Healthcare providers in Bury and Greater Manchester are celebrating after being shortlisted for an HSJ Award for their work to improve care for infants with a suspected cow’s milk protein allergy (CPMA).

NHS Bury Clinical Commissioning Group (CCG), Bury and Rochdale Care Organisation (part of the Northern Care Alliance NHS Group) and the North West Paediatric Allergy and Infection Network are delighted to announce that they are finalists for this year’s Community or Primary Care Service Redesign HSJ Award category for their work into the early identification and treatment for infants with CMPA.

The judging panel, made up of a diverse range of highly influential and respected figures within the healthcare community, have shortlisted the healthcare partners despite tough competition from hundreds of excellent applicants.

The project was initiated to address the concerns of families with infants who may have CPMA and the aim behind it was to empower both families and healthcare professionals to be confident in supporting infants with an allergy or intolerance.

Their work to improve the quality of care, experience and access to support services for infants with suspected CMPA has been selected for an HSJ Award based on their ambition, visionary spirit and the demonstrable positive impact that their project has had on the experience of patients and staff within the health care sector.

The project saw a large number of health professionals across different healthcare organisations work collaboratively together to develop a new pathway that ensures a more consistent approach to diagnosis and prescribing for infants with a suspected allergy or intolerance to cow’s milk protein. The project also resulted in an improved referral process for families to a community dietitian and early support from health visitors, as well as the development of innovative group education sessions, following feedback from parents.

Resources for families and healthcare professionals can be found here.

The new pathway has already led to a reduction in prescribing costs. In its first 14 months prescribing costs have almost halved, taking them from £232,000 to £122,000. An element that was integral to the success of the pathway was the new role of the health visiting team. This involved health visitors supporting parents with the ‘home re-challenge’, which is a process to determine if a child has an allergy to the protein found in cow’s milk, and determine whether a review with a community dietitian is required.

The new pathway has been welcomed by the health visiting team and this has been critical to the success of the pathway. The changes have directly improved patient experience and led to more appropriate referrals and a reduction in waiting times for community paediatric dietetic services, which have fallen from over 20 to four weeks. This has in turn eased demand for day admissions by a fifth.

When the project first began, 202 children were receiving different types of milk products on prescription due to an allergy or intolerance and 92 of them met the criteria for a community dietitian review. The review found that 40 had either outgrown or no longer had an allergy, 43 needed a further review by a dietitian and nine needed different formulas.

The new pathway has had other benefits, not only in terms of improving access to services and providing a better patient experience for infants and their parents, it has increased the knowledge of key practitioners and developed an electronic pathway with diagnostic and prescribing guidance readily available to GPs.

Dr Peter Arkwright, Consultant Paediatric Allergist and Immunologist at Royal Manchester Children’s Hospital and Chair of the North West Paediatric Allergy Network said: “Milk allergy in infants is not only a common problem but can also make parents feel anxious. It is great to see that Bury CCG and Bury & Rochdale Care Organisation have been so successful in streamlining their service to ensure that children with allergies are treated appropriately. We look forward to this good practice being shared and taken up across other CCGs.”

Angela Gilchrist, Medicines Optimisation Technician and project lead for NHS Bury CCG said: “We are delighted to have been shortlisted for the Community or Primary Care Service Redesign Award. When we first started this project, our aim was to speed up diagnosis, get infants on the correct product and reduce waiting times when an infant does need to see a community dietitian. Not only have we achieved all of this, we have also improved the experience and access to support for the parents and their children too.

“Compliance to the pathway from healthcare professionals has been positive; it has had an excellent uptake in GP practices and every member of the health visiting team is using it too. We are already building on the success of the pathway by introducing a group session for families with a dietitian. These sessions focus on dairy free weaning and another introduces the ‘milk ladder’, which supports the reintroduction of dairy products into a diet in a planned way with specialist support when an infant is around 12 months of age as most children with milk allergy will outgrow the problem. Families are also benefitting from the peer support available.

“NHS Bury CCG is trailblazing across the north west and leading the way. The North West Paediatric Allergy and Infection Network are introducing the pathway to our counterparts across the region to show what can be achieved within their own organisations. Our aspiration is to see the pathway become standard practice across the country.”

HSJ editor Alistair Mclellan added: “We would like to congratulate Bury CCG, Bury and Rochdale Care Organisation, and the North West Paediatric Allergy and Infection Network on being finalists in the category of Community or Primary Care Service Redesign ahead of this year’s 2019 HSJ awards.

“We are looking forward to welcoming them to the ceremony in November, to join us in recognising the very best achievements and innovations in the healthcare sector. The entrants this year have been of incredible calibre, and each of the finalists in this category have been chosen based on their outstanding commitment to excellence in healthcare.”

The full list of nominees for the 2019 HSJ awards (partnered by GRI) can be found here.

Winners will be selected ahead of the 2019 HSJ awards ceremony, which is due to be held at the Battersea Evolution Centre, London on November 6th.

Picture caption: (L-R) Angela Gilchrist (Medicines Optimisation Technician and project lead, NHS Bury CCG), Suzanne Dixon (Network Manager North West Allergy and Infection Network) and Jayne Fielding (Paediatric Dietician).