTH AUTHORITY FOR ALLERGY
8. Introduction
1. As part of its work around Allergy services, the Department of Health, considering the House of Lords Science and Technology Committee’s report on Allergy, wrote to all Strategic Health Authority (SHA) Chief Executives to invite declarations of interest in being identified as the lead SHA for allergy and for setting up a pilot allergy centre in England.
2. This agreement provides a framework for the lead SHA and sets out the Departments expectations in taking the project forward.
9. Background information
1. The House of Lords Science and Technology Committee published its Report on Allergy on 26 September 2007 and the Department of Health co-ordinated the Governments response, which it published in November 2007.
2. The Department welcomed the Committee’s report, which highlights allergy as an issue to be addressed by a range of stakeholders, including the Government.
3. One of the Committee’s recommendations is for the Department of Health to establish a lead SHA to work with its Primary Care Trusts (PCTs) to develop the first allergy centre.
“We recommend that the Department of Health should establish a lead Strategic Health Authority, preferably not in the South of England, which would work with its Primary Care Trusts to develop the first allergy centre. A full cost analysis should be integral to this to assess the efficacy of diagnosing and managing allergy using the “hub and spokes” model. Improved education of clinicians in allergy, with an accurate diagnosis recorded on the Systemised Nomenclature of Medicine (SNOMED) system, should assist a thorough cost analysis to be carried out. The lessons learnt from the pilot allergy centre should then be used to inform the development of further allergy centres in other regions.”
4. To take this recommendation forward, the Department of Health wrote to all SHA Chief Executives to invite declarations of interest in being identified as the lead SHA for allergy.
10. Scope of the Agreement
1. The lead SHA will champion innovation and improvements in allergy services in England.
2. The lead SHA will develop a model to pilot the first Allergy Centre. The lead SHA will evaluate, in the light of local needs and priorities, whether the ‘hub and spokes’ model suggested by the House of Lords report would be likely to be more beneficial to people suffering from allergies than other possible models for enhancing local services.
3. In evaluating the models, the lead SHA will work with key stakeholders, particularly patient representative groups, clinicians and representatives from all other SHAs, to ensure that the views and opinions of service users and other providers are well considered.
4. As part of developing that model, the lead SHA will continue to work with key stakeholder and will consider:
• how to draw on best national and international practice
• the geographical context i.e. the model will need to work equally well in rural and urban environments
• demographic data, including SNOMED
• equality issues
• training and education requirements for all professions involved in the care of allergy patients (e.g. primary care, emergency care, etc)
• how to engage with all clinicians/ professions involved in the care of allergy patients, including primary, secondary, tertiary and emergency care, school nurses, health visitors, occupational health
• including diagnostic and treatment services (including immunotherapy)
• provision for child and adult services
5. Any potential model should have an evaluation tool built in so that it is possible to assess transparently its success and viability. The evaluation criteria should be discussed with stakeholders and experts in allergy and immunology and agreed with all other SHAs.
6. Any potential model should be future proofed, in particular in line with Lord Darzi’s recommendations in his report “High Quality Care For All - NHS Next Stage Review final report” and should take into account wider policy change and review.
7. The lead SHA will pilot a model and building on the evaluation of the model, will develop a framework that could be used nationwide. In doing so, the lead SHA will consult and engage with NICE in the Pilot evaluation process and toolkit development.
8. The lead SHA will work with the Department of Health to provide support for baseline business, in particular in relation to parliamentary business, for example in providing contributions to Ministerial briefing and assisting with the answering of parliamentary questions.
9. As champions of innovation and improvement in Allergy services, the lead SHA will consider and explore how it could implement further recommendations from the House of Lords Science and Technology Committee Report on Allergy. In particular around the utilisation of existing services, clinical trials, academic links and the education of GPs and post-graduates etc. This could be taken forward as part of the pilot allergy centre work.
10. The lead SHA will ensure that the work is allocated sufficient administrative support, to enable it to work effectively, for example to manage media enquiries and take a pro-active approach to communicating with the media, healthcare professionals, patients etc about the work being undertaken.
11. Quality Requirements
1. The lead SHA will:
• Discuss with the Department of Health a project plan and timetable for:
o the identification of a project manager
o evaluating the different models for an Allergy centre
o piloting the first Allergy centre in England
o developing a framework and toolkit for any successful model that could be used nationwide.
