Who are we?
LivingCare are a diagnostic and outpatient provider working across Yorkshire. We hold a range of AQP contracts and Sub-contracts across Yorkshire. Established by Dr Stephen Feldman with a wish to provider care closer to his patients who attended his GP practice in Morley, Leeds. This principle 16 years ago was relatively new, however over the 16 years LivingCare has continued to provide an increasing range of services closer to the community.
What do we do?
LivingCare can work with other providers, GP practices, acute trusts and the CCG to provide the following outpatient and diagnostic provision:
We know that CCGs and Acute Trusts have stringent Standing Financial Instructions as well as varying contract arrangements.
Our provision can be commissioned on various basis:
CCGs can commission up to £122,976 of activity on a specific service in line with the EU Threshold without formal EU Tender procedures, subject to the SFIs of the organisation.
NHS Trusts can commission up to £189,330 of activity on a specific service in line with the EU threshold without formal EU tenders, subject to the SFIs of the organisation.
Alternatively, for the above services we have Any Qualified Provider contracts which are consultant led, and with the CCG approval use this mechanism for patient choice.
We also are on some national frameworks of which NHS Trusts and CCGs can use to call off.
Mobilising Clinics and
We have a long experience of mobilising services in very tight timescales, through to a longer period of integration into the local healthcare economy. This will be in line with any CCG or Trust commissioning discussions.
We would where possible use local consultants and medical team who are established or have knowledge in the local pathways to ensure the patients have the appropriate care pathway.
We would utilise SystmOne to record all patients and these would form part of the GP record. We would subcontract with the local NHS Trust Pathology and Histology laboratory to ensure that the processing of samples is held locally.
Depending on the arrangements with the commissioning body would depend on the arrangements regarding accommodation. This would range from us working within GP practices and renting rooms and theatre space, through to working within Acute Trust estate.
Of our patients 96% would highly likely or likely recommend us to friends and family, this is of a sample size of 11% of our patients responding. We offer flexibility in our appointments, and location choice. As part of this our aim is to make our services as efficient and cost effective for our commissioning partner. Our services consistently run at a 5% DNA rate, and we utilise 92% of our patient appointments (3% - clinically not appropriate, unable to be filled or consent withdrawn).
Our patients have many options to communicate with us – from:
This enables us to support the patient in attending and booking their appointment whilst at work, university and their personal life.
We can add clinics into ERS system for patients to book directly into, along with setting up secure servers for patient image transfer and IPT of patients between providers.
We have a range of data mechanisms that we use to monitor performance. This includes our dashboard for availability which enables NHS Trusts, CCGs in the local area to identify patients and optimise flow.
On a monthly basis we undertake a full SUS submission flowing into national datasets for activity, wait time and outcomes.
Our team would happily work with you to develop solutions for the data to meet your requirements and any reporting across the healthcare economy – including capacity and demand activity.
The Clinical Nurse Lead for each service works under delegated powers of the Registered Manager for their service. This is in line with the requirements of the Care Quality Commission with reporting lines back through the Registered Manager to the Medical Director and the board. The emphasis is to provide the service with a multidisciplinary team led by our consultant.
All staff take part in regular staff meetings where they are given opportunities to discuss team performance, service delivery issues and contribute to service developments and improvements. The Clinical Services Manager will also attend the meetings to ensure that clear lines of communication are encouraged and established.
Underpinning this is our clinical governance processes encompassing:
Education & Training
Research & Development
In order to deliver our services we need to ensure we have high quality clinical
environment that enables clinicians to undertake safe treatment. We audit our facilities on a monthly basis to ensure that they are up to our high expectations. Our facilities are regulated through the CQC, and our Gastroenterology is accredited by JAG.
We ensure we have full processes for IPC, Health and Safety and clinical delivery. Any incidents or issues are reported via our incident form and are dealt with quickly. Our incident rate is currently at 0.03% and our complaints rate is 0.05% of patients.
As a provider of services we need to ensure we protect those patients who are vulnerable. We do this through ensuring our clinicians are fully trained to the appropriate level, that they have read our policies and are knowledgeable of the local safeguarding policies and safeguarding teams.
We recognise that budgets and spending is tight across the health economy. We would work within the Leeds AQP prices for the work that we undertake for any commissioners – this is reflective of our salary costs for our central teams. These prices are however based on zero volume contracts and there is opportunity based on guaranteed volumes of patients. We will never charge over national tariff for procedures and outpatient appointments.
Could we work
We know that it often is hard to discuss outsourcing care to an external organisation. However, we would like the opportunity to discuss services and working with you to develop services and improve patient flow in the system.