A new national approach to large-scale change?

Developing new models of care in the PACS vanguards: a new national approach to large-scale change? | The Kings Fundlight-bulbs-1125016_1920This independent report was commissioned by NHS England as part of a package of support provided to primary and acute care system (PACS) vanguard sites by The King’s Fund. The PACS model is an attempt to bring about closer working between GPs, hospitals, community health professionals, social care and others.

The report offers a unique set of first-hand perspectives into the experience of those leading a major programme at the national level and those living it at the local level. The insights shared will be invaluable to those constructing future national support programmes intended to facilitate transformation in local health and care systems. The lessons learned will also be highly relevant to those involved in the ongoing implementation of PACS and similar models.

Full report: Developing new models of care in the PACS vanguards: a new national approach to large-scale change?

See also: An international perspective on developing new models of care in the PACS vanguards

 

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STP governance arrangements

The Healthcare Financial Management Association (HFMA) has published Sustainability and transformation partnerships: developing robust governance arrangements.

This document examines governance arrangements within Sustainability and Transformation Partnerships, accountable care systems and new models of care. It includes a diagnostic tool which can help highlight where robust arrangements are already in place and where more work is required.

A systems approach to health and care design

A more holistic or ‘joined-up’  systems approach to health and social care provision could help  transform the way these essential services are delivered and address the needs of a changing patient population | Royal College of Physicians

The Royal Academy of Engineering, the Academy of Medical Sciences and the Royal College of Physicians have published Engineering better care: a systems approach to health and care design and continuous improvement.

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Image source: http://www.raeng.org.uk

This report explores how an engineering approach could be applied in health and social care to develop systems that meet the needs of patients, carers and NHS staff.  It presents a framework to support ongoing work in service design and improvement in health and care.  It found that more widespread application of a rigorous systems approach to health and care improvement, has the potential to have a transformative effect on health and care.

Full document: Engineering better care: a systems approach to health and care design and continuous improvement.

 

New care models: harnessing technology

New care models: harnessing technology | NHS Confederation

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This report explores how five vanguards are implementing innovative digital technology solutions. It suggests that the starting point for the introduction of any new technology should always be from the perspective of the end user and that end-users should always be involved in the co-production of technological solutions.

Full report: New care models: harnessing technology

Additional link: NHS Confederation press release

Large scale general practice

Rosen, R. Kumpunen, S. Curry, N. Davies, A. Pettigrew, L. Kossarova, L. (2017) Summary booklets on lessons for large-scale general practice. | Nuffield Trust

In July 2016, the Nuffield Trust published Is bigger better? Lessons for large-scale general practice  which examined the factors affecting the evolution of general practice and its impact on quality, staff and patient experience.

The Nuffield Trust has now released four booklets which sit alongside this main report covering:

 

Elective care: model access policy

We’ve produced this policy in response to requests from providers and wider health systems for guidance and support in producing their own elective access policies | NHS Improvement

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The purpose of this policy is to ensure all patients requiring access to outpatient appointments, diagnostics and elective inpatient or day-case treatment are managed in line with national waiting time standards and the NHS Constitution.

The policy:

  • is designed to ensure the management of elective patient access to services is transparent, fair, equitable and managed according to clinical priorities
  • sets out the principles and rules for managing patients through their elective care pathway
  • applies to all clinical and administrative staff, and services relating to elective patient access at the trust

Access the full policy here

New model of Primary Care provision

New report from the Nuffield Trust evaluates an initiative called the Primary Care Home (PCH) model developed by the National Association of Primary Care (NAPC).

The primary care home model was developed by the National Association of Primary Care as a response to workforce challenges, rising demand and opportunities to shape transformation in local health and care systems across England.

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Image source: nuffieldtrust.org.uk

This report from the Nufield Trust suggests that the new models of primary care provision are showing early signs of success but will need more resources and support for these models to work well on a permanent basis.

The evaluation found that participating in the primary care home programme had strengthened inter-professional working between GPs and other health professionals while also stimulating new services and ways of working, tailored to the needs of different patient groups.

It was judged to be too early in the scheme’s development for the Nuffield Trust to quantify impacts on patient outcomes, patient experience or use of wider health services.

Full report: Primary Care Home. Evaluating a new model of primary care.

Related: New primary care model needs resources, say experts | OnMedica