“The Project Team were really responsive and did exactly what we asked them to do, and we are very pleased that not only do we have a tool that we can now use ourselves, we also have a number of people who have been trained to use it.”
NHS England’s national team developed a “Channel Shift” tool that looks at modelling the combined effect of diverse urgent and emergency care (UEC) interventions at a system level. To support use of the tool at a local level, NHS England commissioned SCW – working in partnership with Catalyze Consulting and Jeanes Consulting – to work with the Cornwall health and care system.
All areas of England are being required to implement new Urgent Treatment Centres (UTCs) during 2018/19. Cornwall therefore needed to develop the economic case about how many UTCs they should have and where they should be located. Another major challenge for the Cornwall health and care system is the high number of Delayed Transfers of Care (DToC) from their acute hospital; system leaders therefore wanted to understand to what extent can the introduction of Integrated Community Teams (ICTs) help to reduce these delays.
The final challenge faced was the system’s limited ability to share data, interpret data and model the data to project forward for strategic planning purposes.
By developing a set of guiding questions for the analysis, through a co-productive project team approach, we were able to coach the client organisations (CCG, STP, NHS England, acute Trust, community Trust, and local AHSN) to a point where data was able to be safely and appropriately shared.
We used this information to help support Cornwall colleagues to determine which priority interventions they wanted to investigate and develop further – this helped them to decide to focus on UTCs and ICTs.
We built a bespoke and innovative ‘UTC Selector’ Tool that can be used flexibly to explore the impact on Emergency Department activity as a result of choosing any particular configuration of potential new UTCs; this brought into sharp relief the trade-off between equity of access, clinical utilisation, and operating cost.
We also explored what capacity and skill-mix would be required for an ICT to achieve maximum impact on reducing DToCs. We raised questions on how best to work across organisations, suggesting system-wide Key Performance Indicators that would encourage new organisational behaviour (e.g. ICTs should be held accountable through new KPIs outside their current remit and empowered to affect the patient journey across organisations).Finally, we trained a team of local business intelligence and finance experts in how to use the model beyond the end of the project period so they could effectively use it routinely in future to understand the impact on a wider range of UEC interventions.
We provided insight into how to optimise the system to best meet the demands of the patient population, avoiding unnecessary duplication
We provided practical advice on how to reduce the number of DToCs, ensuring patients are not spending than need be in hospital
We highlighted the system’s need to become more amenable to sharing the financial data across organisations, and seeing the benefits in doing so
Through the ICT work, we identified the potential to release up to 46 beds in the local acute Trust
We demonstrated how the channel shift tool is designed for application in any UEC system, as is the new UTC Selector Model that is now available for use.