In May 2022, NHS England published the final report of the stocktake by Dr Claire Fuller, Chief Executive-designate Surrey Heartlands Integrated Care System and GP on integrated primary care, looking at what is working well, why it’s working well and how we can accelerate the implementation of integrated primary care (incorporating the current 4 pillars of general practice, community pharmacy, dentistry and optometry) across systems.

In our recent series on the recommendations identified in the Fuller Stocktake Report published on LinkedIn and Twitter, we shared our thoughts on data, population health management, leadership, personalised care and access. In the report, Fuller emphasises that crucial to the development of Integrated Care Systems (ICS) is creating the right environment that aligns to the needs of the local population. We share this optimism around the opportunities that the new health and social care reforms provide in transforming how primary care is delivered.

Data, Data, Data

Data was one of three environmental conditions discussed in the Fuller report alongside workforce and estates. Improvements to how we collect and use data is in our opinion a key ingredient for the NHS to be able to provide truly personalised and patient outcome-focused solutions, at neighbourhood and place level.  According to Dr Fuller, “Primary care must be at the heart of each of our new systems – all of which face different challenges and will require the freedom and support to find different solutions.” Indeed, if primary care is to be at the heart of each new Integrated Care System, then a clear and aligned, locally owned (end to end) data-driven approach is a necessity.

A patient centric population management approach supported by high quality data will drive new proactive models of care that improve health and wellbeing, reduce health inequalities, and identify interventions which could improve outcomes, and even reduce demand. Furthermore, overcoming barriers to enable data sharing across multiple organisations within systems could in turn be a lever toward shaping a transformative approach to improvement and collaboration.

Shifting the focus – integration and joining the dots

Empowering local leadership in the delivery of locally aligned care and facilitating integration are key conditions emphasised in the report.  A leadership that is brave, and one that fosters a culture of partnership working and embedded strategic and long-term thinking, with the headspace needed to do this, is a key enabler.  It’s also about recognising that a one-size-fits-all health and care system will struggle to meet the increasing complexity of people’s needs, and meet expectations around how those needs should be met. Whilst the report advocates supporting community partners to operationally embed relevant teams as part of existing PCN teams, how we orientate providers to neighbourhood is not yet quite clear and should be high on the agenda for leadership teams.

Right care, right place, right time

For Integrated Care Systems, galvanising a system approach to managing access to same day urgent care is paramount.  This includes challenging the perception of current system provider remits and responsibilities to ensure that the right care is delivered in the right place, first time and indeed by the right healthcare professional. Of equal importance is the development of interventions and mechanisms to support elective recovery, and safe management of patient risk whilst waiting. For instance, without the well documented workforce challenges being properly addressed, managing access to same day urgent care is unlikely to be achieved. At the same time, the workforce challenge is one that will not be resolved in the short to medium term, and cannot be met within the local systems alone. Therefore, an integrated approach is not an option but a necessity to deliver right care at the right place, first time.

Digital enablers

Technology also plays a key role in ensuring that patients are seen in the right place, by the right healthcare professional at the right time, and provides the foundation for long term sustainability in health and social care. Interoperability between provider systems will enable joined up care, drive service improvement and innovation, and facilitate integration and personalised care. New technologies will support flexible, tailored services that support people’s health, wellbeing and promote independent healthy lives. During the course of the pandemic the use of digital tools and technology to manage long-term health conditions at home and to support independence increased significantly via interventions such as virtual wards, and outpatient video consultations. This momentum should be maintained and more informed alignment of digital technology to ensure consistency and interoperability in enabling system wide complimentary solutions will be key.

Vision to action

At Acumentice, we take a holistic and bespoke approach to working with our NHS clients, supporting them to create common goals, a shared purpose and build a collective vision. We are currently working with Integrated Care System clients to identify opportunities, challenges and priorities to inform a Primary Care Strategy refresh and to inform strategic direction. We also support multiple clients at all levels in approaching digital and data transformation to ensure they deliver current and future Population Health Management aims discussed in Fuller Report. For more information on how we can help your organisation https://acumentice.com/services/

We, at Acumentice, welcome this stocktake. With growing challenges in not just NHS hospital waiting times but also at GP surgeries, a report by Dr Claire Fuller on integrating primary care is useful and timely. It is an important and accessible guide on how to improve access, experience, and outcomes for communities by providing three essential offers: streamlined access to care, proactive and personalised care alongside helping people to stay well longer.

Mental health services have never been in such a demand as they are in 2022. At the end of 2021, the number of referrals for specialist NHS mental health care reached a record high in England. NHS Digital told the BBC that there were 4.3 million referrals for conditions including anxiety and depression – and 1.025 million of these referrals were for children or adolescents.

The Royal College of Psychiatrists said that in December 2021 alone, 1.8 million mental health consultations had taken place. This was a great feat, considering this was the same time the Omicron variant of Covid-19 swept across the UK. Despite this, however, around 1.4 million people were still waiting for treatment.

