Modernisation Initiative

In 2003 the Charity made a grant investment of £15 million for the Modernisation Initiative to improve kidney disease, stroke and sexual health services in Lambeth and Southwark.

The areas were selected following extensive consultation with the beneficiary Trusts about local health priorities and which areas of services would most benefit from a comprehensive review.

Three dedicated project teams worked closely with Guy’s and St Thomas’ NHS Foundation Trust, Lambeth Primary Care Trust, Southwark Health and Social Care, King’s College Hospital NHS Foundation Trust and NHS London, as well as local community and voluntary groups to review the existing services and pilot new approaches.

Patients and service users played an intrinsic role in describing how they wanted services changing, helping develop new information materials, testing new approaches and offering peer support.

The funding for the first three projects came to an end in spring 2008 with the projects teams having brought about significant improvements to services, in many cases setting a precedent for the rest of the country. The Initiative has also providing a huge amount of learning for future health service improvement programmes.

An independent evaluation of the Modernisation Initiative approach has been undertaken by a team from the University College London and King’s College London and their final evaluation report will be published in winter 2008.

Key outcomes of the first Modernisation Initiative programme

• Stroke
• Kidney Disease
• Sexual Health

Stroke services
The stroke project has pioneered a number of services which are in line with the aspirations of the National Stroke Strategy. Key achievements include:

• Guy’s and St Thomas’ NHS Foundation Trust has become one of the first Trusts in the UK to use telemedicine to diagnose and treat acute strokes in the home. This enables consultants to diagnose patients remotely and ensure that patients receive the appropriate treatment. In some cases patients may be eligible for the thrombolysis drug, which if given within three hours can reduce the damage caused by a stroke.
• A protocol for patient care has been agreed across all of the healthcare providers to help ensure that all patients get the same level of care.
• An early support discharge service involving a multi-disciplinary team – such as neuro-therapists and rehabilitation workers – means patients can get the care they need at home.
• Training for professionals working with stroke patients has been enhanced via a ‘stroke competency framework’.
• Patients have helped develop a range of resources to help train health and social care staff and other books and dvds give advice on dealing with the challenges of daily life following a stroke.

A £157,000 grant awarded by the Charity in February 2008 is supporting a stroke user involvement network beyond the lifetime of the Modernisation Initiative project. The network engages patients with service providers; it also gets people who have had a stroke involved in training health and social care staff and on board as peer supporters. The network is being managed by the Disability Advice Service Lambeth and Blackfriars settlement in partnership with Lambeth Primary Care Trust and Southwark Health and Social Care.

A range of resources have been produced by the stroke team which may be useful learning and information tools for patients and staff alike. See them here »

Kidney disease services
The kidney disease project aimed to address the whole patient pathway from diagnosis through to treatment – both dialysis and transplant options - as well as improving palliative care. Highlights of the programme outcomes are:

• The project set out to raise awareness of the benefit of having regular blood pressure (BP) checks. Three different campaigns were launched to target Caribbean, West African and white middle-aged men. Local DJs championed the campaign; leaflets were dropped into places of worship and barber shops, and a BP bus attended the south London festivals. The evaluation showed that over 45,000 people may have taken action to get their BP checked as a result of the campaign.
• A number of approaches were piloted to help GPs identify patients with high blood pressure and better manage their symptoms. A ‘Reduce the pressure’ toolkit has had a tangible impact on the numbers of patients identified as ‘hypertensive’ and improved management of these patients in the two boroughs.
• Awareness of the range of dialysis options has been improved through the production of the ‘Your Kidneys’, your choice’ and ‘Living Life to the full on dialysis’ resources. Self care has been promoted and facilitated both within hospital and at satellite dialysis units. The numbers of people dialysing at home has also increased as patients have become more empowered.
• The project has also raised awareness of the benefits of living donor transplantation and has introduced a blood cleansing system which enables people with an incompatible blood group to donate their kidney.
• The overall experience of kidney disease patients has been improved through enhancements to the hospital environment (including artwork selected by patients), the introduction of menu choices for inpatients and improved transport and communications. A special book of recipes has also been produced for people with kidney disease.

A range of resources have been produced by the kidney disease team which may be useful learning and information tools for patients and staff alike. See them here »

Sexual health services
The sexual health project has brought together providers from across the acute and community sectors to identify where improvements could be made in the sexual health provision across the two boroughs. The main achievements were:

• The launch of the Camberwell Sexual Health Centre, which is run by King’s College Hospital, providing a sexual health on the high street in specially designed premises. Key improvements to the existing service include longer opening hours (9.30am – 9.00pm Monday to Friday), the use of touch screens giving sexual health information and a token operated ‘vending machine’ for simple diagnostics tests and condoms. The centre has set a precedent for sexual health provision across the two boroughs and three more centres in Vauxhall, Bermondsey and Streatham have been developed based on the same model.
• Pharmacists have been trained to offer more in the way of sexual health advice and screening including emergency contraception and testing for Chlamydia and gonorrhoea.
• Mystery shoppers have been engaged to provide constructive criticism of existing services and to evaluate the impact of new approaches. A mystery shopper toolkit provides guidance into how to set up their evaluation method.
• New guidelines and protocols have been introduced via a network of sexual health professionals across Lambeth and Southwark. These address services for the treatment of sexually transmitted infections; contraceptive provision and pregnancy testing. The group has expanded across SE London to enable ongoing user involvement.

A range of resources have been produced by the sexual health team which which may be useful learning and information tools for patients and staff alike. See them here