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.

A first for Acumentice, this summer, NHS Graduate Management Trainee, Wil Peake, joined the team for an 8 week flexi placement.

As part of the Graduate Management Training Scheme (GMTS), it is encouraged trainees use their flexi placement to gain a broader and more holistic view of the wider healthcare sector.  After working in an operational role at the Royal London Hospital, and as Strategy Lead at Bart’s Health NHS Trust, Wil joined Acumentice as a Junior Consultant.

Over the 8 weeks, Wil worked with our Managing Director, Karina Malhotra, and our Senior Consultant, Philip Purdy, and having visibility and access to our senior management team provided valuable insight into some of the work we’ve been supporting at two major clients.

Continued Professional Development is very important to Acumentice and we therefore wanted to ensure Wil gained as much as possible from the experience and could also make a meaningful contribution from the beginning. Wil joined us as we were beginning a project supporting a client to visualise key elements of their elective care data with the aim of improving clarity of interpretation thus making it easier to identify potential challenges. Despite this being a new area for Wil, the Acumentice team ensured that with thorough training and ongoing support, Wil was able to make meaningful contributions to these data packs which led to him becoming increasingly involved in direct communications with the Trust we were supporting.

As the placement has come to an end, we can confidently say the experience has been mutually beneficial and we would definitely welcome the opportunity to receive an NHS Graduate Management trainee again. Read on to hear from Wil’s perspective:

New experiences

When I started on the NHS Graduate management training scheme (GMTS) in 2019, I had no idea what was coming. In fact, if I could go back and tell that younger me – I think he’d struggle to believe it as would we all with the ensuing events about to take place.

The GMTS includes a Flexi placement component – where trainees can apply for placements in an organisation of their choice, provided it will bring new experience and perspective to their time on the scheme and future career. When it came to applying for a Flexi, I was looking for innovative companies in the private sector that would have a meaningful impact in the post-COVID NHS. This broadening of my experience could only bring with it a more accurate understanding of the context that the healthcare sector now finds itself in and I was excited to secure a placement with Acumentice.  I’ve experienced first-hand the complementary nature of NHS organisations such as ICS’s collaborating with consultancies. The wealth of knowledge and resources that can be concentrated on a single task allows the consultancy to agilely deploy an iterative process to produce its task specific outputs.

Data visualisation

One of the projects that I assisted with was the development of data packs and visualisations supporting a high volume low complexity (HVLC) elective hub in London. Acumentice increased management bandwidth by producing weekly analysis of the combined PTL and condensing them into one self-contained data pack. It’s no overstatement that NHS staff have many competing demands for their attention, and it’s been great to see how Acumentice can facilitate the rapid communication of impactful data, thus enabling rapid informed decision making.

I’ve seen the unique viewpoint a third party has, like Acumentice, to see complex and systemic NHS issues from an outside perspective, often enabling them to question ongoing assumptions and status quo by providing further breadth of experience and working knowledge from different disciplines. This type of thinking can help us see the opportunities for change more clearly. Without the cultural ability to see our actions and the changes around us from a systemic perspective, and the capacity to evaluate proposed solutions in the context of their effects on the wellbeing of the system, we can be prone to falling into repetitive patterns of behaviour. An observer from outside the system can therefore be a powerful change agent. When that outside observer is a network of highly experienced professionals with backgrounds from across the health service, such as Acumentice, their capacity for impactful change is amplified.

Acumentice perfectly fit my flexi placement criteria. They’ve created many mutually beneficial, and lasting relationships with the NHS and I’ve seen first hand how they are able to offer a new perspective, with a wealth of diverse knowledge and practical experience. In addition, they can provide additional capacity by supplementing management bandwidth across the wider health system . Furthermore, they represent a key resource capable of delivering a focused “task and finish” style approach that is invaluable when dealing with time sensitive projects within a complex system. Their processes are open to feedback input throughout, and modifications being made in real time allow for a truly bespoke service.

I believe that the synergistic and complementary relationship between the NHS and organisations like Acumentice will continue to play an important role in supporting the NHS to face its challenges and I look forward to bringing the benefit of my experiences back to the NHS.

Wil Peake

Junior Consultant

NHS GMTS Trainee

Acumentice is pleased to announce that it is one of seven providers that has been awarded a national framework for the provision of Data Validation Services by The Countess of Chester Hospital Commercial Procurement Services (COCH-CPS).

With the framework in place, NHS organisations can access highly specialised support enabling the testing and validation of patient data during the process of migrating from a legacy patient administration system (PAS) to a modern electronic patient record (EPR) system.

Benefits of the national framework

Having been awarded a place on this national framework, this should provide added reassurance to NHS organisations looking for Data Validation Services knowing that in becoming an approved supplier, Acumentice have met high quality standards including Cyber Essentials Plus.

Further benefits of the framework for NHS organisations include:

• Providing assurance to the Board, CCGs and patients of the accuracy of patient data
• Supporting RTT and other patient access standards
• Improving patient data quality held in the EPR
• Supporting the optimal use of a new EPR from implementation
• Ensuring effective transfer of knowledge helping to develop in-house central validation and booking teams expertise

Karina Malhotra, Managing Director at Acumentice said: “We’re really proud to have become an approved supplier on this framework scoring the maximum mark for our technical abilities. Data validation services are an extremely important enabler of elective care recovery, and I’m very much looking forward to contributing to the success of the framework, now our third, and ultimately working with new NHS partners to bring sustainable improvements through a value for money and technically expert service.”

Andy O’Connor, Director of Commercial Procurement Services at COCH-CPS said, “We put this framework in place to help the NHS improve the quality of patient data held, and how this is managed. We’ve selected the leading specialists to help NHS organisation provide assurance to their Boards, their commissioners and most importantly their patients that data is working to deliver better outcomes.”

Data validation services from Acumentice

Data validation services from Acumentice have supported multiple trusts with improving their data quality through carefully considered operational changes coupled with ‘smart’ data validation and correcting hundreds of thousands of records across various patient administration systems.

By working in partnership with hospital trusts and organisations, they can find out the specific operational and data issues impacting their performance metrics to ensure the right changes are made.

Each service is bespoke to the organisation’s needs, following an initial assessment to identify specific issues. These can be targeted to specific cohorts of high-risk patients, or they can be more generalised to the Trust’s needs with recommended improvements that provide sustainable solutions.

The team also understands how complex it can be moving patient data from a legacy PAS system to a modern EPR system and organisations don’t always have the skills internally to complete a smooth digital transformation. Acumentice can deliver an efficient reconfiguration to support all operational and clinical needs.

Our team is looking forward to forging new partnerships within the NHS, supporting their transition to modern EPR systems and providing expert advice on data quality and validation.

If you’re an NHS Trust looking to migrate from a legacy PAS to a modern EPR system or require more information, get in touch with Acumentice at info@acumentice.com or contact The Countess of Chester Hospital Commercial Procurement Services at info@coch-cps.co.uk.