SHA and PCT Commissioners require cost effective solutions, where budgetary requirements are known and stable. Commissioners also wish to make strategic decisions that maximise the value of their investments, ideally supported by a business case rather than just responding to Government targets & standards.

Strategic Solutions for Long Term Conditions
Since 2005, 1st Retinal Screen has developed a generic solution offering, known as Chronic Disease Register Intelligence solution (CDRIntell). It's scope includes support for all areas of chronic disease or long-term conditions. It has a generic programme management component, which may be deployed for any call and recall programme. It is the only solution which is truly cross sector in it's approach. It enables Commissioners to understand the needs of their population, and for Providers to understand their patients. This information is based on data collected as a result of episodes of care within primary care, community care and hospital care.
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More Service for Your Money
By using CDRIntell to support the Retinal Screening Programme, it ensures that investment in information infrastructure is made wisely, because once the infrastructure is in place it can readily be extended. Unlike other solutions, CDRIntell provides not only a full NSC performance dashboard, but also full Diabetes NSF support and, with marginal additional resource, other long-term conditions can be fully supported.
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Supporting Long-term Conditions
As Commissioners and Finance Managers will be aware, 80% of secondary healthcare is provided to those with long-term conditions and often individuals suffer from a number of these conditions. CDRIntell provides the information infrastructure to manage patient flows between primary care, specialist intermediate care services and secondary care - thus helping to ensure patients are always receiving care in the most appropriate setting. For example, Hospitals will be supported with Discharge Notification Lists (DNLs) produced by CDRIntell, (which identify those patients who are candidates for discharge from the hospital sector), showing that their key risk factors are presently stable and there are no significant complications (clearly it is for the Consultant to confirm discharge).

CDRIntell ensures that General Practice is informed of the Discharge and other significant episodes of care for their patients (eg the latest laboratory test results) thereby removing duplication and wastage. A recent study in West London noted that of the in-patients within Cardiology, 39% where not known to General Practice even after two months of their discharge - leading to a 28% re-admission rate rather than 14% where General Practice were aware of their patients' hospital episode.

CDRIntell is designed to ensure everyone knows the latest about their patients and that they are supported in providing the appropriate level of care, we provide Notification Services for this purpose. For example Notification Services ensure that General Practice are informed of all Hospital Episodes and Consultants are given access to relevant prescribing data for their patients. One could parallel this approach to the Case Management agenda where, via access to correct information, health professionals can provide more effective care to those patients who are at risk. All of this takes place within a Secure Framework.
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Insurance
The risks inherent in the provision of a screening programme are continually assessed  and comprehensive insurance is agreed and established with the commissioners of each programme to protect both the NHS and 1st Retinal Screen.
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The Investment
Commissioners and Finance Managers will already understand that this investment in information infrastructure should be matched to a change agenda – as the NHS changes its focus from largely responsive to being proactive. The health economic benefit of these changes will be significant and we have financial models to support the development of a locally relevant business case for investment - often with in-year positive returns. Taking better care of your patients with long term conditions will lead to significantly reduced resource requirements within the Hospital sector, a more fulfilled workforce, and more commissioning choices.
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Retinopathy Screening Service
1st Retinal Screen offers to provide a managed service for Diabetic Retinopathy Screening, this is deployed using our CDRIntell service (linked to PASA approved software as required) and delivers the highest quality offering available. The service is more cost effective than comparable internal NHS solutions and more strategic - providing the additional features noted above. Diabetic Retinal Screening Service can be delivered within a price range of £30 and £50 per patient per year - the price determined by the scope of the service, the length of the contract and the diabetic population being served.
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Reducing the Risks
The risks associated with an internal NHS solution are significant and 1st Retinal Screen can minimise these. A full risk analysis has been prepared and can be provided upon request. The key risks are associated with effectiveness and are financial. 1st Retinal Screen offers a stable, predicable price for its services. We can commit to our pricing model  for several years as our detailed costing model allows us to confirm all pricing elements - this compares very favourably with the limited financial modelling presently undertaken by the NSC which does not take into account many of the costs of providing the service.
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