Nottingham West Clinical Commissioning Group has incrementally commissioned a range of long term conditions pathways that have spread and sustained as models of good practice.

Services include Specialist Nurse case management in Diabetes, Heart Failure, COPD, community clinics in COPD, Diabetes, and Pain Management, extended pulmonary rehabilitation, and community ward model of multi-disciplinary case management.

Recent improvements include End of Life Nurse Co-ordinators, pulmonary rehabilitation extended to heart failure, and dedicated psychological support.

The locally developed information system Ehealthscope supports policy and pathways information alignment. An end of life log and care home residents log support care management of these patients, most of whom have long term conditions.

Patient satisfaction is high and their stories evidence that people are being kept alive longer and in better overall health, with fewer hospital admissions and more holistic support for families.

The CCG has also focussed on improvements for patients with Dementia and Learning Disabilities, and in 2013 is focussing on neurological conditions and Physical Disability Sensory Impairment, working with local partners for example supporting people in retirement living, and supporting carers.