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Achieving the NHS's vision through service redesign and pathway efficiencies

Technology and data sharing are at the heart of new NHS vanguard

NHiS Paul Midgley Sue ThomasThe NHS needs an extra £30bn to realise the vison laid out in its Five-Year Forward View: £8bn will come from the Treasury – the remainder will come from doing things differently. Healthcare data and technology experts from NHiS, which was set up in response to a growing need in the marketplace for quantitative and qualitative data to inform service redesign and pathway efficiencies, show how this can be achieved.

In January 2015, individual organisations and partnerships were invited to trial new ways of running primary and secondary care services in their local area by becoming 'vanguard' sites for the NHS as part of its Five Year Forward View.

Principia Partners in Health in Rushcliffe, Nottinghamshire, was one of the first vanguards to gain approval from the NHS. It integrates care for patients in the community through 'PartnersHealth', and the Accountable Care Organisation (ACO), which comprises all 12 GP practices in the local area.

Technology, and data collection and sharing are at the heart of Principia Partners in Health's ambitious plans to change the way that local healthcare services are run.

Instead of operating a traditional, two-tier primary and secondary care system, Principia Partners in Health will have a four-tier system. The first two tiers will comprise self-care, which will be enabled through digital educational initiatives, and care at home. These services will be facilitated by telehealth devices, and aim to avoid costly hospital stays for the ageing population, where possible.

The third tier will be community care, which will be run by PartnersHealth, and an integrated combination of GPs and allied HCPs such as physios and mental health specialists. Hospital care will be the fourth tier.

Instead of relying heavily on Hospital Episode Statistics (HES), Principia Partners in Health plans to capitalise on other data, particularly relating to patient experience, such as patient surveys and 'family and friends' feedback. Sources could also include charity databases and the social enterprise, Patients Know Best.

It will be really important for pharma sales reps to have relationships with local organisations to work on data

Other technological innovations will include developing patient apps, including one for self-care, and running a social marketing programme that will, for example, help to promote the organisation's focus on preventing illness and maintaining good health.

Paul Midgley (picture above, left), patient and public senate member at the East Midlands Academic Health Science Network, and director of NHS Insight for NHiS, said: “The NHS needs an extra £30bn to realise the vison laid out in its five-year view. £8bn will come from the Treasury - the remainder will come from doing things differently.

“Data collection and sharing are very important in saving money and getting things right for patients and there are lots of enablers in our plans that are all related to collecting and sharing information through technology.”

He concluded: “The biggest constraints will be new models of care, different pathways and using channels other than HES to capture data. This means you won't necessarily have national datasets that can predict across the country. So it will be really important for pharma sales reps to have relationships with local organisations to work on data and maybe consider partnering with an intermediary.”

Mapping care pathways puts healthcare services on track
Mapping the care pathway to find out why so many patients from the Isles of Scilly were not attending out-patient appointments at hospitals in Cornwall revealed a simple, yet fundamental, flaw in the system.

It transpired that patients were being given early morning appointment slots; yet they had to travel to hospital by helicopter and no flights were available before 9am, meaning that they missed the appointment time.

The problem has since been addressed in various ways including the use of Skype to conduct some patient consultations online.
Sue Thomas (pictured above, right), CEO of commissioning excellence for NHiS, which works directly with the NHS and pharma, was working with the then Primary Health Care Trust in Cornwall to map patient pathways.

She said: “It was a very simple problem, but one that was not easy to identify unless you looked at care pathways and process mapped what was going wrong.”

Process mapping can also be invaluable in helping organisations to partner with the NHS to develop new models of patient centric care. For example, NHiS is currently working with a range of organisations, including hospitals, CCGs, a university and social services to improve care for people with Parkinson's in Bristol.

NHiS is part of healthcare intelligence provider, Wilmington Healthcare, which also incorporates Binley's, OnMedica and Wellards. For more information, log on to www.nhis.com

In association with NHiS

24th June 2016

From: Healthcare

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