Dr Tom Oakley, Feedback Medical’s CEO, looks at the next steps following the Hewitt review ahead of this week’s NHS ConfedExpo conference.
Ahead of this week’s NHS ConfedExpo conference in Manchester, one of the focus points during the event will be on the next steps to making Patricia Hewitt’s independent review into the future of integrated care systems in England a reality. The review contains a wealth of creative, practical and pragmatic ways to transform our model of health and care for the better.
The review advocates for a much more connected approach to delivery, an approach that requires a rethink in how different care settings work together and, as a result, the way that funding flows across the system.
There are three key elements drawn out by the review that are particularly welcome in signalling the way forward for the health and care system across England to improve population health outcomes in a meaningful way:
- Smoothing the pain points
- Better multidisciplinary working
- Having the right infrastructure
Here at Feedback Medical, our approach to facilitating joined up care has been led by these very principles at every stage of our journey. At our core we exist to better connect pathways of care, give clinicians and their colleagues time back to focus on their core mission, and to bring better outcomes and stronger accountability for patients.
Let’s go through each element point by point.
Smoothing the pain points
Firstly, there are recommendations to improve technical efficiency within each element of healthcare by enabling the system’s most valuable resource – its people – to work more effectively.
We therefore need to see greater urgency to embrace new ways of working through digital channels, such as asynchronous communication via platforms such as Bleepa. Intelligent use of digital technologies can dramatically reduce administrative burdens on clinical staff – particularly where data platforms are fully integrated to reduce documentation burden and duplication.
Given the multitude of challenges faced by the health and care system right now, not least through our workforce shortages, a reduced administrative burden and increased ease of collaboration – freeing up precious staff capacity – is one of the immediate steps that can help to address some of the public’s key priorities:
- Better access across each domain of care
- Faster diagnosis
- Reduced referral to treatment backlogs
- Safer, faster patient discharge
Digital solutions that span care settings enable a regional view of patient flow, combining this with a digital dashboard that gives both integrated care leaders and frontline clinicians much clearer visibility of the status of each patient and where they are in their care journey is a vital tool in helping to address many of these challenges.
The simple dashboard view within Bleepa’s platform gives health and care professionals the ability to track a patient’s progress at a glance, while also providing a deep dive into individuals’ case notes and test results in a couple of clicks – the ability to have both a ‘bird’s eye’ regional and patient-specific view through one platform.
Better multidisciplinary working
Secondly, the review highlights opportunities to support much more effective multidisciplinary team (MDT) working across provider sites.
Bleepa can support a wider range of clinicians across different care settings to collaborate in providing safe, effective and timely care. Its powerful asynchronous communication functions reduce the need for specialists to be temporally and geographically co-located, so expertise can be sourced from any locality and more flexibly over time.
Following the implementation of Bleepa at the Northern Care Alliance, benchmarking showed that referral response times were reduced by as much as two days, on average, and that up to 5.6 weeks of a full-time clinician’s time could be released per annum.
The ability to collaborate on patient cases on a rolling basis, based on results and colleague availability allows clinical discussion to progress more rapidly. Patients do not need to wait for MDT slots in order to be discussed, the discussion starts as soon as they join a care pathway or as soon as results are available.
Asynchronous communication also allows clinicians to deliver other care services in a less disrupted way as they can finish their clinic or operation and then pick up the case discussion. Dedicated MDT sessions, where clinicians need to block out sessional time for a video call or in person meeting can become a thing of the past, freeing up time to be used for further clinic or surgical work.
It is about using your existing specialist clinical staff more effectively. Using Bleepa to enable diagnostics-led, multidisciplinary review pathways via the community diagnostic centre (CDC) programme has reduced the need for traditional outpatient appointments and has demonstrated a significant impact by reducing referral to treatment (RTT) waiting times by approximately 70% compared to national targets, all without the need for additional clinical staff.
Indeed, it is difficult to see how the health and care system can meet NHS England’s 28-day faster diagnosis standards for cancer care by continuing to pursue its current care model. Adopting a diagnostics-led approach which leads straight to asynchronous multi-specialty review holds the potential to speed up these diagnostic and care pathways, anchored around CDCs.
The right infrastructure
This brings us to the report’s third key element: The need for flexible infrastructure to enable the scaling of innovation necessary to bring many of the recommendations woven through the Hewitt review to life.
From pathway redesign to the spreading of best practice, practical solutions that can stitch together existing clinical systems across sites efficiently and safely can offer a way forward.
Our technology creates a common view of a patient’s clinical pathway across provider sites, around which clinicians can collaborate. This approach gives flexibility both to the patient and the clinical workforce. Patients can attend any centre for investigation and be treated by the same regional workforce that leverages experts across multiple sites in order to deliver a capacity service regionally.
Currently, there is a view that single, region-wide electronic patient record systems (EPRs) are needed to enable seamless cross-provider working. However, this is a very expensive and long-term way of creating regional collaboration, compared to the connected, patient-orientated infrastructure delivered by tools such as Bleepa, which can be deployed at a fraction of the cost and in a matter of weeks.
This impetus around EPRs is understandable, particularly given the proportion of acute care settings still relying on paper but this won’t fundamentally change how clinicians and their colleagues work and won’t release the operational efficiencies of asynchronous working across sites that is required to impact the backlog and deliver more regional care delivery models.
Smaller interventions
Given the multitude of challenges faced by the health and care system right now, a better approach would see a range of smaller interventions that make existing systems and infrastructure more flexible.
Not only will this enable care to be provided more efficiently, but I believe that this approach is better aligned with making the goals of the Hewitt review a reality.
To find out more about how Bleepa can help your NHS organisation, contact us here