• provide updates on progress by e-mail and telephone as appropriate
• attend an annual review meeting with Department of Health representatives.
2. The Department of Health will:
• establish a lead contact for the lead SHA
• keep the lead SHA informed of any relevant policy change
• attend update meetings as required
• attend annual meetings
12. Funding
1. The Department of Health is able to provide funding in the region of £60,000 in 2008/09 to support the lead SHA in its work.
2. The expectation is that the lead SHA will find the resources from within its existing budget for this work. If an application to the Department of Health for further funding were considered necessary, the lead SHA would need to alert the lead contact in the Department, for consideration as part of the Comprehensive Spending Review planning rounds.
13. Applicable Documents and Reference Material
1. The lead SHA will take into account existing documents and work programmes, including but not limited to:
• Allergy: House of Lords Science and Technology Committee Report on Allergy - 6th Report of Session 2006-07
• Government Response to the House of Lords Science and Technology Committee Report on Allergy
• Lord Darzi‘s report: High Quality Care For All - NHS Next Stage Review final report and associated documents
• Skills for Health National Occupational Standards for Allergy
14. Contacts
1. Until further notice, all correspondence to the Department shall be sent to the address given below for the attention of, the Allergy Services Review Project Lead.
Allergy Services Review Project Lead
Department of Health
Wellington House
133-155 Waterloo Road
London SE1 8UG
Tel:
|NSF Documents - Unformatted Document |
"RE: FW: DH Allergy Lead"
|File Reference: |AWL/021 Vol 2 |
|File Title: | Allergies - Government Response to House of Lords Science and Technology Report |
|Filed by: |/ES/DOH/GB on 02/11/2010 at 13:41 |
|Created by: |" \(NWSCT\)" @NWSCT.nhs.uk> on 02/11/2010 at 10:53 |
|Recipients: |Mary Newman; " \(NWSCT\)"; (SendTo, CopyTo & BlindCopyTo if applicable) |
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Dear Mary
In May 2009 the Department of Health (DH) allocated £40k 2009/10 and £40k 2010/11 to support the development of outcome measures relating to the North West Allergy Pilot.
On the DH's recommendation, a piece of work was commissioned from the University of Liverpool's Clinical Evaluation Unit to establish a baseline that would enable evaluation and the assessment of the impact of local service improvements. Unfortunately, this piece of work has yielded a more limited outcome than had been anticipated. As a result, a substantial proportion of the funds allocated for this piece of work are still available.
We have an opportunity to support the Primary Care Research & Development Centre for Population Health Sciences: GP Section at The University of Edinburgh (led by Professor Aziz Sheikh) with the development and evaluation of a core set of patient reported outcome measures (PROMs) for allergic diseases. It is hoped that region would be then involved in undertaking some qualitative research into the patient-perceived benefits (or otherwise) from their experience of the region's tertiary allergy services. This would be in a context of increasing our understanding of the extent to which these services achieve one of the most significant outcomes of care.
Before attempting to develop this into a more detailed proposal, I am writing to enquire whether this would be a piece of work that the DH would support from the funding already made available.
As time is short, an early reply would be greatly appreciated.
Many thanks in advance,
North West Allergy and Clinical Immunology Project Manager
North West Specialised Commissioning Team
M: 07824 639448
nwscg.nhs.uk
-----Original Message-----
From: @dh..uk [mailto: @dh..uk] On Behalf Of xxxx.xxxxxx@xx.xxx.xxx.xx
Sent: 19 October 2010 09:30
To: (NWSCT)
Cc: xxxx.xxxxxx@xx.xxx.xxx.xx; @dh..uk; (NWSCT)
Subject: Re: FW: DH Allergy Lead
Dear
With apologies for the delay in getting back to you, Mary Newman has
suggested you send what you have to her in the first instance.
Regards,
, PA to
Mary Newman
Head of Clinical Strategies
CPSD (NHS Medical Directorate)
WEL
"
\(NWSCT\)"
< @N To
WSCT.nhs.uk> Mary Newman/POLICY/DOH/GB@DOH
cc
05/10/2010 10:45 " \(NWSCT\)"
< @nwsct.nhs.uk>,
/ES/DOH/GB@DOH
Subject
FW: DH Allergy Lead
Dear Mary
After calling regarding an answer to my below request, has
advised that is no longer the Department of Health Lead
for Allergy. We would be most grateful for a DH contact to approach for
this and other issues relating to the DH Allergy Pilot Project.