Mental health and Covid-19

It’s no secret that the events surrounding Covid-19 have had a significant impact on the mental health of many people across the UK and the effects are still being felt in 2022. The Office for National Statistics found that over two-thirds of adults in the UK (69%) reported feeling worried about the effect Covid-19 would have on their life. Concerns were related to worrying about the future, feeling anxious and feeling bored.

While forced locked downs and fear of catching a potentially fatal virus have been drivers for the worsening of mental health, other factors added to the situation. Furloughs and redundancies halted careers and caused financial strain while those working with frontline services had added stresses of continuing to operate through a pandemic.

This, combined with the lack of access to mental health services has ultimately made the situation even worse; and the backlog in cases has continued to rise even as we entered 2022.

National measures to tackle the mental health crisis

Back in 2019, the NHS released its Long Term Plan to tackle the mental health crisis and improve care. One of the headlines of this new plan was:

New and integrated models of primary and community mental health care will give 370,000 adults and older adults with severe mental illnesses greater choice and control over their care and support them to live well in their communities by 2023/24.

In a call welcomed by many, this was the beginning of the switch towards integrated care systems (ICS).

How does an integrated care system support improvement of mental health service access?

An integrated care system means NHS organisations, local councils and others must take collective responsibility for delivering NHS standards, managing resources and improving the health of the population.

The hope with ICSs is that patients will have greater access to a wider range of mental health services and that it will have increased priority in local healthcare planning.

Since the announcement in 2019, many ICSs have been set up across the UK. In February 2022, the first State of Integrated Care was released by NHS Confederation. The report revealed that 90% of system leaders believe they have been able to improve joint working. In fact, the pandemic had helped speed that process up as staff had to adapt quickly to the demands of care.

However, one  concern being felt across all healthcare systems is the national workforce shortage and mental health services are no exception. Indeed, The Royal College of Psychiatrists explained that workforce shortages are causing “painfully long waits for [mental health] treatment”. In 2021, they found that 568 out of 5,317 vacancies hadn’t been filled. This is causing some patients to wait 18 weeks or longer for treatment. The current NHS workforce data shows there are 4,500 full-time consultant psychiatrists for 56.5 million people – that is one consultant per 12,567 people.

To address the workforce shortage in mental health services, The Royal College of Psychiatrists is calling for an extra 7,000 medical school places on top of the current 8,000 by 2029.

Health and Care Act 2022 and Mental Health

The new Health and Care Bill introduces various measures to tackle the backlogs accelerated by Covid-19 and rebuild health and social care after the pandemic. The funding is coming from the Health and Care levy which will generate £36 billion over the next three years. The Bill also contains measures to tackle health disparities and create safer, more connected services to make the health and care system more sustainable.

It furthermore aims to roll out more mental health innovations, such as one example at  Somerset ICS. Here, a 24/7 helpline was set up to direct those looking for mental health support to voluntary, social care and NHS services. The scheme brings together doctors, nurses, psychologists, and charities such as Age UK, Citizens Advice, Rethink Mental Illness, and others through a shared recovery and care planning system, so all professionals involved in an individual’s care can communicate with each other. This means that patients are directed to the right service quickly, stopping them from bouncing around services until they find the right one.

The new healthcare bill and investment in mental health services are incredibly important. Mental health services have long felt neglected in national policy, so it’s great to see that change with the new bill, adding exposure to the support that is needed to reduce waiting times.

Even as this bill was put through to the UK government, mental health waiting times continued to rise. And it’s likely that challenge will remain, even as Trusts work to tackle the crisis. Furthermore,  as patients waiting for treatment continue to rise, so will the scrutiny placed on mental health Trusts.

Increased scrutiny could necessitate the need for single pathway levelpatient tracking list (PTL) per Mental Health Trust, for example. This would require Trusts to be able to effectively record and manage all patients via such PTLs, yet many Mental Health Trusts may not be able to do so quickly as mental health pathways are complex and also for the fact that they have not faced this task previously. This is where Acumentice can support Mental Health Trusts.

Acumentice and mental health waiting lists

With ambitious targets now set out by NHS England for Mental Health services, there’s now an expectation for trusts to deliver them. Here at Acumentice, we are leading the work on introducing a set of systems to record, monitor and report whole pathways waits from referral to treatment as part of our data quality improvement services for Mental Health Trusts.

Beyond that, our data validation strategies will ensure you have the right information about every patient, allowing you to get through your mental health waiting lists to ensure all patients get the care they need when they need it.

With integrated care now required across the country, we are also working on ensuring these improvements in mental health trusts are taking into account the use of new and innovative technology to improve integration efforts and reduce administrative burdens. It’s vital that all services are able to focus on provision of clinical care with effective digital transformation  to support efficiency gains.

