Blog | Achieving ICS: How a standardised approach to outpatient management technology can enhance the delivery of STPs

From Mike Sanders, Intouch with Health CEO

In 2017, the next steps review of the NHS Five Year Forward View set out how Sustainability and Transformation Partnerships (STPs) would drive integrated care across England, creating new opportunities to improve services for the public.

As part of a series of practical and realistic steps for the NHS to deliver a better, more joined-up and more responsive care system in England, a dashboard was established to give a baseline assessment of the 44 STPs set up across the country and drive improvements in care under the three core areas of hospital performance, patient-focused change and transformation.

However, this drive towards more integrated care services presents its own challenges. There has always been pressures when aligning the national agenda with needs at regional and local levels. Inevitably, specific accountability requires Trusts to focus on, perhaps, a more individual rather than collective view.  The need to deliver their own services, and along with them, management of the required finances, has been understandably, of greatest importance. Often, budget limitations- coupled with the fact that investment from the budget of one organisation could lead to benefits elsewhere in the system, has not delivered all that it could do for the greater good of the local population. It has been recognised that ‘silo budgets’ cannot deliver holistic healthcare, hence the move in the past to ‘pooled budgets’.

Similarly, if a silo approach to transformation is taken, solely on a site-by-site basis, hospitals – and subsequently NHS Trusts – can end up working within a network of disconnected systems and processes that stifle efficiency and productivity, impede care and do very little to improve patient outcomes and experience.

Standardised outpatient management technology can drive integrated care services

Acute care, and in particular, outpatient journey management, is one area that presents a major opportunity to ensure this silo effect is avoided, while delivering measurable progress that will help STPs improve hospital performance, kick-start transformation and deliver true, patient-focused change under the Integrated Care Services (ICS) umbrella.

Take outpatient flow management as an example. Many NHS hospitals are now making use of centralised digital patient flow management dashboards to monitor and control an outpatient’s movements for the duration of their hospital visit. These dashboards can flag patient status icons selected on check-in, including if a patient is vulnerable, visually impaired or requires an interpreter, thus helping to improve the patient’s overall experience and deliver long-term, patient-focused change.

The same digital dashboard can also be used to help staff manage clinic capacity on any given day. This might include calling patients to clinic rooms, monitoring the status of activities such as blood tests, and creating alerts for follow up appointments to be scheduled.

If solutions like this are applied across groups of hospitals within STP regions, as part of a standardised patient flow management pathway, it immediately opens up the potential of cross-hospital patient flow balancing, not only between individual hospitals but also Trust-wide.

When standardised technology solutions are applied to control patient flow across groups of hospitals, it helps create a streamlined and consistent way of working that empowers staff, delivers a consistent patient experience and achieves more efficient ways of working. Trusts are also better equipped to react quickly in a crisis, using readily available technology to manage patient care and ensure a joined-up, cohesive and efficient approach to the transfer of patient information digitally between hospitals.

The NHS already recognises the benefits of working in this way. Many specialties, such as cancer services, are delivered in focussed care centres. This model of care could be extended and further applied, for example, in the case of a second COVID-19 peak. Trusts, using the same patient management platform across all hospitals in a geographic area, would be better placed to create an infection centre hospital and transfer patients in and out between sites across the same area as required. While treating patients who need to physically attend hospital will still be required, there is also the opportunity to treat some patients remotely. What is essential is that those patients who attend a physical appointment (in-person) are managed on the same platform as those patients who attend a virtual appointment (remotely).

Supporting the delivery of long-term care patients while reducing hospital attendances

The rapid implementation and success of video consultations during the COVID-19 pandemic has demonstrated how virtual clinics can be used to transform the way the NHS delivers care. When applied to treat patients with Long Term Conditions, the same technology effectively combines real time care and support for patients, with remote interaction from nurses and clinicians. This enables increased care and support in the community while also supporting the NHS Long Term Plan to reduce the number of patients attending hospital.

When this kind of technology is applied across multiple hospital sites across an STP region, it can rapidly unlock cost savings while delivering patient focused change, improved hospital performance and digital transformation.

These top line examples are just some of the many touchpoints in the outpatient journey that can be transformed at STP level to achieve more integrated care services. To achieve real, measurable transformation, it is vital to review and consider how each stage of the patient journey can be managed more effectively. From an elective surgery patient carrying out a pre-operative questionnaire at home via a link sent to their iPad, to an outpatient checking-in for their appointment on their smartphone, and a clinician recording a procedure code and booking a patient follow-up appointment using an electronic outcome form, every stage of the process must be taken out of silo and reviewed to create a seamless patient pathway.

More importantly though, the technology used to manage each of these touchpoints must work cohesively while integrating seamlessly with each trust’s PAS/EPR to ensure that digital transformation only serves to empower patients and staff, not hinder them. A digitally-enabled, integrated and sustainable solution is critical to success.

The result of a holistic approach to outpatient journey management at STP level, where the same technology is used by multiple hospitals across multiple trusts, can be immensely powerful indeed - and can deliver real, measurable transformation at every level.

Acting now to introduce standardised technology to improve the delivery of Acute care through better-managed outpatient flow can move all 44 STPs significantly closer to achieving integrated care services by 2021, while also ensuring targets, ranging from infection prevention and improved patient experience, to reductions in outpatient traffic and empowering long term care patients in the community, can be achieved.

Find out more

Intouch with Health has a full suite of patient flow and elective care solutions working in over 100 hospitals in the UK. These solutions are fully integrated to the Trust's hosts systems and can be delivered alongside several partner solutions, at scale, and at pace to fully support STP / ICS digital transformation.

Contact the team on info@intouchwithhealth.co.uk to find out more.