The issue at hand
With increased focus on integrated care, whole systems leadership and more recently the introduction of the Better Care Fund, the need to understand how patients/service users access services is more pressing than ever.
In July 2013, the Chief Executives of Derbyshire wide Trusts, the 4 CCGs and both Directors of Social Services identified two principal integration needs:
• Tackle the urgent pressure on emergency services
• Better understanding of how patients “flow” through the whole health and social care system, where they touch services, when and how and what it costs
The Pi intervention
A pilot was commissioned, using Pi Care and Health to match data across all 12 organisations to better understand the total impact of these flows on the health and social care economy. One of the key drivers was a real concern for ensuring better use is made of the “Derbyshire Pound”.
Pi helped by creating dynamic integrated dashboards which allow all agencies to analyse the patient and service user data in more detail and at the same time to have a whole systems view of how health and social care can interrogate the combined data in a readily accessible form, as well as create their own dashboards and analysis.
The full value and utilisation of this tool was supported through a number of workshops and regular User Groups, sharing the capabilities of Pi Care and Health and the aims of the project to improve cost effectiveness of the delivery of care.
During the mobilisation phase organisations contributed to a dashboard design group to shape the standard configuration of the Pi Care and Health dashboards. Due to the flexibility of the system these have grown in use, and as additional datasets have come online. The regular monthly refresh of data stimulated ongoing discussion about the growing potential of a whole systems approach.
The datasets during the project grew to include SUS, social care, mental health trust, ambulance, out of hours, 111 and local flow data.
The pilot has certainly put Derbyshire on the journey to understand how they can achieve better value in the health economy with the ‘Derbyshire pound’.
The significant results were presented to the CE’s group, who decided to take immediate action to roll out the pilot even further. The health and social care community can now move forward with the focus of Better Care Fund and determine the demand for services and resourcing them more effectively for better outcomes and value for money.
- Derby Hospitals NHS FT
- Chesterfield Royal NHS FT
- Derbyshire Healthcare NHS
- FT (Community and Mental Health services)
- Derbyshire Community Health Services NHS Trust (Community Services)
- Derbyshire Health United (Out of hours, Walk in Centre and 111)
- Derby City Council
- Derbyshire County Council
- Southern Derbyshire CCG
- North Derbyshire CCG
- Erewash CCG
- Hardwick CCG
- East Midlands Ambulance Services (EMAS)
The NHS Chief Executives and Directors of Social Services have now agreed to proceed to a full roll out of this leading edge development. It is notable that the recent reservations raised about the Better Care Fund, have been overcome in Derbyshire by the full engagement and leadership of the Acute Sector from the outset.