Capability: Analytic Applications

The NHS landscape is constantly evolving – it’s the responsibility of trusted solution partners to keep pace with NHS organisations and contribute expert data knowledge to help them on their journey 

Everyone’s talking about finance collaboration in the new Integrated Care System (ICS) structure, but it’s not easy for anyone to make headway in this unfamiliar landscape. It’s not as if the decks have been cleared to make time and space to understand and address the opportunity: NHS leaders and finance teams are still grappling with everyday pressures and priorities within their own Trust. ICS is another challenge to add, albeit one that offers excellent opportunities to improve patient care and experiences. 

Up to now, costing data has been used by NHS Trusts for national cost collection (NCC) and internal service line reporting. Solutions like CACI’s Synergy 4 help Trusts to make this happen in the most efficient and integrated way possible and to gain greater value from their data for service design and improvement. But now, there’s a new challenge level. How can Trusts also share and embrace costing data from other Trusts within their ICS?  

The rewards of understanding and analysing patient pathways across organisations 

In principle, it’s clear that a holistic approach to analysing patient pathways – spanning acute, mental health, ambulance and social care organisations and community settings – has the power to greatly improve patient outcomes and experiences as well as delivering better value and efficiency to ease the burden on NHS care teams. But the practical processes and channels for sharing data and insight are far from clear. 

CACI’s NHS engagement team has been working closely with our NHS clients to understand the complex considerations around sharing data between Trusts in a secure way that produces reliable and meaningful information that can help develop patient-centric services and make the most of NHS resources.  

Trusts are engaging with a range of new data challenges for ICS  

Information Governance (IG) for shared data is a key concern for NHS finance teams. Data must be anonymised, in order to protect patient confidentiality, but Trusts must be able to match patient identifiers to understand the end-to-end pathway through multiple touchpoints and organisations. 

Finance teams are also keen to understand more about the quality of data that could be shared by other Trusts. Data formats may be an issue: there are multiple systems and data sources in use, even within individual Trusts, which can make it hard to match data and adopt a holistic approach. With clinical decisions and budget allocation potentially riding on the analysis, it’s critically important that pooled data is accurate, de-duplicated and in comparable formats, to avoid inaccuracies. Reporting on insight from shared data can produce unfamiliar results in the broader ICS context: for NHS leaders to trust the integrity of the data and analysis, these results need to be clearly presented and explained. 

These are uncharted waters for NHS Trusts, for the new ICS organisations and for data solution partners like CACI. It’s not surprising that most efforts to launch costing data-sharing projects have so far been tentative. We’ve talked to finance managers who have shared data to explore the opportunity – generally they’ve done this in manual and fragmented ways, such as emailing manually created data files. This is clearly not a scalable approach for time-poor NHS finance teams, even if the attendant data protection and security issues could be resolved. 

 Operational finance teams can see the potential, but many are worried about IG, concerned about undermining their own Trust’s financial priorities within the ICS and don’t have the time or the mandate to focus on unpacking the issues. It’s already creating frustration. Some NHS leaders have a management accountancy background: they don’t yet have the data literacy training or experience to champion or direct a completely new costing data-sharing approach with confidence. This is a challenge we’ve also recognised: CACI’s Healthcare Insight Success Cycle (HISC) includes data literacy training modules which can help increase knowledge and confidence. 

Collaboration with solution partners can enable ICS collaboration 

How can NHS Trusts and ICS organisations break down these barriers and access the resources they need to unlock the potential of data-sharing? Partners like CACI can help to shoulder some of the load by ensuring that technology and data solutions are continually evolved and adapted to handle the emerging opportunities and challenges. Driven by the feedback and hands-on experience we gain from our NHS colleagues, we’re working on our Synergy proposition to develop the data-sharing, analytics and IG capabilities that will support the emerging ICS data-sharing requirement. 

We know that ICS organisations are at different stages of their thinking about Trusts. They also have diverse levels of capability, resources and experience in producing Trust-level service insight from costing data. Everyone has a different starting point for their new ICS data-sharing journey.  

How does your Trust’s approach and experience to date match up with our current understanding of the ICS landscape? At CACI, we’re highly aware that priorities, issues and opportunities are constantly evolving within the NHS. We’re rising to the challenge of delivering a costing proposition that’s built for the complex demands of today and tomorrow, supporting better outcomes for patients, better decision information for clinicians and better use of resources for the NHS. We want to support Trust finance and analytics teams by sharing our NHS data knowledge to help build data literacy among NHS leaders, so they can champion ICS from a position of understanding.   

That’s why we are working alongside our NHS colleagues, engaging with their current challenges and offering data strategy, process and capability insight to help them move forward on the journey, as we evolve our Synergy proposition.

