Capability: Talent, Services & Support
Background:
Croydon Health Services NHS Trust is a mid-sized hospital in Croydon that provides acute and community care through services and departments ranging from A&E, adult and paediatric critical care to outpatient and inpatient treatment and community services.
Prior to partnering with CACI over a decade ago, the Trust did not have their own data warehouse. Their in-house and bespoke systems were built using tools like Microsoft Access and SQL Server, which challenged their ability to load their structured data properly and time-efficiently. As a result, the Trust conducted a tender to enlist support for this, and after gauging the simplicity and ease with which CACI could help them meet their data warehouse optimisation needs, established a partnership.
Challenge:
Croydon Health Services’ entire in-house, bespoke system had been run by one person. This presented a risk to the organisation, particularly in the event of any changes made to statutory submissions or to the Healthcare Resource Group (HRG).
Husein Kermali, Head of Information Systems at Croydon Health Services NHS Trust, explained the Trust’s thinking in opting for a more organised route that would guarantee their protection by working with an organisation as opposed to an individual to oversee the entire system.
“One of our reasons we chose to go with [an organisation-led] warehouse in the first place was so things like the HRG group, the statutory submissions and anything that comes online from us from an NHS perspective would be something that we knew that warehouse would be capable of delivering.”
Solution:
The Trust implemented InView back in 2011-2012 as a one pass system. CACI created Extract, Transform & Load (ETL) processes through InView based on pre-existing system knowledge and an understanding of what Croydon Health Services endeavoured to do with their data from the point of partnership.
A few years later, in conjunction with their existing data provider, the Trust went from PIEDW extracts to Nautilus 835 extracts, which resulted in CACI taking over a significant amount of the ETL process for the Trust. The positive working relationship between the Trust and CACI built up the Trust’s confidence in the difference CACI could make for their data processing capabilities.
“We know that CACI is always there when we’ve got issues, we know that [CACI] knows the detailed processes very well. [CACI] also work for a multitude of Trusts… so they know they’ve seen all the issues that we’re having in other Trusts, and what all the Trusts are trying to do,” Husein explained. “I think with that kind of vision, [CACI] can see a lot more than we can. I think that makes CACI a great partner to be with.”
Results:
When the CDS010 was retired and 011 E CDS came online a few years ago, Husein flagged that “if [the Trust] did that in-house, that would have been a lot of work.” According to Husein, CACI had the extracts ready for this through InView, CACI’s modular data platform, easing Croydon Health Services’ involvement in the process.
“With the simple product upgrade of InView, [CACI] had all the elements within their product already. We just had to populate the fields that we needed. The output that was delivered was then ECDS 011 compliant, which saved us a lot of time,” Husein continued. “[CACI] did all the testing… we just had to make sure that we filled in the elements that we needed for the easy desk submission, so that was amazing because it saved a lot of time.”
Croydon Health Services has also benefitted from being involved in the ETL process throughout its development by CACI. The supplementary documentation provided at the end of any piece of work with CACI has given the Trust unrestricted access to changes made through InView or ensuring that everything they wished to capture had indeed been included.
The Trust has applied their learnings from CACI’s processes to successfully implement their own data quality (DQ) reports and dashboards that highlight potential problems and look up issues through a warehouse load process. The processes followed by their Data Quality team have also ensured that when data now goes through to the data warehouse, those issues disappear.
How Synergy4 simplified the merging of two Trusts into Black Country Healthcare NHS Foundation Trust
Background:
Black Country Healthcare NHS Foundation Trust is a provider of mental health, learning disability and community support services. Following the merging of the Trust with Dudley and Walsall Mental Health Trust in 2020, Black Country Healthcare Trust was tasked with combining two vastly different costing systems and strategies into a singular costing service and line reporting system. This proved to be no easy task, as Dudley and Walsall’s costing system was Synergy3, while Black Country Healthcare Trust had their own bespoke internal system. The differences between the Trusts’ costing of their services further amplified these difficulties. However, a pre-existing contract with CACI proved to be the key to streamlining this uniquely complex circumstance.
Challenge:
- Merging two Trusts into one. This major change came with extensively different processes that had to be identified and differentiated. Unifying two teams also proved to be extraordinarily difficult for the Trust while keeping up with the demands of day-to-day tasks.
- Learning a new system. The different systems that the Trusts were on and the necessity to quickly move to a new, singular system was a colossal change for the team, with its difficulties augmented by the substantial changes made to costing methodologies.
- Adjusting cost centres within the Trust’s childhood account. This included adjusting the lengths, descriptions and meanings of the cost centres to ensure information remained correctly organised and that no information relating to either Trust was removed.
- Maintaining cohesion while importing. When running imports through the Trust’s activity or costing data, ensuring all elements were executed sequentially proved to be difficult.
- Meeting reporting and national costing deadlines.
Solution:
CACI equipped Black Country Healthcare Trust with Synergy4, a comprehensive patient level information and costing system specifically designed for the NHS. This system made the environment available for the Trust to work with two separate methodologies throughout the transitional merging period and securely organise pre-existing child accounts and allocation methods. Through Synergy4, the Black Country Healthcare Trust could deliver accurate patient-level costing and accurately report on findings. CACI was also tremendously understanding of the Trust’s unique merging circumstances, which simplified the complex transition of unifying two systems into one.
According to Mandip Bal, Lead Costing, Reporting and Finance Systems Accountant at Black Country Partnership NHS Foundation Trust, “The support and understanding offered by CACI was substantial, which enabled us to transition onto that new system.”