Many thanks in advance,
North West Allergy and Clinical Immunology Project Manager
North West Specialised Commissioning Team
M:
nwscg.nhs.uk
From: (NWSCT)
Sent: 17 August 2010 15:35
To: @dh..uk'
Cc: (NWSCT)
Subject: DH Allergy Lead
Dear
I hope you are well. and I are progressing evaluation criteria for the
NW allergy pilot and I am writing to check that you are still our contact on this piece of work?
Kind regards,
North West Allergy and Clinical Immunology Project Manager
North West Specialised Commissioning Team
Quayside, Wilderspool Park, Stockton Heath
Warrington, WA4 6HL
----- Forwarded by /POLICY/DOH/GB on 11/07/2011 11:42 -----
|Mary Newman/POLICY/DOH/GB | |
|10/11/2010 20:43 |To |
| |" \(NWSCT\)" < @NWSCT.nhs.uk> |
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| |/ES/DOH/GB@DOH, /POLICY/DOH/GB@DOH, " \(NWSCT\)" < @nwsct.nhs.uk>, |
| |POLICY/DOH/GB, /ISD8/DOH/GB |
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| |RE: FW: DH Allergy Lead(1) |
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I've now checked with colleagues who deal with both PROMS and general outcome measures, and their view is that this proposal should not be regarded as a priority for funding, and that we should ask you to repatriate the unspent funds. I assume this can be done by RLA. I am sorry if this is a disappointment. Can I ask you to set the process in train please?
Mary Newman
Head of Clinical Strategies
CPSD (NHS Medical Directorate)
WEL
020 7 / 07
If you need to arrange a meeting with me, please contact my secretary, in the first instance.
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| |FOI request - NW Allergy Pilot - NHSBU Contribution |
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As discussed please see the emails below which contain the information I have regarding the FOI request on the North West Allergy Pilot.
I know you discussed the information sent by NHS North West with . may advise if there are any implications for providing this document as it is in draft.
I have copied to at Food Standards so she is aware I'm submitting the attached email.
I have also attached the draft letter from SofS to Jo Swinson MP in response to her questions in the House, which is why I came to having the attached information. I don't not have the final signed copy which may be available from SofS's office.
As also discussed you have agreed to make appropriate redactions of names.
If you require further information please let me know
Kind regards
NHS Business Manager (North West)
NHS Business Unit
NHS Finance, Performance & Operations Directorate
5W03, Quarry House
Quarry Hill, Leeds
LS2 7UE
Tel: 0113 25 45672
Fax: 0113 25 46430
----- Forwarded by /PR-OFF/DOH/GB on 27/07/2011 13:19 -----
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| |RE: Information request: North West allergy pilot |
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Please see the contribution below: -
In line with the recommendations made by the House of Lords Select Committee investigation into allergy in 2007, the Department of Health asked one of the Strategic Health Authorities, NHS North West, to lead on allergy services. The Department of Health provided initial funding for NHS North West to start to develop a pilot allergy centre, which would take a holistic approach to adult and paediatric patient care and cover primary, secondary and tertiary care in an integrated way. This pilot is underway, and will be evaluated for effectiveness and, if successful, form the basis of a model that could be rolled out across the country.
It is expected that the report of the pilot scheme in the North West of England will be published in September 2011.
I hope this is helpful. Please do not hesitate to contact me if you if you need anything further
Kind Regards
*********************
T07 Programme Manager
Food Allergy Branch,
Food Standards Agency, 125 Kingsway, London, WC2B 6NH
Tel: 020 7276
.uk
***** Save paper- Do you need to print this? *****
-----Original Message-----
From: @dh..uk
Sent: 13 July 2011 16:53
To:
Cc: dh..uk; dh..uk
Subject: Information request: North West allergy pilot
Dear
I was hoping you may be able to help. I am drafting a letter from SofS in
response to the comments made at Health Orals yesterday
Jo Swinson (East Dunbartonshire)(LD): Hospital admissions for food allergy
went up by 500% between 1990 and 2006, and there are 15 million hay fever
sufferers, which has a real impact on productivity, so we urgently need
better allergy services. When will the Government report on the pilot in
the north-west of England of a new model of allergy services?
