Prescribers' SPaCE website: Sharing Practice and Continuing Education for multi-disciplinary Non-Medical Prescribers (#1746)

Creation
Draft
Initial
Detailed
Accepted
Adoption
Idea Description
Supplementary Information
Detailed Submission Data
Innovation 'Elevator Pitch':
Prescribers' SPaCE website says it all! 
Overview of Innovation:
The Prescribers’ SPaCE website provides an effective online community for multi-disciplinary Non-Medical Prescribers (NMPs).  It enables NMPs to work together to share ideas, evidence-based resources and good practice tools. The resource supports Continuing Professional Development (CPD), with access to the latest evidence and information on relevant courses, events and conferences.  A key benefit for the NMPs is that Prescribers’ SPaCE contains a CPD tracker, which automatically records CPD as users interact with the site.  It generates a personalised certificate of CPD, which can be printed or saved for paper and digital portfolios.  The aim of Prescribers’ SPaCE is to support quality prescribing and the efficient development of new and extended roles by NMPs within their locality.  It provides a platform for NMP innovation to be celebrated and shared to develop non-medical prescribing across the NHS.
To register free for the Prescribers’ SPaCE website please go to www.nonmedicalprescriber.co.uk
 
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
Similar Content3
Innovation 'Elevator Pitch':
OrthOracleTM – Multidisciplinary on-line orthopaedic educational resource for clinicians, industry, academia and patients
Overview of Innovation:
The training of surgical specialities in the UK has both shortened and is less intense due to the combined effects of a restructured medical training and the European working time directive.
As these influences have been felt over the last decade the resources available to educate both surgeons and the medical workforce have not evolved to account for them. There is far greater requirement to demonstrate continuing education.
 
Allied with this are increased expectations from patients both in terms of their outcomes and level of information available to them to assist in making more informed choices about their healthcare. Increased professional regulation and a requirement to annually demonstrate appropriate levels of professional supporting activities are also areas where a high quality resource delivering validated CPD outcomes has huge potential.
 
Surgery is an inherently visual discipline and the optimal demonstration of its techniques requires the clear illustration of human anatomy as well as it’s adjustment. Existing educational resources do not reflect the interdisciplinary nature of orthopaedic practice nor provide the range or quality of material that is required today.
 
Each Atlas will document the management of a patient from initial assessment through to surgery and then to rehabilitation. Surgical procedures are detailed with high definition images and commentary provided by a Board of senior Consultant Surgeons. Implant technologies for each procedure link directly to industry information.
 
Data is managed to allow different website front ends to be displayed for differing  members of the wider healthcare team and patients. The rich data will support the future development of simulation tools.
 
Boards meet regularly to review new procedures, best practice, patient safety and guidance, medical technologies and research.
 
OrthOracle is not just a digitised text book; it is an interactive web based resource, written by practicing clinicians bringing together the best in clinical practice and orthopaedic technologies covering the entire treatment pathway and facilitates collaboration between clinical, academic and industry sectors leading to improved patient outcomes.

www.footsurgeryatlas.com

The OrthOracle concept has been tested via an early version of The Foot Surgery Atlas, launched in 2007 which, despite no advertising, regularly received over 55,000 hits per month 
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
OrthOracle directly support NHS workforce development .
 
The content of OrthOracle is produced by a Board senior practicing surgeons and healthcare professionals working within the NHS and private sector, helping to promote and disseminate best practice in all aspects of the healthcare journey.
 
The management of workforce issues such as CPD and revalidation are assisted by the provision of approved and certified educational materials ((ongoing discussions with Royal College of Surgeons (Edinburgh) in partnership with Birmingham office and other Healthcare , Allied Healthcare regulators and bodies)).
 
A planned secure clinician and patient specific interface for real-time outcome monitoring will assist with safe and optimal patient management.
 
Patient focussed information on their operation, rehabilitation and consent will enable patients to be better informed and prepared for their treatment. This will involve the patient more actively in the process leading to more efficient use of resources and with the aim of improved outcomes.
 
The availability of such a dynamic educational resource 24/7 facilitates training provision, is cost effective and ensures knowledge of procedures is up to date thus ensuring a better informed workforce with improved patient outcomes at all levels of professional practice.
 
