Early adopters
All NHS staff in England and Wales can now access the Map's national care pathways and quickly view the latest evidence, including NICE guidelines, distilled and visualised on their computer.
Early adopters and specialist clinical networks are now using one of the key features of the Map to incorporate local knowledge and best practice into a pathway and then make this available to other NHS staff across primary and secondary care.
Wales
The Map is helping to improve the speed of communication of best practice and enhance integration of local resources. The NHS trusts and boards in Gwent and Conwy & Denbighshire, that have used the Map for over a year, identified the following as part of a formal benefit identification process.
Clinicians found that the Map:
- provided better understanding of certain diseases
- reduced unnecessary pathology testing
- provided greater confidence in dealing with clinical problems outside of areas of expertise
- helped in looking for alternative diagnoses
Non-clinicians highlighted:
- better communication between clinicians
- a unified approach to evidence based care
Gwent
An example of a clinically localised pathway in the Map is seen on the Gwent view of the Map. The 'Management of catheterised patients' aims to prevent unnecessary admissions due to inappropriate catheter management across Gwent Health Community. The pathway highlights the need for patients to be discharged with a plan for follow up by a district nurse.
Case study: Management of catheterised patients
Conwy & Denbighshire
A new pathway for knee pain is due to be published in Conwy & Denbighshire in October 2007. This pathway aims to improve understanding of key referral criteria, enhance patient care and reduce waiting times. Publication of this pathway is being supported by a programme of communication for both primary and secondary care clinicians, including meetings, posters and email. Additionally, a plan has been put in place to measure the benefits of the new pathway.
Case study: Developing a knee pain pathway
Wales National
Nephrologists in Wales are using the Map as a way of delivering clinical information to primary care in order to reduce the number of people presenting to secondary care with late stage of chronic kidney disease (CKD). Their all-Wales CKD pathway is planned for October 2007 publication on the Map. The results of this project will then be used to guide the deployment of further Wales-wide guidance and National Service Frameworks (NSFs), eg. diabetes.
Case study: Welsh Nephrology pathway
Early adopter sites in England
Bristol
The Map is being used as a clinical tool to aid the communication of the Avon, Somerset and Wiltshire Cancer Services' (ASWCS) breast cancer pathway which is due to be published in October 2007. In the future, ASWCS would like to communicate all 11 tumour pathways within the Map of Medicine. It is intended that the Map will be vital in communicating timed local pathways and hence helping to improve care and outcomes for cancer patients.
South Bedfordshire
The Map is working with South Bedfordshire local health community to localise and publish a number of pathways. The first of these, chronic obstructive pulmonary disease (COPD)', has been developed to share best practice across the community. This pathway is awaiting sign off by local clinical governance before it is made available on the Map, planned for October 2007.
Wirral
The Map is working with the Wirral Modernisation and Practice Based Commissioning teams to publish up to 15 pathways by March 2008. The 'Heart failure' and 'Chronic obstructive pulmonary disease (COPD)' pathways are approaching completion and a gap analysis with the national NHS pathways will be conducted prior to seeking clinical governance approval. The intended benefits of the project are to improve communication, share best practice and share locally agreed protocols and referral criteria across the community.
Case study: Improving care delivery and commissioning
Royal Free Hospital, London
Given the Map's beginnings at the Royal Free, it has been available for a number of years in both the medical school and hospital. More recently, in order to help meet the government's 18 week referral to treatment targets, there have been a number of service redesign projects which have produced new care pathways. The Map is to be used as a tool for communicating these 18 week compliant pathways, with the first due to be published in October 2007.
Case study: Achieving Goverment targets - 18 week wait
Milton Keynes
The project team are strengthening the Milton Keynes view of the Map by adding local information on the 'Smoking cessation' and 'Obesity' pathways to signpost clinicians to available local services and resources. Following this work, the first clinically localised pathways will be available early in 2008.
Elsewhere in England, the Map is working with other early adopter sites on specific challenges faced locally, including:
- West Hertfordshire - cardiology pathways
- Mid Hampshire - 18 week referral to treatment and clinical system integration
- Western Cheshire - 18 week referral to treatment and commissioning
To find out more about early adopter sites contact us at info@mapofmedicine.com