Please join the conversation through our user groups and round tables or get in touch directly to share your priorities and issues and pose any questions that we could help you answer through our NHS data experience and expertise. Contact consultant Susan Brooks in CACI’s NHS team.

Since 2018, the NHS has seen Trusts building closer relationships with local councils and other important strategic partners such as the voluntary, community and social enterprise sector.

The 2021 NHS Long Term Plan cemented an integrated care system (ICS) that would build on lessons learned and invest in keeping people healthy, while setting future social care priorities.

The introduction of ICS throughout the NHS, along with the government’s new Health and Care Bill, brings health care under one umbrella, and highlights the importance of data sharing to enable joined up support across the NHS, local councils, and other partners.

ICS is helping change attitudes to data sharing and how data can be used to improve service provision. This presents a huge opportunity for NHS organisations to improve services and accelerate elective care activity. It enables better use of data by consolidating, managing and sharing it more efficiently and easily, resulting in better care through more easily pinpointing where problems or hurdles exist.

While Trusts will have a wealth of organisation and patient data, bringing it together to produce meaningful insight that can drive decision making and improvements, and access additional funding, is crucial.

Joining up health services

The Health and Care Bill changes how the NHS is structured and puts ICS on a statutory footing, enabling partnerships that better join up health and care service, improve the community’s health, and reduce health inequalities. Benchmarking across Trusts becomes possible, enabling more effective and consistent patient outcomes.

Each ICS is led by an Integrated Care Board (ICB), which will have responsibility for NHS functions and budgets across the ICS. The system sees 42 new ICBs replace Clinical Commissioning Groups (CCGs), with a change from 106 CCG geographic areas to 42 ICBs.

Currently, much of the work with data in the NHS focusses on delivering upon statutory requirements. But moving forward, data will also become a tool for planning and measuring, informing decision making for improvements to clinical practise and leveraging data to improve the cost of care and the patient experience.

Sharing information across Trusts enables benchmarking of services, while patient pathways remain the priority at all touchpoints. Technology can be used to leverage knowledge of the environment and constraints and provide a proactive view of activity. This will allow Trusts to have a much clearer view of the entire patient journey, and will be the start of the changing future of healthcare.

It will help ICS to look ahead at long-term population heath needs based on demographic data, and better understand future problems – enabling a next level of planning that may not previously have been considered.

The current state of integrated care systems

The NHS Confederation, which supports and speaks for the healthcare system in England, Wales and Northern Ireland, has carried out a review of ICS progress in 2021/22.

In the first of what will be annual reports into the evolution of ICS, it highlights what is working well and where it feels improvements are needed. These include:

1.  ICS leaders may not have sufficient time and space to deliver the radical changes needed.
2.  ICSs should make decisions at the most local level possible and be empowered to define what metrics they will be assessed on based on local priorities.
3.  One of the biggest strengths of ICS so far has been improving joint working between partner organisations. Around 90% of system leaders believe they have been able to effectively improve joint working.
4.  System leaders are committed to the principle of subsidiarity and 90% say this principle already applies to their system.
5.  Another strength of ICS has been local workforces. ICS leaders feel they are making significant contributions to mitigate workforce pressures and improve working culture, with nearly 80% confident to deliver a ‘one workforce’ approach by July 2022.
6.  More support is needed to help systems contribute to local social and economic development.
7.  There is uncertainty about how the experiences and insights of leading primary care services at neighbourhood level inform system-level planning and strategy.
8.  The biggest obstacle to further progress is national workforce shortages. The NHS Confederation is seeking amendments to the health and care bill to strengthen the duties of the Secretary of State for workforce planning, and has asked the government to develop and publish a health and care workforce strategy as a priority.

Taking the next steps forward

Data insight is crucial to help Trusts improve patient outcomes and drive cost savings. But finding the best approach to accessing the right funding and realising your digital strategy presents its own challenges.

CACI’s NHS services portfolio demonstrates our ability to support data projects at any stage of the data lifecycle, helping Trusts determine local priorities, accelerate timelines, maximise staff resources, improve joint working, and plan strategically for the future. And we combine all this with our wide experience of healthcare customers.

Data can become the building blocks of your solutions, showing you where services are at capacity, how to redesign them to avoid bottlenecks, and how to meet challenges and maximise opportunities.

Plan a call with one of our NHS experts today and take the first step towards optimising your organisation’s data provision. 

Read our latest blog ‘Challenges facing NHS Trusts – and how to tackle them’.

And for more expert insight, download our essential whitepaper – Elective Care, how NHS changes are bringing opportunities for Trusts and patient care.