For more information on how we can support your mental health trust, get in touch with the team today.

We’re pleased to announce the hiring of Wendy Baines as a new Principal Consultant to help integrated care systems (ICSs) execute sustainable recovery plans.

Wendy will work with ICSs to understand the challenges and opportunities arising from the elective recovery plan, alongside helping us expand our range of healthcare consultancy services.

Frontline experience

In the last 15 years, Wendy has worked in various senior management NHS roles which have given her vital experience and expertise in all aspects of healthcare delivery, alongside having significant healthcare management consultancy experience.

Her previous roles in the healthcare sector have included both operational and transformational roles. This includes work ranging from diagnostic training academies and community diagnostic centres to service reconfiguration and helping strategies evolve from concept to operational model stages.

Wendy has a successful history of achieving sustainable, evidence-based change across clinical and non-clinical projects. Her strengths are recognising the different needs of individuals to make change happen. She can also identify the tools and technologies that enable digital transformation in healthcare services. Most important is Wendy’s attention to focusing on the human elements of change.

Baines has also lectured at Liverpool’s Edge Hill University. Her work and experience around the North of England open up a great opportunity for Acumentice as we continue to work with NHS Trusts across the whole of the UK.

With all this experience under her belt, Wendy will use it to look at how primary and secondary care services can work together effectively while helping ICSs in navigating the elective care recovery plan. She will help to build and implement a variety of strategies that help to reduce the impact of the elective care recovery plan on the workforce and patient pathways.

Wendy said: “I am immensely proud of what I have achieved working across a variety of NHS organisations over the last fifteen years and the relationships I have built with the clinical and non-clinical teams. The need for expert support is now greater than ever.

“Whilst NHS England sets out a progressive agenda for the recovery of elective care services, there is quite often insufficient capacity to actualise recovery solutions whilst maintaining a high standard of care, and at the same time future-proofing services.

“I look forward to working with Acumentice in supporting the NHS on its journey to sustainability.”

“We are thrilled to have Wendy join the team as principal consultant,” said Karina Malhotra, founder and Managing Director of Acumentice. “We’ve experienced large growth in the last 6 months, so expanding the team feels like an organic step forward.

“Wendy’s level of expertise and breadth of knowledge of the NHS, especially around Community Diagnostic Hubs, is a great asset. We look forward to her playing a vital role in the future growth of Acumentice”.

Acumentice supports the NHS on elective care management, data quality improvement and digital transformation. With a specialism in elective care, we’re in a unique position to respond to the new complexity of current recovery and restoration endeavours.

To see how Wendy and the team can help your trust with its elective care recovery plan, get in touch with Acumentice today.

 

 

 

 

 

 

 

Covid-19 has created a huge impact on elective care. With resources focused entirely on treating patients affected by the pandemic the NHS is now facing the largest elective care recovery programme in history.

 

A sustainable elective recovery programme is built upon strong clinical leadership, innovation, operational management, and engagement of patients supported by effective data insights.

 

This complex undertaking must be done safely and accurately, but trusts face huge challenges to return to normal activity levels. However, with the right steps, this also represents a great opportunity to create sustainable elective care service models and improved patient outcomes.

 

To highlight the importance of intelligent data analysis to elective care recovery and sustainability, Acumentice have produced a video for the HSJ explaining how this works in practice. Featured in the video are:

 

Martina Dineen – Divisional Director of Operations, Surgery, Cancer & Cardiovascular at Imperial College Healthcare

Karina Malhotra – Founder & Managing Director of Acumentice

 

Below are two key findings from the contributors in providing sustainable elective care recovery:

1. Good understanding and integration of data will inform elective care recovery

Multiple IT systems are rightly used to help manage patient care across the NHS. With it, there needs to be a thorough understanding of each individual data set and what they’re telling us. The data used must be able to tell and capture individual patient circumstances which can then be utilised to support the NHS to effectively prioritise patients, alongside driving safe booking strategies.

 

What’s also important is that any technological solution that is used in the NHS must be able to integrate with existing systems to ensure a smooth transition for all Trusts.

2. Shared Learning and Collaboration

The best way to ensure the right data is collated and used effectively is for NHS and non-NHS expertise to share and collaborate with each other.

 

There’s so much big data in the NHS now, it’s vital to know which is the right data set, to ensure there is context for that data while visualising that data in the right way.

 

Shared learning and creating strong partnerships will help in this recovery. NHS leaders facing this monumental recovery challenge must look around them for those key skills and expertise and also look further to what the industry can bring to the table. That is why it’s important to work with a team in an advisory or intelligent capacity on this recovery journey ultimately aiming to achieve better outcomes for patients and their safety.

 

Find out more by watching the video to learn more on what Imperial NHS Trust and Acumentice say is required to improve elective care sustainably.

 

For more information on elective care recovery services and how your Trust can collaborate with an expert team, get in touch with Acumentice today.