Collaboration with QEH Clinical Photography department in developing advanced image capture technologies and protocols.
 
Board meetings regularly bring together NHS clinical consultant with industry to facilitate dialogue on implant development with potential commercial and research spin off benefits for the NHS.
Online Discussion Rating
5.50 (2 ratings)
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
OrthOracle has a global reach. Based in Birmingham with planned events within the Region, supports the Region’s international profile providing a showcase for academic, clinical and industrial skills creating opportunities for the development of new clinical skills, training and product development.
 
It is envisaged that the editors in chief of the 5 additional Surgical Atlas’ (hip, knee, shoulder, spine, hand & wrist) will be recruited from West Midlands Trusts. A number of the additional 25 contributing editors will also be from West Midlands Trusts.

In addition, project support and administrative staff will be sourced locally from within the region.
  • 6 speciality Boards meeting 3 times per year to be held regularly in West Midlands
  • Unique opportunity for industry to gain regular feedback from Consultant Surgeons
  • Potential for creating global opportunities for West Midlands organisations in new product development, research and training.
  • The multidisciplinary scope of OrthOracle and its high profile internationally active Editorial Boards support the hosting of an annual Digital Orthopaedics Conference which we hope will be based here in the region.
  • In consultation to directly support the proposed Medical Technologies assessment hub
  • OrthOracle creates a global clinical research nexus and hosting opportunity for surgical training, virtual and augmented reality training products and facilities
  • It will also provide Human Factors, User Experience design and multidisciplinary healthcare integration building upon existing world class regional strengths
  • Opportunities for the development and delivery of medical related educational programmes and CPD modules via regional organisations, in association with professional bodies, Royal Colleges and regulating authorities.
  • OrthOracle will immediately create new jobs and support existing employment locally; growing rapidly as additional Surgical Atlas’ and content develops.
  • Look to Developing a global training focus on Orthopaedics here in the West Midlands, building from the position the region has held for many decades in orthopaedics expertise.
 
NOTE: This training platform has the ability to cover a wide range of surgical fields – following the success of Foot & Ankle we will be developing other orthopaedic areas as well as inviting other renowned surgeons to develop their own speciality areas from this foundation.
Current and planned activity: 
Editorial teams members provide Consultant medical services directly and indirectly to the NHS across numerous regions.
 
Clinical photography services of QEH will provide all OrthOracle photography services and project represents a FTE dedicated post. These services are currently being used for the Foot Surgery Atlas.

Planned activities
  • Engage with Health Education England re: workforce development.
  • Seek  Regional surgeons to join Editorial Boards
  • Continue discussions with RCS (Ed) & other AHP bodies, specialist groups and regulating authorities re: partnership, accreditation and CPD
  • Establish a project office
  • Develop a robust marketing strategy/plan
  • Develop sustainable business development strategy/plan
  • Seek Regional participants to assist in evaluating and developing the training delivery process
  • Undertake scoping study re: surgical simulation and augmented realitywith University of Birmingham Prof. Alan Wing & Prof Bob Stone 
What is the intellectual property status of your innovation?:
OrthOracleTM is a registered Trademark
 
All images in each Surgical Atlas are digitally watermarked and site content monitored to protect from unlicensed data stripping.
 
A policy relating to patient photographs and IP issues applying to all Editorial Board members’ organisations is currently being finalised.
 
A specialist IP legal advisor is retained by Surgical Armoury Ltd to manage should an IP issues arise from the OrthOracleTM project.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
Regional Scalability:
The individual Atlas’ within the OrthOracle and supporting information/services are delivered on-line and so availability is worldwide and at scale.

Additional Orthopaedic surgical specialities will be rolled out as soon as editorial boards are in place using the same procedure capture format. Current plans are for Hip, Knee and Shoulder sections to be undertaken this year as Editors in Chiefs have been identified and are all prominent West Midlands Orthopaedic Surgeons.

Where possible all contributors and service providers will be sourced from within the West Midlands and the project administration centre will be based in Birmingham. There is a pressing need for a Chinese language version and discussions have been held with the head of the West Midlands Chinese business community who is very keen to support the project and a regionally based specialist medical translation service has been identified.
Measures:
Detailed tracking of website visit statistics will be undertaken and the number and nature of individual visits will be captured and reviewed. Page specific statistics will be interrogated to establish where the page/site design can be refined. Log in data will be collected and generates geographic, organisational, professional and demographic data of the user population. Additional information will be directed to specific groups as appropriate.