Mr Lansley: I fear that I do not know when that will be available, but I
will certainly write to the hon. Lady. I have visited the allergy unit at
Addenbrooke’s hospital in my constituency, and I know how effective, and
indeed cost-effective, such work can be in treating allergies.
I've been advised you may be able to provide information on this pilot.
Essentially, I'm trying to get further background information and a date
for when the pilot will report its findings. I would be grateful if you
could provide any information by 12noon tomorrow if possible.
Kind regards
NHS Business Manager (North West)
NHS Business Unit
NHS Finance, Performance & Operations Directorate
5W03, Quarry House
Quarry Hill, Leeds
LS2 7UE
----- Forwarded by /PR-OFF/DOH/GB on 27/07/2011 13:19 -----
|< @northwest.nhs.uk> | |
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| |RE: Contribution request - SofS letter following orals - food allergy pilot |
| |at Addenbrookes |
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Please find attached a short paper prepared by the North West SCT outlining the preliminary key findings from the report. Please note this information is strictly confidential and should not be placed in the public domain at this stage.
NW SCT are currently finalising the final report in relation to the allergy pilot and hope to publish in September 2011.
thanks
Programme Manager (Parliamentary & Engagement)
Office number:
Mobile:
-----Original Message-----
From: dh..uk
Sent: 13 July 2011 15:43
To:
Cc: Subject: Contribution request - SofS letter following orals - food allergy pilot at Addenbrookes
SofS's office has asked us to provide a letter from SofS to respond to the
following comments made at health orals:
Jo Swinson (East Dunbartonshire)(LD): Hospital admissions for food allergy
went up by 500% between 1990 and 2006, and there are 15 million hay fever
sufferers, which has a real impact on productivity, so we urgently need
better allergy services. When will the Government report on the pilot in
the north-west of England of a new model of allergy services?
Mr Lansley: I fear that I do not know when that will be available, but I
will certainly write to the hon. Lady. I have visited the allergy unit at
Addenbrooke’s hospital in my constituency, and I know how effective, and
indeed cost-effective, such work can be in treating allergies.
Can you provide background to the pilot at Addenbrookes please - our policy
lead will need to answer the question of when it reports.
I would be grateful if you could respond by 12noon tomorrow (14 July 2011).
Kind regards
NHS Business Manager (North West)
NHS Business Unit
NHS Finance, Performance & Operations Directorate
5W03, Quarry House
Quarry Hill, Leeds
LS2 7UE
Jo Swinson MP
House of Commons
London
SW1A 0AA
I agreed to write to you in response to your comments at Health Orals on
12 July 2011 about the allergy pilot in the North West of England. As you are aware, evidence shows that the incidence and prevalence of allergic disease in the population is increasing.
You may also be aware, that in line with recommendations made by the House of Lords Select Committee investigation into allergy in 2007, the Department of Health asked NHS North West to lead a pilot on allergy services. NHS North West developed a pilot allergy centre, to take a holistic approach to adult and paediatric patient care and cover primary, secondary and tertiary care in an integrated way. This pilot is underway, and will be evaluated for effectiveness and, if successful, form the basis of a model that could be rolled out across the country.
It is expected that the report of the pilot scheme in the North West of England will be published in September 2011.
We will ensure that you are informed of the findings of the pilot when they are available.
I hope this reply is helpful.
ANDREW LANSLEY CBE
Please see the attached document giving the latest update on the Allergy Report. Recommendations 10.1 – 10.10 are of significance to the North West Allergy Pilot.
-----------------------
Professor Sir Bruce Keogh
NHS Medical Director
Richmond House
79 Whitehall
London SW1A 2NS
Tel: 020 7
[pic]
Professor Sir Bruce Keogh
NHS Medical Director
Richmond House
79 Whitehall
London SW1A 2NS
Tel: 020 7
[pic]
Professor Sir Bruce Keogh
NHS Medical Director
Richmond House
79 Whitehall
London SW1A 2NS
Tel: 020 7
[pic]
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