Portsmouth Hospitals Trust (PHT) established that their plans for elective activity for 2019/20 as part of their contract would exceed the available financial envelope, with potential increases in demand expected across a number of specialties. The impact of this contract overspend was an affordability gap for the partnership and limited flexibility within the system to address known issues or for contingency planning.
Portsmouth Integrated Care Partnership (ICP) initiated the elective project to empower the partnership to work collaboratively with the aim of developing a shared understanding of the pressures and opportunities within the system.
The contract between CCGs and PHT is an Aligned Incentives Contract (AIC), whereby organisations agree that the failure of one is the failure of all, with risks shared and managed. This approach has encouraged open, honest dialogue and has paved the way for multiple organisations to work together on transformative projects.
South, Central & West (SCW) and PHT produce a monthly report that includes data on referrals, outpatient activity, inpatient activity, waiting lists and diagnostics. Data sources are from national, regional and local sources, using the most appropriate data source based on the requirement. In addition to the dashboard a briefing pack is prepared that provides a narrative that adds depth and intelligence to supplement the data.
It’s important to note that the dashboard and briefing pack are used as part of a transformative approach, where the data is not used to hold organisations to account; it’s used to identify opportunities where collaborative working can support the system to develop solutions.
The project has helped change the culture of discussion within the system, promoting greater transparency and enabling open and honest conversations to take place. There is agreement that the data within the dashboard is correct and appropriate, shifting the focus to investigating issues and developing solutions that work for the system and for patients.
Not only has the project helped demonstrate a more joined up and collaborative approach; there has also been a reduction in resources required to maintain the project. After an initial investment in time and effort to agree data sources, define data specifications and agree the constructs of the project, ongoing resources focus on translating the data and building the narrative.
The success of the project hasn’t gone unnoticed, with HIOW STP commissioning the development of the project as the HIOW Elective Care Network. SCW are commencing discussions with University Hospital Southampton NHS Foundation Trust, Hampshire Hospitals NHS Foundation Trust and Isle of Wight NHS Trust to expand the dashboard to include data for all four main acute providers within HIOW.