Several areas of the site, such as general surgical images and data will be available as a Freemium service, however a stratified subscription model is currently being developed for individual and organisational users who wish to access the wealth of supporting information and services such as the ability to create individual and annotated versions of specific procedures, clinical administration documentation such as patient consent forms, patient guides, access to  research/evidence database, CPD content.

The provision of quality accredited CPD material is a core deliverable of OrthOracle and advanced discussions with The Royal College of Surgeons (Edinburgh) are ongoing with their President, CEO and Head of Education. The College is keen to support this project from their Birmingham offices. Other accreditation and provider bodies have been identified and approached.

A user friendly CPD portal will be created to record individual user CPD in accordance with Professional/regulatory body requirements for audit and revalidation. Each surgical procedure includes specific CPD modules set by the procedure’s submitting surgeon. Individual user access times and interactions can be recorded to facilitate site usage and page viewing metrics.

This education and training platform will be further developed through the development of associated virtual and augmented reality simulators linked to OrthOracle content (Regional partners for the development of these have been identified e.g. Profs Bob Stone and Alan Wing – Bham. Uni)
Adoption target:
Conservative business model assumes global (not WM) registered members numbering 10,000 year 1, 50,000 year 2 & 100-200,000 year 3 (Orig. Atlas had 50,000 users/mth by 2015 without promotion)

Assuming 20% take up by registered users of one or more of the pay-for services Atlas will be viable midpoint year 2

RCS(Ed) promotion to members not inc
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Innovation 'Elevator Pitch':
OrthOracle is a multidisciplinary on-line resource comprising a suite of Surgical Atlas’ delivering high definition image based Orthopaedic surgical techniques and educational content for Clinicians, Industry, Academia and Patients
Overview of Innovation:
The training of surgical specialities in the UK has both shortened and is less intense due to the combined effects of a restructured medical training and the European working time directive.
As these influences have been felt over the last decade the resources available to educate both surgeons and the medical workforce have not evolved to account for them. There is far greater requirement to demonstrate continuing education.
 
Allied with this are increased expectations from patients both in terms of their outcomes and level of information available to them to assist in making more informed choices about their healthcare. Increased professional regulation and a requirement to annually demonstrate appropriate levels of professional supporting activities are also areas where a high quality resource delivering validated CPD outcomes has huge potential.
 
Surgery is an inherently visual discipline and the optimal demonstration of its techniques requires the clear illustration of human anatomy as well as it’s adjustment. Existing educational resources do not reflect the interdisciplinary nature of orthopaedic practice nor provide the range or quality of material that is required today.
 
Each Atlas will document the management of a patient from initial assessment through to surgery and then to rehabilitation. Surgical procedures are detailed with high definition images and commentary provided by a Board of senior Consultant Surgeons. Implant technologies for each procedure link directly to industry information.
 
Data is managed to allow different website front ends to be displayed for differing  members of the wider healthcare team and patients. The rich data will support the future development of simulation tools.
 
Boards meet regularly to review new procedures, best practice, patient safety and guidance, medical technologies and research.
 
OrthOracle is not just a digitised text book; it is an interactive web based resource, written by practicing clinicians bringing together the best in clinical practice and orthopaedic technologies covering the entire treatment pathway and facilitates collaboration between clinical, academic and industry sectors leading to improved patient outcomes.

www.footsurgeryatlas.com

The OrthOracle concept has been tested via an early version of The Foot Surgery Atlas, launched in 2007 which, despite no advertising, regularly received over 55,000 hits per month 
Stage of Development:
Close to market - Prototype near completion and final form may require additional validation/evaluation and all CE marking and regulatory requirements are in place
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
OrthOracle directly support NHS workforce development .
 
The content of OrthOracle is produced by a Board senior practicing surgeons and healthcare professionals, helping to promote and disseminate best practice in all aspects of the healthcare journey.
 
The management of workforce issues such as CPD and revalidation are assisted by the provision of approved and certified educational materials ((ongoing discussions with Royal College of Surgeons (Edinburgh) and other Healthcare regulators and bodies)).
 
