FYFV: Closing the 3 gaps in 5 years

The Five Year Forward View (FYFV), published in October 2014, spells out a shared vision for the future of the NHS based on new models of care. But turning that vision into reality means closing the gaps within the current national care model that don’t support the aim of quality, affordable, preventative care. The three gaps, categorised as: health and wellbeing; care and quality; and funding and efficiency, all present numerous opportunities for sites to employ innovation that leverages digital data for true, measurable service improvement.

Innovation is more than IT

In the transition to a paperless NHS, it’s important that Trusts go beyond the “checklist approach” when evaluating IT solutions. IT products that meet data collection and electronic patient record (EPR) requirements, as well as strict NHS specifications, like those associated with the NHS e-Referral Service (formally Choose and Book) are unequivocally necessary but the process of collecting and verifying the accuracy of that data should not be a separate function carried out alongside delivering clinical services.

As outlined in a previous article, Clinically Driven Digital Roadmaps, IT systems should be designed and selected based on their ability to support and improve clinical processes. Enabling improved patient management and outcomes means choosing a solution that has end-to-end capabilities and allows clinicians to capture data as a by-product of delivering patient care, not an additional administrative burden that results in less time with the patient.

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Figure 1: CaptureStroke has improved SSNAP levels since it was introduced in December 2013

Re-designing systems around the patient is also an important mechanism in closing the health and wellbeing gap. While the FYFV outlines that the answer to this gap is largely centred on targeted preventative care programmes and the primary care service, there’s also a need for more systematic use of evidence-based intervention strategies. IT systems that are mature enough to be both interoperable, and offer clinical decision support, can support intervention strategies and facilitate communication and continuity of care between primary care, Trusts and communities.

Enabling a modern workforce

Closing the gaps in care and quality hinges on effective use of rich, high quality data that can inform decisions and answer important questions not only about an individual patient’s care but about the service overall. The FYFV acknowledges that the move to new care models rely heavily on multidisciplinary teams (MDTs) to meet the growing demands of community-based care, which is slowly replacing acute-based care. MDTs also have the important function of providing continuous, coordinated care throughout a patients’ journey – something that is virtually impossible without systems that:

  • facilitate communication between care teams;
  • enable real time data insights;
  • supports mobile working; and
  • generates reports that are easy to understand and use.

Measuring the amount of care and the quality of that care delivered throughout the pathway and across sites isn’t a quarterly exercise carried out exclusively by management using retrospective (and often outdated) reports returned by national bodies anymore. A safer, more efficient, more cost effective 7-day NHS service means exploiting the information revolution; in other words – real time access to high quality data that can be interrogated and acted on immediately.

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Figure 2: CaptureStroke improves stroke care performance by increasing specialist efficiency through access to information

Health Economics: Realising affordability and delivering value

The FYFV echoes the caution that affordability is crucial to the sustainability of the NHS. Currently very little data is being collected that helps sites, the greater NHS or government understand the cost and scope of delivering care for certain disease types. Increases in lifestyle diseases and chronic disease are not only largely preventable but a costly disease burden that will have a long term impact on tax payers.

Not knowing what it costs to treat cancer, for example, severely limits the prediction, planning and procurement of the entire NHS service, not just the specific pathway. But knowing what an individual patient, a local population and the broader national demand for a service is, informs quality and efficiency of services across the board. And that requires accelerated innovation that focuses on value for patients and taxpayers.

The right IT systems can help close the funding and efficiency gap by effectively utilising hospital, GP, administrative and audit data to support quality improvement, research and the identification of patients who require health and social care support. Rich, usable data also helps Trusts make informed decisions to more accurately project budget costs, as well as comply with Best Practice Tariffs to ensure appropriate reimbursement.

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Figure 3: CaptureStroke improves Practice Tariff Performance by providing fast access to data rich information

Efficiency in all areas

In his speech urging the NHS to go paperless, Secretary of State for Health, Jeremy Hunt, said that: “Over a million people have some form of contact with the NHS every 36 hours and have done so for over 60 years. This produces mind-boggling amounts of data that, if properly utilised with the right safeguards, can help improve treatments, unlock new cures and transform the face of modern health and social care.”

Good quality data generated and managed by a robust health IT solution can improve efficiency across the healthcare system, ensuring NHS health services meet patient expectations while also having the capability to manage and predict disease patterns and trends in this evolving healthcare landscape. With the move towards a paperless NHS, clinically-focused health IT solutions have an important role to play in closing the three identified gaps to ensure the NHS achieves its vision of providing quality, affordable and preventative models of care.