Practical value in the NHS

The King’s Fund has previously highlighted the fact that addressing waste and variability in clinical work can create better value in the NHS. But what does value mean to people working in the NHS – and how it is being applied in practice? | The King’s Fund Blog

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‘Value’ sounds like a familiar concept but it can mean different things to different people. One definition of value in the health and care sector is ‘health outcomes per dollar spent’, so attempts to increase value can look at either improving quality or reducing cost.

In early July we held a roundtable discussion with health service providers to better understand their approach to value improvement – initial research for a new project intended to understand the practical barriers and challenges that frontline clinical, operational and managerial leaders have encountered in pursuing better value health care. Experts who attended – including a chairman, chief executive, chief nurse, deputy chief operating officer, change leader, and representatives of national bodies – agreed that the emphasis should be on patient care. Clinicians are more likely to engage in a programme that revolves around the quality of services, and better care is typically less wasteful, so as one participant put it, ‘if you focus on quality, money will fall out’ [spending will reduce]. Consultants will often drive through successful programmes with change management teams, but we also discussed the role of junior doctors, nurses and therapists, who frequently witness low-value care and understand how to fix it. We know that substantial changes in practice can be delivered as we have seen, for example, in generic prescribing, reduced length of stay and the move towards day case surgery.

Read the full blog post here

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Leeds Teaching Hospitals reducing agency spend case study

This case study shares the experience of Leeds Teaching Hospital NHS Trust on how they reduced levels of medical agency spending | NHS Employers

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The Leeds Teaching Hospitals NHS Trust has reduced its medical agency spend by introducing a central deployment service and making effective use of e-rostering to deliver a consistent and professional approach to the deployment of junior doctors.

This case study details the work the trust has carried out, from the medical workforce team working with medical managers, consultants and junior doctors to standardisation of processes. Read up on the steps they took towards improvement and the successes that have been achieved.

Download the full case study here

Health creating economy

The UK Health Forum has published Proposals for a health-creating economy.

This report sets out the Forum’s view that the UK must continue to be an international leader on global non-communicable diseases prevention through engagement at home and abroad with global institutions, governments, the public sector, civil society and commercial operators. This position will in turn lead to savings to the NHS through reduced avoidable demand on services.

NHS efficiency map: updates

The HFMA and NHS Improvement have worked in partnership to update and revise the NHS efficiency map.

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Image source: HFMA

The map is a tool that promotes best practice in identifying, delivering and monitoring cost improvement programmes (CIPs) in the NHS. The map contains links to a range of tools and guidance to help NHS bodies improve their efficiency.

The national focus on improving efficiency and productivity will mean taking local action to deliver savings remains a priority for all NHS organisations. Aimed at NHS finance directors and their teams and other NHS staff with an interest in the delivery of CIPs, the purpose of the NHS efficiency map is to highlight existing resources on eliminating waste, increasing efficiency and at the same time improving quality and safety.

The map is split into three sections: enablers for efficiency, provider efficiency and system efficiency. The map highlights the successes some NHS providers have had in delivering specific efficiency schemes and provides sign-posts to existing tools and reference materials. It also includes updated definitions for different types of efficiency.

The map will be updated as new tools and case studies are produced.

The case studies produced to date are:

NHS efficiency map

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The Healthcare Financial Management Association and NHS Improvement have updated the NHS efficiency map.

The map is a tool that promotes best practice in identifying, delivering and monitoring cost improvement programmes in the NHS.  It contains links to a range of tools and guidance to help NHS bodies improve their efficiency.

Aimed at NHS finance directors and their teams and other NHS staff with an interest in the delivery of cost improvement programmes, the purpose of the NHS efficiency map is to highlight existing resources on eliminating waste, increasing efficiency and at the same time improving quality and safety.

Total transformation of care and support

The Social Care Institute for Excellence has published Creating the five year forward view for social care: how transformed and integrated health and care could improve outcomes and cost-effectiveness.

This updated paper explores the potential for scaling up the most promising examples of care, support and community health services, initially using data from Birmingham City Council, modelling their outcomes and costs.  Originally published in November 2016, it has been updated to include additional models.

The report contains the following chapters:

Vision for transformed care: Re-shaping services around the needs and strengths of individuals, families and communities.

Key messages and summary: Outcomes can be improved, and costs reduced, if the sector scales up promising practice.

Case studies: Six models of care and their potential impact on costs and outcomes.

Models of care: Overview of promising practice that support transformative change in health and social care.

Conclusions and next steps

The paper is available to download here

Engaging Health Care Volunteers to Pursue the Triple Aim

New reimbursement models, pressure to reduce costs, increased emphasis on prevention and relentless focus on the patient experience and clinical outcomes require attention to patients and families in new ways | American Hospital Association

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Image source: AHA

As hospitals, health systems and other providers navigate this evolution, health care volunteers stand out as key contributors in the success of pursuing the Triple Aim, a framework developed by the Institute for Healthcare Improvement that outlines an approach for maximizing the performance of the health care system. The intent is that every activity or process be aligned with these three domains:

  • Improving the patient experience of care (including quality and satisfaction)
  • Improving the health of populations
  • Reducing the per-capita cost of health care.

High-performing health care organizations are striving to adhere to these principles as they seek to best serve their patients, families and communities.

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Image source: AHA

This resource showcases how Volunteer Services strategically supports the Triple Aim. The information comes from interviews with volunteers, auxilians, directors of volunteer services and chief executive officers, who shared critical success factors in engaging volunteers in these efforts. It features case examples depicting how volunteers support the Triple Aim, including programs dedicated to:

  • Reducing avoidable readmissions
  • Improving the patient experience
  • Improving HCAHPS scores
  • Enhancing community engagement
  • Improving quality
  • Increasing health care access
  • Lowering health care costs
  • Improving patient safety

Read the full report here