A planned secure clinician and patient specific interface for real-time outcome monitoring will assist with safe and optimal patient management.
 
Patient focussed information on their operation, rehabilitation and consent will enable patients to be better informed and prepared for their treatment. This will involve the patient more actively in the process leading to more efficient use of resources and with the aim of improved outcomes.
 
The availability of such a dynamic educational resource 24/7 facilitates training provision, is cost effective and ensures knowledge of procedures is up to date thus ensuring a better informed workforce with improved patient outcomes at all levels of professional practice.
 
Collaboration with QEH Clinical Photography department in developing advanced image capture technologies and protocols.
 
Board meetings regularly bring together NHS clinical consultant with industry to facilitate dialogue on implant development with potential commercial and research spin off benefits for the NHS.
Online Discussion Rating
6.00 (3 ratings)
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
OrthOracle has a global reach. Based in Birmingham with planned events within the Region, supports the Region’s international profile providing a showcase for academic, clinical and industrial skills creating opportunities for the development of new clinical skills, training and product development.
 
It is envisaged that the editors in chief of the 5 additional Surgical Atlas’ (hip, knee, shoulder, spine, hand & wrist) will be recruited from West Midlands Trusts. A number of the additional 25 contributing editors will also be from West Midlands Trusts.
 
  • 6 speciality Boards meeting 3 times per year to be held regularly in West Midlands
  • Unique opportunity for industry to gain regular feedback from Consultant Surgeons
  • Potential for creating global opportunities for West Midlands organisations in new product development, research and training.
  • The multidisciplinary scope of OrthOracle and its high profile internationally active Editorial Boards support the hosting of an annual Digital Orthopaedics Conference which we hope will be based here in the region.
  • In consultation to directly support the proposed Medical Technologies assessment hub
  • OrthOracle creates a global clinical research nexus and hosting opportunity for surgical training, virtual and augmented reality training products and facilities
  • It will also provide Human Factors, User Experience design and multidisciplinary healthcare integration building upon existing world class regional strengths
  • Opportunities for the development and delivery of medical related educational programmes and CPD modules via regional organisations, in association with professional bodies, Royal Colleges and regulating authorities.
  • OrthOracle will immediately create new jobs and support existing employment locally; growing rapidly as additional Surgical Atlas’ and content develops.
  • Look to Developing a global training focus on Orthopaedics here in the West Midlands, building from the position the region has held for many decades in orthopaedics expertise.
 
NOTE: This training platform has the ability to cover a wide range of surgical fields – following the success of Foot & Ankle we will be developing other orthopaedic areas as well as inviting other renowned surgeons to develop their own speciality areas from this foundation.
Current and planned activity: 
Editorial teams members provide Consultant medical services directly and indirectly to the NHS across numerous regions.
 
Clinical photography services of QEH will provide all OrthOracle photography services and project represents a FTE dedicated post. These services are currently being used for the Foot Surgery Atlas.

Planned activities
  • Engage with Health Education England re: workforce development.
  • Seek  Regional surgeons to join Editorial Boards
  • Continue discussions with RCS (Ed) & other AHP bodies, specialist groups and regulating authorities re: partnership, accreditation and CPD
  • Establish a project office
  • Develop a robust marketing strategy/plan
  • Develop sustainable business development strategy/plan
  • Seek Regional participants to assist in evaluating and developing the training delivery process
  • Undertake scoping study re: surgical simulation and augmented reality 
What is the intellectual property status of your innovation?:
OrthOracleTM is a registered Trademark
 
All images in each Surgical Atlas are digitally watermarked and site content monitored to protect from unlicensed data stripping.
 
A policy relating to patient photographs and IP issues applying to all Editorial Board members’ organisations is currently being finalised.
 
