AcneAcne is a common skin condition that affects most people at some point in their lives. It causes spots to develop on the skin, usually on the face, back and chest. The spots can range from surface blackheads and whiteheads – which are often mild – to deep, inflamed, pus-filled pustules and cysts, which can be severe and long-lasting and lead to scarring. At LivingCare we can treat both mild/moderate acne and severe acne. Roaccutane treatment can also be considered for severe acne.
WartsWarts are small lumps that often develop on the skin of the hands and feet. They vary in appearance and may develop singly or in clusters. Some are more likely to affect particular areas of the body. For example, verrucas are warts that usually develop on the soles of the feet. They are non-cancerous, but can resemble certain cancers. Most people will have warts at some point in their life. They tend to affect children and teenagers more than adults. At LivingCare we can offer a Cryotherapy service for warts and verrucas. This involves liquid nitrogen being applied to your wart for a few seconds to freeze and destroy the affected skin cells. After treatment, a sore blister will form, followed by a scab, which will fall off 7-10 days later. A session of cryotherapy usually takes 5-15 minutes and can be painful. Large warts usually need to be frozen a few times before they clear up. You will probably need to wait a few weeks between each treatment.
EczemaEczema is a condition that causes the skin to become itchy, red, dry and cracked. It is a long-term (chronic) condition in most people, although it can improve over time, especially in children. Atopic eczema can affect any part of the body, but the most common areas to be affected are: Backs or fronts of the knees Outside or inside of the elbows Around the neck Hands Cheeks Scalp LivingCare can treat both discoid eczema and mild/moderate childhood atopic eczema.
AlopeciaAlopecia is the general medical term for hair loss. There are many types of hair loss with different symptoms and causes. At LivingCare we can see patients who suffer from Alopecia Areata and Androgenic Alopecia; Alopecia areata causes patches of baldness about the size of a large coin. They usually appear on the scalp but can occur anywhere on the body. It can occur at any age, but mostly affects teenagers and young adults. In most cases of alopecia areata, hair will grow back in a few months. At first, hair may grow back fine and white, but over time it should thicken and regain its normal colour. Some people go on to develop a more severe form of hair loss, such as: Alopecia totalis (no scalp hair) Alopecia universalis (no hair on the scalp and body) Alopecia areata is caused by a problem with the immune system (the body's natural defence against infection and illness). It's more common among people with other autoimmune conditions, such as anoveractive thyroid (hyperthyroidism), diabetes or Down's syndrome. Androgenetic alopecia is a common form of hair loss in both men and women. In men, this condition is also known as male-pattern baldness. Hair is lost in a well-defined pattern, beginning above both temples. Over time, the hairline recedes to form a characteristic "M" shape. Hair also thins at the crown (near the top of the head), often progressing to partial or complete baldness. The pattern of hair loss in women differs from male-pattern baldness. In women, the hair becomes thinner all over the head, and the hairline does not recede. Androgenetic alopecia in women rarely leads to total baldness.
Moles, cysts and skin tags"Moles, skin tags and cysts are skin growths that are usually completely harmless but can look unsightly. They can become troublesome if they catch on clothing or you cut them while shaving. Many people choose to have them removed privately because it is seen as a cosmetic procedure. We can remove these through our Minor Surgery service. Sometimes, moles can be cancerous (Usually visible in the form of a new mole, an existing mole or mark that has changed in appearance. It is often found on the neck, shoulders and hips in men and on the legs, hips and shoulders in women - but can occur in any area of your body). This is why our consultant Dermatologist will always see patients with moles before booking to have them removed via our Minor Surgery service.
PsoriasisPsoriasis is a skin condition that tends to flare up from time to time. It causes red, flaky, crusty patches of skin. Treatment with various creams or ointments can often clear or reduce patches of psoriasis. Affected patches are usually found around the elbows, knees, scalp and lower back but can appear anywhere on your body.
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 https://intel.livingcare.co.uk 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.