In 2016, NHS organisations and local councils came together to form sustainability and transformation partnerships (STPs) setting out their proposals to improve health and care for patients. These partnerships are continuing to improve and evolve and the systems are increasingly work together to better manage health outcomes of the populations they serve.
In order to support this evolution the underpinning support services need to adapt to ensure that they can meet both the current and future needs. Across the Frimley Health and Care Integrated Care System a pilot was established across the local system involving the three local CCGs , the local acute provider and the Frimley facing SCW analytical and contracting teams, with the intention that the pilot approach would be adopted across all providers at the roll out stage. The pilot focused on three key challenges to assist with a more coordinated approach to manage performance across the system:
There is a need to have a better understanding of, and focus on the system activity/ financial pressure points (cost of service).
There is a need to ‘short circuit’ the current processes and ways of working to better understand the System and Commissioner pressures in a more timely manner (i.e. speed and agility).
There is a prerequisite to improve the ‘trust’ in the data and to ensure that there is consensus between the Frimley partners.
The approach is based upon working collaboratively across the system to an agreed common outcome, underpinned by a streamlined governance structure consisting of the Data Collab Group; Investigations Centre, and System Performance & Cost Group, and investigations lifecycle. These groups have representation and involvement from all system partners.
The overall approach is segmented into six key stages. This helps those reading the report know where they are in terms of progress and with a simple traffic light rating system this supports the level of confidence there is in the quality of data / information used. This provides clear ownership over each stage of the approach and has helped improve collective understanding and develop a common narrative within Frimley.
Outlined below is a summary and key owners of the 6 x stages:
The Data Collaboration Group (Data Collab) responsibilities are two-fold. Firstly to assess and identify key areas of further investigation. A key aspect to this is to ensure early collective agreement of the question being investigated with a consistent approach and methodology being used to data mine, working collaboratively with all relevant system partners. This drives an increased trust and integrity in the data and supporting analysis. Secondly, on a monthly basis they are responsible for monitoring and analysing breaches against pre-agreed threshold measures to provide an early warning to the System.
The Investigations Centre uses the agreed outputs from the Data Collab Group to explore and interrogate the data and augment it with operational insight and knowledge to give a single interpretation of what is happening and why – a common narrative across all partners.
Data Journalism. The final output and analysis is tailored for the relevant, and appropriate, audiences to explain the story of the original question. This includes translating the data and narrative away from technical language into a format which is easily understood and read by all interested parties. This includes creating different and varied visualisations, such as the examples below.
The senior executive endorsement from all partners has been key in ensuring the full benefit of the pilot was realised. The pilot has begun to change cultural and behavioural approaches that are vital in sustaining the change as it transitions to business as usual.
Other benefits resulting from the pilot include
- Increasing collaboration - changing individual organisational behaviour to be more system focussed.
- Upskilling existing staff to deliver the Data Journalist approach required to tailor the output to the audience and facilitate questions that resolve the problem rather than a focus on data integrity.
Increased understanding and awareness of operational issues affecting performance and activity management.
An on-going review of analytical reports, aligning them to business needs, retiring reports than are no longer used or valid.
Influencing other systems outside of Frimley that have begun to adopt elements of the approach.