“Saw great data from Symphony Project today. The reality of multi-morbidity made stark. Multiple conditions drive cost exponentially, not age.” Dr Martin McShane, Director for Long Term Conditions, NHS England
: “My colleagues and I here in the New Care Models Team have been hugely impressed by your ambitions for Symphony, and by the progress that you have already made in connecting the data.” Samantha Jones, Director, New Care Models Programme – Five Year Forward View
The Somerset STP includes one CCG, two acute trusts (one in partnership with a local community and mental health provider) and a coterminous local authority. It also includes the South Somerset Symphony PACS Vanguard and a Digital Exemplar in Taunton. SCW has supported this health and care community with analytics for system planning, assurance and evaluation as follows.
System planning: By co-ordinating the development of a comprehensive patient-level data set and working with the University of York’s Centre For Health Economics on its interpretation, we have given Somerset’s health and social care providers vital insight into the relationship between the cost of care and co-morbidity, facilitating the development of a more appropriate integrated care system in the region. The health and care system has subsequently developed an integrated care model, which initially focuses on patients with three or more co-morbidities, regardless of the type of disease conditions.
In co-creating a fully costed patient-level dataset across all settings of care for the Somerset population, using our comprehensive and well-established risk-stratification process, SCW has provided an analytical resource that supports the system to:
identify cohorts of patients suitable for integrated care, across the whole Somerset geography and for patients with any condition or any group of conditions;
clearly understand how those patients interact across all settings of health and care, and the costs incurred in each;
clearly understand multi-morbidity, which supports the design of care approaches to ‘treat the patient, not the condition’;
define a benchmark from which to assess and measure developments in integrated care;
complete further mapping analysis to identify geographical factors that influence the cost of care; and
conduct further economic modelling to accurately predict changes in cost and activity across settings of care.
We have also collaborated with Experian to apply their Mosaic social indicator index at a household level to generate further insight into factors such as the effect of social isolation on the cost and settings of care; and with NHS Improvement to support their investigations into payment innovation mechanisms for long-term conditions. NHS Improvement used our work as a key case study in their guide for creating patient-level linked data sets. To enhance value for the system, our Symphony analysts in Somerset and SCW’s data management service worked with NHS Digital (NHSD) analysts to develop a DARS-compliant framework for integrated data. These proposals went to NHSD IGUARD approval in March 2017 and SCW was the first (and remains the only) proposal in the country for integrated data that has received NHSD IG sign-off.
SCW won the national tender for formal evaluation of the Symphony PACS Vanguard. This was a consortium bid with York University’s Centre for Health Economics who would lead the quantitative econometric evaluation based on Symphony patient-level linked datasets previously created by SCW data teams. We also engaged the South West Academic Health Science Network to support further qualitative evaluation.