Redesign is a process that reviews current care pathways and specifies improved new ones. It requires clinical and managerial input and should involve patients to decide the new care pathway's shape.
Our work has focused on redesign of care pathways from primary care into consultant outpatient services. Such redesign has largely involved introduction of new services provided by practitioners with a special interest (PwSIs), who for some conditions can provide an alternative to a consultant referral.
This type of redesign is of great strategic importance: it helps to ensure that patients are treated by the most appropriate healthcare professional in the most appropriate location. This improves patients' experiences (for example, by reducing waiting times) and also helps organisations to manage demand for acute healthcare, make appropriate shifts in activity provided by hospital and community sectors and introduce a greater range of providers. Redesign can therefore help to create more patient-focused and sustainable healthcare systems and introduce choice for patients.
This report looks at how primary care trusts (PCTs) can support redesign of care pathways at the primary/secondary care boundary. It draws on learning from organisations that have already established new care pathways. Its aim is to help PCT managers to understand the organisational factors that support redesign, and learn from practical examples how to overcome local barriers to create sustainable new services.
Included in this report:
- redesign at the primary/secondary care interface
- planning and supporting a redesign programme
- delivering and evaluating a redesigned care pathway
- engaging local stakeholders to establish the redesign programme and deliver new care pathways
- recommendations