Extract, Transform, and Load (ETL) is a process in data warehousing that involves
* extracting data from outside sources,
* transforming it to fit business needs (which can include quality levels), and ultimately
* loading it into the end target, i.e. the data warehouse.
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Open access. Commissioning is a term used in the English National Health Service (NHS) to refer to what most health systems call health planning or strategic purchasing. Drawing on research from a recent in-depth mixed methods study of a major integrated care initiative in North West London, we examine the role of commissioning in attempts to secure large-scale change within and between health and social care services to support the delivery of integrated care for people living with complex long-term conditions.
It is unfortunate that due to the decision by NHS England asking all local teams not to communicate any information about their Sustainability and Transformation Plans (STP), we now see inaccurate reports in the national media.
The STPs have been discussed for several months with health, local government, regulatory bodies and the third sector. The idea has been to collaboratively prepare a credible plan for delivering better services whilst also identifying cost savings. The work around STPs involves the creation of 44 geographical “footprints” across the UK, ours being Shropshire and Telford & Wrekin.
Community pharmacists must be able to routinely prescribe medicines for people with long term conditions and refer them directly to other healthcare professionals to ease the overwhelming demand facing the NHS says the Royal Pharmaceutical Society (RPS) in a new report to be launched at the House of Commons tomorrow.
As Birmingham and Solihull join the Integrated Personal Commissioning Programme (IPC), John Short explains why he believes IPC will work well for people with enduring mental health needs, as a way to offer people the flexibility they need to find their own route to recovery.
The number of admissions to hospital are rising steeply and are outstripping increases in the NHS budget, according to new analysis published today by The King’s Fund.
Now our microbiologists, who are infection specialists, visit the wards every day to see every patient who is receiving intravenous antibiotics. Where appropriate, patients are either switched to oral antibiotics and discharged, or switched to the Outpatient Parenteral Antimicrobial Therapy (OPAT) service and discharged.
The patients recruited to OPAT are provided with an information leaflet and changed to intravenous antibiotics that can be given once per day. They then come to hospital daily as outpatients and hospital transport can be arranged, if required. The OPAT Clinic is a patient-friendly area where patients can relax in comfortable chairs, whilst receiving their treatment. The microbiology team clinically lead the service, direct the antimicrobial treatment and refer to other specialists when appropriate. As the service is infection specialist-led, a wider range of infectious diseases can be accepted for treatment.
Transforming how health and care services are delivered can be both exhilarating and fiendishly difficult. The recent publication of some sustainability and transformation plans (STPs) has now brought both these issues to the fore. The plans reveal considerable ambitions to integrate services, embrace population-based healthcare and bite the bullet on painful service reconfigurations.
Practices which offered additional appointments showed a reduction in the number of their patients attending emergency departments (also known as A&E) for minor conditions. There was no overall reduction in emergency visits. Costs were reduced for emergency departments but by less than the cost of the additional appointments. The study did not evaluate whether or not this is cost saving to the health service as a whole nor if health outcomes were improved.
IPC is about making “five key shifts” in how health and social care systems and professionals deliver care, so that in addition to personal budgets, people also have access to more peer support and local community resources, with greater connections made between statutory services and the voluntary and community sector.
In Hampshire we are working to deliver IPC, locally known as “My Life, My Way”, for disabled children and adults, as well as young people who are in transition from children to adult services. We aim to ensure that over 1,000 people locally have a personal health budget or integrated personal budget by 2018.
We want our young people who are moving on to adulthood to be able to say “Transition, what transition?” and we believe that IPC offers a clear, innovative and comprehensive framework to deliver that ambition.
Following a review, including patient and carer experiences, four objectives were formed. First, there should be a fully integrated person-centred care pathway. Second, that early diagnosis should be made by a specialist memory clinic, with a clear referral pathway and a person-centred, ‘One Stop’ approach. Third, all GPs should be made able to make a diagnosis in the moderate to later stages of the illness. Fourth, that all patients should have consistent access to evidenced-based interventions wherever they were diagnosed
The redesign process was at all times in consultation with patients and carers, GPs, the voluntary sector and with reference to best practice. Project groups of clinicians from each organisation and locality were set up to design and deliver the new integrated service which was implemented across Devon nine months later.
As part of the vanguard, we’ve been working with colleagues from Nova, a local strategic infrastructure third sector organisation, on a very exciting project. West Wakefield have funded Nova to design and test the delivery of a small grants, micro-commissioning programme.
This is for grassroot voluntary and community sector groups, to develop services that provide a non-clinical activity in direct support of GP practices and their patients.
A ground-breaking healthcare project pioneered by The Royal Wolverhampton NHS Trust (RWT) continues to grow with another GP practice joining the pilot scheme, Vertical Integration (VI), which aims to deliver better care for patients.