A specialist IP legal advisor is retained by Surgical Armoury Ltd to manage should an IP issues arise from the OrthOracle project.
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
2 years
Ease of scalability: 
Simple
Regional Scalability:
The individual Atlas’ within the OrthOracle and supporting information/services are delivered on-line and so availability is worldwide and at scale.
Additional Orthopaedic surgical specialities will be rolled out as soon as editorial boards are in place using the same procedure capture format. Current plans are for Hip, Knee and Shoulder sections to be undertaken this year as Editors in Chiefs have been identified and are all prominent West Midlands Orthopaedic Surgeons.
Where possible all contributors and service providers will be sourced from within the West Midlands and the project administration centre will be based in Birmingham. There is a pressing need for a Chinese language version and discussions have been held with the head of the West Midlands Chinese business community who is very keen to support the project and a regionally based specialist medical translation service has been identified. 
Measures:
Detailed tracking of website visit statistics will be undertaken and the number and nature of individual visits will be captured and reviewed. Page specific statistics will be interrogated to establish where the page/site design can be refined. Log in data will be collected and generates geographic, organisational, professional and demographic data of the user population. Additional information will be directed to specific groups as appropriate.
Several areas of the site, such as general surgical images and data will be available as a Freemium service, however a stratified subscription model is currently being developed for individual and organisational users who wish to access the wealth of supporting information and services such as the ability to create individual and annotated versions of specific procedures, clinical administration documentation such as patient consent forms, patient guides, access to  research/evidence database, CPD content.
The provision of quality accredited CPD material is a core deliverable of OrthOracle and advanced discussions with The Royal College of Surgeons (Edinburgh) are ongoing with their President, CEO and Head of Education. The College is keen to support this project from their Birmingham offices. Other accreditation and provider bodies have been identified and approached.
A user friendly CPD portal will be created to record individual user CPD in accordance with Professional/regulatory body requirements for audit and revalidation. Each surgical procedure includes specific CPD modules set by the procedure’s submitting surgeon. Individual user access times and interactions can be recorded to facilitate site usage and page viewing metrics.
This education and training platform will be further developed through the development of associated virtual and augmented reality simulators linked to the OrthOracle content (West Midlands partners for the development of these have been identified e.g. Profs Bob Stone and Alan Wing – Bham. Uni)
Adoption target:
Conservative business model assumes global (not WM) registered members numbering 10,000 year 1, 50,000 year 2 & 100-200,000 year 3 (Orig. Atlas had 50,000 users/mth by 2015 without promotion)
Assuming 20% take up by registered users of one or more of the pay-for services the Atlas will be viable midpoint year 2
RCS(Ed) promotion to members not inc
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Overview summary:
Making a difference to people with diabetes aims to make 1,000 positive differences for people with diabetes with 500 difference makers, developing a self-motivating network of change agents to give people the confidence, tools, know-how and enthusiasm to make a change to what they do what they do and improve patient experience and care. 
 
Challenge identified and actions taken :
Diabetes expenditure is approximately 10% of the NHS budget, with the West Midlands spending £94million on diabetes prescriptions between April 2012 and March 2013. There is also a wide variation in the achievement of good clinical outcomes. Only 16% of patients who are prescribed a new medicine take it as prescribed, experience no problems and receive as much information as they need. In primary care, around £300million per year of medicines are wasted (likely to be a conservative estimate), of which £150 million is avoidable. NHS England has a priority on medicines optimisation, which aims to deliver improved patient outcomes through a patient-centred approach. 
 
 
Impacts / outcomes: 
Difference maker: Emma Innes, Matron in Diabetes, in conjunction with the In-Patient Diabetes Nurses
Project outline: Redesigned the in-patient pathway at Worcestershire Royal Hospital by proactively seeing all patients on the Acute Medical Unit who were high risk: newly diagnosed diabetes, admitted with hypoglycaemia <4 or hyperglycaemia >11 mmols or use Insulin. The aim was to be able to review and intervene in diabetes management before the effects of acute illness, poor oral intake and non-specialist management could cause any adverse events with the diabetes control.
Difference made:
  • Over nine months after the service change, the diabetes errors on the Acute Medical Unit reduced to 0 from 10 errors recorded over the nine months prior
  • Increased number of patients seen by the DSN team initially, but this is balanced by the fact that patients on the medical wards are more stable due to the early intervention.  

Difference maker: Dr Andrew Askey, GP, Walsall CCG
Project outline: To improve screening for renal complications in people with diabetes by ensuring they have annual urinary albumen:creatinine ratio performed. An EMIS prompt was designed to alert clinicians when ACR screening was due, and further refined to advise on READ coding microalbuminuria or proteinuria and prescribing appropriate medication (ACEi, or AiiR blocker).
Difference made: In 2014, 469 people with diabetes had ACR screen in my practice, increasing to 613 in 2015 with an increase of 144 people screened.  In addition, 55 patients were coded with microalbuminuria or proteinuria, and 28 were started on ACEi medication.


