Industry voice: Dorset is transforming the journey from hospital to home for patients needing continuing healthcare by digitising the assessment process against a proven improvement blueprint
NHS Clinical Commissioning Groups (CCGs) are under pressure nationwide from NHS England to find £850 million savings from growth in the collective Continuing Healthcare (CHC) budget by 2021 and to ensure that scarce health resources are accurately targeted to the right patients for the right amount of time.
Dorset CCG, one of the largest NHS Clinical Commissioning Groups in England, is meeting this challenge head-on with a digital transformation of the Continuing Healthcare (CHC) Service for patients in its care. It is working with IEG4 to digitise the traditionally paper-based process using the company’s Continuing Healthcare Checklist and Decision Support Toolkit, CHC2DST. This provides an opportunity to not only smooth and speed up the path from hospital for patients, but also to unlock savings for those tasked with undertaking these assessments through intelligent workflow and faster decision making.
Simon Meers, (pictured) the CCG’s senior care commissioner, recounts the time he first saw the process delivered digitally: “That was a pivotal moment for us. We realised then that a digital solution would transform our capabilities, boost productivity and increase transparency over the progress and outcomes of cases for everyone involved.”
He explains: “Many of our performance challenges stemmed, not from our care package administration post-decision, but from the manually-managed, paper-based system supporting the decision-making against the National Framework.’’
The National Framework for CHC sets out the process that CCGs must follow as well as the criteria for decision making. However, it was designed in a pre-digital age and the growth in case volumes over the last decade have made it increasingly difficult, and costly, to manage and administrate.
Co-developed by Cheshire-based IEG4 and five local CCGs, CHC2DST digitally enables this process. It eliminates paper, captures data in intelligent forms for re-use and automates many stakeholder communications. It puts managers and administrators in control of the workflow whilst creating case audit-trails automatically. It offers significant gains in accuracy and productivity, allowing staff to cope with a predicted increase in CHC case volumes.
The five local CCGs have seen their performance against key NHS England CHC metrics transformed and have built capacity plans and an effective target operating model to improve performance further against the National Framework.
In fact, they have been so successful that these Cheshire-based CCGs now form part of NHS England’s Strategic Improvement Programme team for CHC, helping to establish and communicate an improved vision and service standard for Continuing Healthcare to their NHS England colleagues.
Indeed, CCG members of IEG4’s CHC2DST User Group are ahead of the game thanks to their digital transformation journeys – within two quarters of CHC2DST usage they delivered improvements of 21% against the 28 Day Decision Turnaround Standard (from 68% to 82%) at a time when NHS England overall saw an improvement of 14%.
User Group CCGs also actively managed reduction of their backlog cases by 65%, compared to a reduction of just 30% across NHS England in the same period. Furthermore, they expect to drive backlog down to zero by freeing up the time of their existing staff resource and are determined for the backlog not to return.
However, says Meers: “As important as the software is, the continued development and close working relationship between our NHS colleagues and IEG4 has been fundamental in creating a proven business blueprint for transformation of the CHC service.”
IEG4’s Simon Williams explains that they worked closely with the NHS over two years to develop and refine CHC2DST. “It’s a classic case of the alignment of people, processes and technology with the strategy to produce a readily-deployable business blueprint for digital transformation. Our cloud-hosted solution can deliver benefits from day one and is deployable within a quarter. The business case for Buy Vs Build is clear: faster to realise benefits and significantly reduced risk.”
Meers believes that the service and support experienced by all those involved in the CHC Assessment process in Dorset will improve with CHC2DST in place: “Decisions for many patients, carers and family members will be communicated much more quickly in future. This will help people to make appropriate plans based on their indicated care pathway and will ensure that they receive the care packages to which they are entitled.”
He and the Dorset CHC team are excited about the digital transformation ahead of them. “We have a lot of planning and communication to do with our stakeholders, but, having the blueprint and knowing that the technology supports it to deliver results provides a major tick in the box,” adds Meers.
Workflow automation and the digitisation of forms are not new or risky. However, before IEG4’s work with Cheshire’s CCGs, the concepts had not been specifically applied to the National Framework which is adhered to by over 200 CCGs.
As NHS England requires all CCGs to start the stopwatch for decision making on receipt of a Checklist into a CCG the need to take control of the process and submission quality digitally is clear. At the same time as delivering faster decisions for patients, all CCGs need to help control the rate of growth in projected CHC spend. Dorset CCG has taken a digital transformation lead in the South to help ensure its finite resources are deployed most effectively going forward.
Repeated on a national-scale, digital transformation of the assessment process and the capture of assessment data offers enormous potential to achieve the win/win of an improved and fairer service that is delivered more cost effectively – and most importantly, ensures that people receive the health care they need.