Next up, we have the finalists in the category of best initiative supporting integrated care systems.
Gloucestershire Hospitals NHS Trust
Overview. Organisations across Gloucestershire ICS have created a patient flow dashboard which allows all partners to see to the current number of patients awaiting discharge from each organisation, enabling faster discharges, improved flow and significantly improved partnership working.
Why? With a build-up of pressures leading to ambulance handover delays and longstanding delays to discharge, organisations across the ICS needed to find quick and simple solutions to help staff work together and do their best for patients. Managing system flow was becoming increasingly difficult as pressures grew, with providers working in siloes and no joined-up approach in place.
What happened? The trust looked at in-house expertise to develop a digital solution to assist in handling these challenges. As all organisations held row-level patient data, it was deemed feasible to join datasets from all partners into one central, secure repository. Data is represented in an interactive tableau dashboard with controlled access, bringing in data from a number sources into one simple view, from any secure device. The information is live, allowing partners to monitor and track patient movement across the sector. The solution provides oversight of patients, leads to improved data quality, supports clinical and operational communication across the ICS and identifies patients who are not designated to a pathway and reduces the risk of them becoming ‘stranded’. It reduces time spent procuring information for clinical teams, supports collaborative working and assists in monitoring demand and capacity across discharge pathways.
Looking ahead. Monitoring demand and capacity will help to inform commissioning of services to meet population needs, and over time the data will provide trend analysis to support predictive modelling of system flow requirements.
NHS Shared Business Services
Overview. NHS shared Business Services (NHS SBS) is transforming corporate services across ICSs within its Insight Diagnostic. Using comprehensive data alongside interviews from ICSs, NHS SBS is reducing duplication, increasing efficiency and realising savings of 20-30 percent on back office budgets.
Why? One of the biggest challenges faced by ICSs is the number of different systems used by provider organisations to complete a single task. Eliminating variance and waste is key to achieving NHS England’s objective of enhancing productivity and value for money.
What happened? To address the needs of all organisations under each ICS umbrella, NHS SBS has created Insight Diagnostic. It uses detailed insight to diagnose the challenges facing an ICS and recommends a series of actions to drive consistency and efficiency. The service identifies the current baseline, evidencing what is working well and where the greatest improvement opportunities lie across the organisation, its people, processes, technology and governance. Data gathering is initially carried out, with analysts reviewing more than 175 separate pieces of data and carrying out interviews and workshops with heads of procurement and finance across the ICS. Then the NHS SBS team creates an individualised presentation for each provider organisation highlighting existing best practice, opportunities for improvement and potential benefits for implementing common processes and systems.
Looking ahead. Creating a shared service ecosystem of finance, HR and procurement services can empower healthcare leaders and help them to improve outcomes by reimagining shared corporate services. NHS SBS says that shared services have the potential to deliver £400 million in operating savings across an ICS and can enable them to realise more than £762 million of procurement saving opportunities.
Overview. Open Medical’s Pathpoint eTrauma and virtual fracture clinic solutions were used to revolutionise Lincolnshire ICS’s orthopaedic trauma care, with 99.7 percent of more than 33,700 referrals handled within 72 hours.
Why? Lincolnshire faces a daunting challenge in delivering joined-up healthcare services due to its rural and motorway-free landscape, and sought to implement an innovative and collaborative solution to overcome these hurdles.
What happened? eTrauma is a cloud-based, regulated and secure platform that offers multidisciplinary teams seamless access to patient information from any location at any time. With the ability to connect geographically dispersed sites and sub-specialty teams, eTrauma allows full visibility of patient experience and supports multidisciplinary teams in making informed decisions. The virtual fracture clinic (VFC) has a centralised interface so that referrals can be sent with templated mandatory fields, ensuring all essential clinical information is captured in one place. The deployment of the solutions in Lincolnshire ICS has streamlined referral management, allowing clinicians to access clinical information through a single system. In addition, they have led to significant improvements in data quality, security and collection, enabling ICS-wide collaboration and visibility whilst retaining local goals.
Looking ahead. The data from these solutions is to support the ICS in further streamlining of processes in addition to providing evidenced feedback to orthopaedic consultants and urgent treatment centre staff. Open Medical says that the achievements at Lincolnshire show that can be accomplished when healthcare providers and technology join forces to create transformative solutions.
Overview. Lantum provides a platform to unite clinicians and employers; their mission is to support all parties to enjoy flexible staffing through Connected Scheduling.
Why? The platform aims to accelerate and optimise the process of filling vacant shifts, saving time, reducing admin burden and improving experience.
What happened? Lantum’s platform focuses on simplifying clinical governance and providing optimal rota management and time-sensitive locum support, and a flexible staff bank feature has been added to help long-term relationships to grow. 19 ICSs, more than 300 primary care networks and 50 percent of practices have adopted Lantum, and it achieves the highest score on the NHS supplier framework. Lantum shares a number of examples, including their work with Dorset ICS; they worked closely with key stakeholders, decision makers and medical professionals to develop and implement an adaptable system offering more functional flexibility, which led to 90 percent shift fill rate in the first month, over 100 organisations signed up, and more than 350 staff fully vetted and onboarded. In 2022, 419,968 shift hours were filled using Lantum, with Kent and Medway ICS accounting for over 22,500 hours by itself. Elsewhere, in Birmingham and Solihull ICS, Lantum’s platform was made fully operational in just six weeks and supported the ICS with a flexible staff bank of 184 staff including 162 GPs.
Looking ahead. Lantum continues to support the healthcare workforce and is committed to boosting uptake and knowledge rates with clinician-focused webinars to share insights, ideas and latest best practices. This is then integrated with dedicated training sessions for practice managers so that they can become increasingly comfortable on the platform and fluent with Lantum’s growing range of tools and resources.
Nottingham and Nottinghamshire ICB
Overview. Nottingham and Nottinghamshire ICB has established the Community Care Transformation Programme (CCTP) to plan for and deliver a future sustainable model of community care provision, to optimise people’s independence by addressing physical, mental and social needs.
Why? At the time of the CCTP’s launch, many community health services were delivered as standalone services; standardised delivery models across the ICB footprint didn’t reflect demographic needs; there was limited integration; commissioned services tended to give limited consideration of the wider determinants of health; the current workforce were at their limits; and the workforce identified more with their employing organisation than with their geographical area.
What happened? The CCTP aimed to address these issues, developing an approach focused on alignment of health and social care resources and workforce in order to implement place-based community teams. The programme is driven by population health data, with personal and community assets fully utilised and developed to support outcomes. An organisational development approach for all community care staff has been developed irrespective of employing organisation and role, and a transparent approach adopted across commissioners and providers to ensure that best value for money is delivered. The programme has engaged with nearly 200 stakeholders to date, identifying ‘what good looks like’ themes. The subsequent service redesign takes place using 100-day transformation cycles, with multiple cycles completed by early 2023 across five early adopter sites.
Looking ahead. The aim is to continue to spread this methodology across the entire ICS to have a far-reaching impact through better planning, integration and communication.