Difference maker: Sat Kotecha, community pharmacist and Chair, Local Pharmacy Network, West Midlands
Supporters: I involved my pharmacy team, patients and the Health Trainer that works from my pharmacy. I also engaged with other pharmacies, a consultant and the company that make the disposable HBA1c tests - the LPC is currently putting a business case together for commissioners to consider.
Project outline: I believe that the person who can make the biggest difference to their diabetes is the patient themselves. However, as diabetes is a 'silent condition', people have no idea if the changes they make are making a difference. I wanted to give people an objective measure to motivate them to make a difference for themselves by measuring HBA1c at baseline and the patient receiving advice on medicines adherence, diet and exercise. There was then a series of follow ups to measure the impact and motivate the individual.
Difference made:
  • 18 patients participated in the service, 10 completed all four consultations, while the rest stopped at various intervals.
  • A range of HBA1c reduction from 3mmol/mol to 14mmol/mol
  • All 18 patients reported changes to diet and increases in physical activity
  • 11 patients reported improved adherence to medication/changes to timing etc
  • Eight patients stopped home BGT as they felt it was unnecessary
  • All 18 patients would recommend to friends and family. 

Difference maker: Julie Taylor, Diabetes Specialist Podiatrist, Staffordshire and Stoke-on-Trent Partnership NHS Trust
Supporters: podiatry line manager, professional leads for podiatry and physiotherapy, statistical support, non-medical prescribing lead, West Midlands Diabetic Foot Network, four GPs in four practices and diabetes consultant, Staffordshire University
Project outline: I wanted to improve timeliness of access to prescriptions for individuals with diabetic foot problems. Current processes cause delays that can have a negative impact on patient and carer experience and clinical outcomes. I wanted to make supplementary prescribing work in my community setting. 
Difference made:
  • My supplementary prescribing increased from 0 to 50 prescriptions, by developing clinical management plans with five independent prescribers (four co-located GP practices who had not experienced supplementary prescribing previously and diabetes consultant)
  • On these 50 occasions, times to prescription improved from minutes to 1 -14 days (from the GP practice)
  • My prescribing prevented at least one hospital admission
  • Nine prescriptions for antibiotics were provided during consultation (commonly delayed by days with existing process and often not in line with local guidance for foot infection)
  • 19 prescriptions for wound dressings/offloading devices that are often incorrectly prescribed due to similar names of products (which require additional prescriptions and associated delayed commencement of appropriate care plans) with a potential saving of >£150 and associated frustrations
  • More importantly, the patient and carer feedback has been very positive, notably regarding convenience and reducing anxiety.
Which local or national clinical or policy priorities does this innovation address:
Long Term Conditions, Quality improvement
Supporting quote for the innovation from key stakeholders:
 “WMAHSN are really good at promoting these great things, and the medicines optimisation programme has this drive behind it that engages people".
Plans for the future:
The initial group of people that made a difference have since gone on to do other joint working projects together and have created an energy and enthusiasm for having a go to make positive change happen.  The legacy of the programme is that the individuals involved have continued to pursue further changes and have made significant achievements at a personal and organisational level. 
Tips for adoption:
This programme is about driving improvement in diabetes and medicines optimisation without dictating how the difference makers achieve their goals. Instead, it has given people time to think and a framework to think differently, with some projects having wide impacts. There were some challenges during the programme which provide constructive lessons for the future. While the aim of identifying 500 difference makers to make 1000 differences was not achieved, the programme showed a rich experience of how a few people can make changes which impact the lives of many thousands of people with diabetes. 

Support for the difference makers included:
  • Two days training around change thinking
  • follow up half day
  • Teleconferences
  • Half day training on ‘Measurement for Improvement’
  • ‘Buddy system to provide support, challenge thinking and identify resources needed.
Contact for further information:
For more information, contact Lucy Chatwin, Business Manager at WMAHSN, on 0121 371 8061 or email lucy.chatwin@wmahsn.org  
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