Use of technology to increase productivity- Qb Testing in Adult ADHD.

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1 Use of technology to increase productivity- Qb Testing in Adult ADHD. Professor Marios Adamou Consultant Psychiatrist, Annette Taylor Acting Deputy Director Strategic Planning & Contracting

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3 Adult ADHD Diagnosis Adult Autism Care Planning Interventions (Health and Social Care) Community Support

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6 Work Undertaken By The Service To Improve Productivity Through The Introduction of New and Different Ways of Working: Introduce nurse led clinics rather than medically led clinics for follow ups. Improve shared care arrangements with primary care so follow ups were from six to nine months. Clearly articulate professional pathways (O/T, Nursing, Psychology, Pharmacy, Social Care). Ensure robust care planning by co-creating and utilising an ADHD specific tool called ADHD STAR

7 Queries from Commissioners in relation to productivity of the Service

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10 Enablers Trust Partnership Expertise Constructive Challenge Risk appetite Capacity System View Honesty

11 Conversation template Calculate Demand Develop Pathway Options Model Capacity for each pathway option Discuss scenaria across pathway options and commissioner options

12 QB Test

13 Enhanced Screening Using Qb Testing As part of the joint working between the CCG and SWYPFT related to the QIPP initiative, the CCG provided non-recurrent funding in 2014/15 for the Specialist ADHD Service provided by SWYPFT to pilot a screening process for those people on the ADHD waiting list. The pilot screening process called Enhanced Screening consisted of the use of a validated screening instrument for ADHD by a clinician and the Quantified Behaviour Test (QBTest) a tool for measuring with the aid of computer software, core symptoms of ADHD. Estimated to predict the presence of adult ADHD with 86% sensitivity. The aim of the Enhanced Screening was to: Screen out those cases on the waiting list which did not require further clinical assessment and discharge these cases from the Service; Ensure that those cases remaining on the waiting list have a high probability of ADHD so when entering the clinical diagnostic pathway, the Service would have appropriate clinical information to allow for a shorter assessment. Consider the use of QB Test in pathway

14 Enhanced Screening Using Qb Testing In total 129 cases from the waiting list were invited to participate in the enhanced screening process. Of these 47 (36%) did not respond or declined invites. Of the 82 invited to screening 14 (17%) DNA d the screening appointment. This equates to 61 cases (47%) of the original cohort not responding, declining invites or not attending the screening appointment. The number of cases screened was 68 (83% of 129). Following the screening 9 (13%) were identified as not requiring further clinical assessment. 59 (87%) of those screened were determined to require further clinical assessment and are currently on a waiting list for that further clinical assessment. In total of the 129: 61 declined the invitation, did not respond or DNA d their screening appointment = 47% 9 were discharged following screening = 7% 59 were determined to require further clinical assessment and remain on a waiting list for further assessment = 46%

15 Clinical & Service Line Commissioning Finance Business Development

16 Clinical/Service Input Design pathway Process map patient journey Recommend workforce Estimate clinical activity requirements Business Development Model demand and capacity requirements Build scenaria Develop KPIs Production of Business Cases Support Clinical and Service Line implementation of Project Risk management Profile patient flow Finance Estimate costs Estimate budget allocation per period Set up financial planning assumptions Establish systems and processes to enable the timely and accurate delivery of monthly management accounts and budget information

17 Next Steps: Only so far on the journey in this partnership work with Wakefield CCG and through the work done so far further investment has been secured to: Operate a sustainable model in Wakefield based on the expected number of Adult ADHD cases for the population size of Wakefield Further non-recurrent funding to support backlog clearance, although further discussions are taking place about investment levels for clearance of backlogs in full.