VPDP cluster support scheme 2015-16
1Background
The NHS in Wales has GP practices allocated to small groupings of practices (clusters) working together with partners across health and social care. The cluster development programme in Wales is supported by the GMS contract, and aims to encourage collaboration between local GP practices to improve services and sustainability. There are currently 64 clusters in Wales and they vary in size between 4 and 12 practices (figure 1).
Flu vaccine uptake remains suboptimal in Wales with uptake in 2014/15 failing to reach Welsh Government targets across eligible groups. There is wide variation in uptake between practices, clusters and health boards(HBs).
Previous general practice schemes supported by Public Health Wales aimed at encouraging flu vaccine uptake have been well received and generally had a positive effect on uptake. These have been at health board and individual practice level. Some practices applied for schemes in 14/15 as a cluster/group rather than individual practices.
HBs have been asked to advise VPDP which clusters have identified flu as a priority area. However not all HBs have responded, so there remains some uncertainty regarding how many clusters in Wales have made flu a priority for 2015/16. The scheme will be open to all clusters but if oversubscribed, priority will be given to with those who have identified flu as a priority with their HB.
Health board / Number of clusters / Number of cluster with flu named as a priority in 2015/16Abertawe bro Morgannwg UHB / 11 / 2
Aneurin Bevan UHB / 12 / D/K
Betsi Cadwaladr UHB / 14 / D/K
Cardiff & Vale UHB / 9 / D/K
Cwm Taf UHB / 8 / 1
Hywel Dda UHB / 7 / 4
Powys tHB / 3 / D/K
totals / 64 / 7
2Aims
Encourage and support cluster working to maximise uptake of flu vaccine in eligible groups
Energise cluster’s and practice’s flu campaigns
Encourage innovation, and peer support within clusters
Identify effective ways of cluster working
Enable sharing of best practice
Increase flu vaccine uptake in eligible groups
3Plan of work
All clusters in Wales will be encouraged to join the VPDP cluster support scheme.
The VPDP cluster support scheme will ask each cluster to appoint a cluster flu lead who will be expected to:
- Support practices within the cluster to identify a practice flu champion
- Present information about flu vaccine uptake to colleagues at cluster meetings
- Share flu vaccine information with each practice in the cluster a timely way
- Encourage practices to access their IVOR reports regularly
- Support practices to integrate key factors that influence vaccine uptake into their routine practice, to include:
- accessing accurate up to date information
- personal invitations to eligible patients
- identify and address accessibility issues
- supporting an end of season practice report
- Identify practice flu champions in each practice within the cluster
- Support practice flu champions by planning and delivering an introductory session in October, monthly meetings November- February, and an end of season meeting in March
- Report to VPDP as requested on experiences and outcomes using appropriate templates
The cluster flu lead will be provided with all necessary documentation to enable them to support cluster practices, collect information and share resources, and identify and share best practice.
The cluster flu lead will need extra time to fulfil this role, and this has been estimated at between 10-20 hours a month from October to March (60-120 hours) depending on the number of practices within the cluster. Reimbursement for the extra time required to fulfil this role has been calculated according to cluster size, and estimated using the equivalent of agenda for change point 30 (mid band 7).
Cluster size / Number of hours allocated to the cluster flu lead / Maximum allocated amount per cluster leadSmallcluster
(4-5 practices) / 60 / £1,080
Medium cluster
(6-8 practices) / 90 / £1,620
Largecluster
(9 or more practices) / 120 / £2,160
Each practice within the cluster is expected to ensure there is a practice flu championwho will be expected to
- demonstrate leadership of the flu campaign within the practice
- attend an introductory sessionwith the cluster flu lead and other practice flu champions (October)
- attend a monthly meeting with the cluster flu lead (November-February)
- demonstrate active support of the practice flu campaign
- attend a summary meeting with the cluster flu lead and other practice flu champions (March)
- complete an end of season report for their practice
It is anticipated that this will require each practice flu champion to dedicate extra time to commit to this scheme and strengthen the flu campaign in the practice under the guidance of the flu cluster lead. Reimbursement for the extra time required to fulfil this role is difficult to estimate and has been calculated according to the number of meetings expected to be attended (6) which could be likely to be around 1.5 hours long, and 3 hours is allocated for report writing so each practice in the cluster is allocated the equivalent of agenda for change point 25 (mid band 6) x 12 hours to reimburse the flu champions for engaging in the scheme (£15 per hour = £180).This is payable as a grant to each practice flu champion following confirmation of attendance and appropriate engagement by the flu cluster lead..
The 2015/16 flu cluster scheme documentation will consist primarily of documents that build on experience gained with the 2014/15 flu facilitator scheme, and also utilise resources developed for the Public Health Wales practice manager flu road shows. The supporting documents will include:
- an overview document for the cluster flu lead
- a presentation package that may be utilised at cluster and practice meetings
- tools and resources to be utilised by the cluster flu lead to support practices
- a summary feedback form for sharing within the cluster and also with VPDP
The background support package and documentation will include descriptions and an overview of:
- GP factors that can have a positive influence on flu vaccine uptake
- Good practice guide for general practice online resource
- EMIS and INPS guides
- IVOR
- other available resources to help raise awareness
- my health text for general practice
- flu e-learning modules
The cluster flu lead will be expected to work with practices to identify a named practice flu champion in a minimum of 75% of practices within the cluster.
The cluster flu lead will be encouraged to support and engage with as many cluster practices as possible, a minimum of 75% is expected, with priority given to the practices with lowest flu vaccine uptake within the cluster. A written review for each practice using the provided documentation is a key element of the end of season flu cluster scheme report.
Throughout the season each cluster flu lead will receive regular correspondence from VPDP with monthly emails/updates to support, help problem solving, and maintain data collection/practice visits.
Audit plus data will be utilised to demonstrate uptake by practice, cluster, and HB, with uptake data requested if a discreet group has been specifically targeted.
End of season feedback from the cluster flu lead is a requirement. Information will be submitted at the end of the season using the standardised documentation. Payment will be made on timely receipt of all necessary reports of the required standard and completeness.
A final report summarising findings and experiences will be shared by Public Health Wales. It is anticipated that this will help inform VPDP on how to best support cluster working.
Proposed timingDesign scheme / September 2015
Launch scheme / October 2015
Recruit / October 2015
Share documentation / October 2015
Support / Ongoing
Collect information / February 2016
Issue grant payments / February 2016
Analyse data / April 2016
Develop a good practice guide for clusters / April 2016
Report findings / June 2016
Date: 16 October 2015 / Version:final outline / Page:1 of 5