7m saved for NHS through early treatment ‘iCares’ scheme

NHS England | September 2018 | 17,000 hospital nights and £7m saved for NHS through early treatment ‘iCares’ scheme

A scheme that identifies and flags patients with long term conditions at high risk of hospital admission is able to ensure they are seen as early as possible. The early treatment ‘iCares’ scheme was established by Ruth Williams, Clinical Directorate Lead at Sandwell and West Birmingham Hospitals, s five years ago after realising how difficult it was for patients to navigate the system and the waste created by multiple teams working in silo.

Patients or carers can ring one line if they need help and are triaged with urgent referrals seen in three hours by a part of the team dedicated to hospital avoidance.


The team of 100 staff make sure patients are seen as early as possible.  The team unites  physios, occupational therapists, advanced clinical practitioners (ACPs), community matrons, nurses, speech and language therapists and many more. Previously, patients were coping at home until in some cases they needed hospital admission. The scheme is based on need, rather than diagnosis.

So far the scheme has helped to reduce hospital admissions by 2,478 per year – 93% of patients who access the service stay in the community after an urgent visit rather than being admitted to hospital. It has also contributed to a reduced length of stay in A&E, reduced length of stay in hospital from 10 days to seven days and reduced readmission rates (Source: NHS England).

Full details on the innovation at NHS England 

Rethinking outpatient services: Learning from an interactive workshop

Nuffield Trust | August 2018 | Rethinking outpatient services: Learning from an interactive workshop

A new briefing from the Nuffield Trust in collaboration with health leaders across the country looks at outpatients. The authors reflect on how several STPs have outlined plans  to reduce the number of outpatients. Leicester, Leicestershire and Rutland intends to reduce outpatient activity by 30% by removing unnecessary new and follow-up appointments. Durham, Darlington, Tees, Hambleton, Richmondshire and Whitby are aiming to achieve a reduction in consultant-led first outpatient appointments by a fifth. 


This briefing reveals opportunities to improve the design of services and challenges if some services should be delivered in their current form.

Read the full news item from the Nuffield Trust 

Download the briefing in full here 

Breast cancer survivors control their follow-up care in Maidstone

NHS England | August 2018 |Breast cancer survivors control their follow-up care in Maidstone

A new case study from NHS England highlights how patients with breast cancer in  are able to control  their own care in Maidstone, Kent.  The Open Access programme enables patients to have access to regular mammograms, support advice and appropriate clinical follow up up to five years following treatment for breast cancer. The programme recognises patients as individuals and that the way in which they want to be supported may change during their recovery, the team introduced an Open Access Programme, based upon a successful model in place at the Royal Marsden Hospital.



Early results

  • A reduction of 3,000 breast outpatient appointments
  • Patients access suitable clinical appointments and contact their nurse appropriately.

Patient benefits

  • Timely referral to an appropriate clinician (ie surgeon, oncologist, nurse)
  • Appointments aligned to patient need or want
  • Fast access to the Cancer Nurse to answer questions and concerns.

Full story at NHS England 

10 medicines introduced in the last 70 years that had the greatest impact

Office of Health Economics | August 2018 | The Impact of New Medicines in the NHS: 70 Years of Innovation

The Association of the British Pharmaceutical Industry (ABPI)= conducted qualitative interviews with health experts, to identify a shortlist of important new medicines introduced in the NHS during the last 70 years. Alongside a eview of the literature and evidence base they attempt to quantify the benefits of these key medicines in terms of health and economic outcomes. ABPI’s  interviews with experts identified a long list of 37 which were then reduced to 10 based on the qualitative data.  


The ten medicines are:

  • Chlorpromazine
  • Polio vaccine
  • Oral contraceptives
  • Second to fourth generation penicillins
  • Beta blockers
  • Beta2 agonists
  • Tamoxifen
  • Immunosuppressants
  • HIV/AIDS antiretrovirals
  • MMR vaccine

The qualitative interviews gave rise to seven themes, these are:

  •  the value of innovation
  •  complementarity and spillovers
  • substitution
  •  policy
  • evidence
  •  understanding
  • collaboration.

ABPI suggest these themes highlight a variety of ways in which policymakers can facilitate positive impact from new medicines. Their role should be considered in the use of medicines in the NHS over the next 70 years and for new medicines currently in the development pipeline.

Download the full report from the Office of Health Economics  The Impact of New Medicines in the NHS: 70 Years of Innovation

Read the ABPI press release here 


Clinical pharmacists in general practice: pilot scheme evaluation

University of Nottingham

This evaluation report showed that clinical pharmacists significantly increase patient appointment capacity and reduce pressure on GPs. More than 490 clinical pharmacists were placed in over 650 practices across England in the pilot project which supports the aim of having over 2,000 clinical pharmacists working in general practice by 2020/21 – a ratio of one per 30,000 patients. The research team investigated the work of the newly created clinical pharmacist roles from the perspectives of the pharmacists, those working immediately with them in their roles, professional stakeholders and patients.