CACI supplied unwavering training and support to the Trust throughout the entire project and merger, ensuring that the Trust was well versed in Synergy4’s functions. This support was crucial for the effective translation of knowledge with consultants, which began with a paper written by CACI outlining how the costing journey would progress throughout the merger.
“Upon reading [this paper], I was in immediate agreement from our Trust,” Mandip explained. “We were able to confidently advise on the seperation and visualise how the model would merge into one following the merging of the Trusts.”
Results:
Operating two unique systems was highly complex, and the impact that CACI’s support had on the transition period and successful merging of the two Trusts did not go unnoticed by the wider business.
“Working with [CACI] is always very pleasant… The support available along with the helpdesk, especially at the project implementation stage, was helpful,” Mandip explained. “After we went live, the support desk was particularly helpful for the business. Whenever I’ve asked questions or enquired about different developments, CACI has always offered solutions or more information. I can deal with everything now through CACI, so quite a few efficiencies in terms of administrative tasks were achieved as well.”
The Trust now confidently runs a single system and has consistently met reporting and national costing deadlines as a result. Following updates made to the National Cost Collection guidance, CACI also ensured the Trust’s system was up to date to further assist with minute details amidst the transitional merging period.
Future:
Black Country Healthcare Trust is keen to explore new developments to Synergy4 as they become available and continue to receive CACI’s support to further enhance their system in the coming years.
Background:
When Stockport NHS Foundation Trust first looked to procure a data warehouse, they were adamant about choosing a provider with a proven track record and experience of delivering products and services to the NHS. Following recommendations and success stories from other users of CACI’s NHS data warehouse solution, InView, it was clear that a partnership with CACI would guarantee Stockport a smooth process with a mature and established provider.
Challenge:
Stockport needed one platform that would contain all data in one place to simplify the collection process and help the team regain control of their data. Over the years, numerous reporting database tables evolved to the point that multiple individual servers were created. This resulted in many duplications with multiple databases across multiple tables, data not being consolidated or structured, analysts having to work across servers and inconsistent information being produced. Having one unified platform would ensure that everyone would pull data from the same source and would avoid analysts working in silos and creating their own new sources of data. A consolidated data platform would provide much needed resilience and structure.
Stockport also wanted to take control of their statutory data processing and reporting. They needed flexibility and control over their own data developments, including more automated data submissions and reporting.
Solution:
CACI’s InView equipped Stockport with a mature data platform that has defined all statutory returns and commissioning datasets. It supports the team’s existing grouping and pricing processes and significantly reduces their month end manual processing, freeing up their time to dedicate their efforts to additional data analysis instead.
Through InView, the team also gained access to a unique support desk headed by a team of CACI’s technical experts, ensuring that any issues arising at Stockport could be mitigated precisely and timely.
“You don’t normally get someone that could just as easily have developed the product on a support line. [Our CACI support lead] knows InView inside out… not only does he know the products, but he also knows NHS data quite well,” Rory MacDonald, Lead Analyst at Stockport, explained.
“We have a lot of confidence in the fact that CACI’s [team of customer care individuals] understand NHS data and keep up to date on policy decisions to be able to respond quickly to changes,” Debbie Hope, Chief Data Officer at Stockport, continued.
Stockport was also able to identify gaps in the recording of patient observations, with a customised InView module specially developed by another one of CACI’s delivery support leads to enhance Stockport’s reporting capabilities. Through InView, the team could rest assured that all statutory elements would be addressed and that building any added functionalities within the platform would be done quickly and easily.
The latest enhancement that CACI’s delivery support lead is developing for Stockport is for their audiology data extraction and collection, whereby data is extracted from their system and data quality reports are being created to find any issues. This helps Stockport streamline some of their diagnostic waiting times reporting.
Results / Benefits:
- According to Rory, CACI’s consultancy and support has far exceeded the organisation’s expectations. “The consultants were all really good in terms of both their technical expertise and dynamic advice,” he commented.
- A noticeable reduction in the overall time spent processing overnight. After setting up a delta load, Stockport realised that every piece of information in their system dating back from the 1980s was being copied over. This process took progressively longer each day because the amount of data being copied over was continuously increasing. They worked with CACI on setting up a delta load where they could identify using interface messages, pull any necessary information and load it into the data warehouse, which significantly sped up the processing time.
- The availability of data. “It’s available to be reported on from early in the morning,” Rory explained.
- The enhanced data warehouse solution allowed Stockport to produce their own national CDS extracts. “We were reliant on and restricted to the pace of our PAS supplier previously for the development of those extracts when there were national changes,” Debbie explained. “We’ve removed that reliance and taken full control of those national extracts.”
- Moving away from manually processing commissioner assignment within the PAS system. “It was a very manual process for using the contracting functionality within our patient administration system to assign the Commissioner for who pays for a particular piece of activity,” Rory explained. “Now that we’ve got all the national commissioner assignment method (CAM) rules written in the data warehouse, we’ve been able to switch off the functionality on the PAS system and transform the work of our data quality team.”
Outcomes/Future:
Stockport’s future ambitions include completely switching off all of the old servers with the legacy reporting databases so that the organisation can have only one development server and one production server for the data warehouse. They are also keen to increase the provision of real-time reporting. CACI will continue to support Stockport by analysing patient flow and frequently refreshing in-patient data to help Stockport understand exactly who is in the hospital at that time, what service they may be waiting for and how waiting times can be reduced, and overall support with the maintenance of their data warehouse.
At the beginning of April 2020, North Bristol NHS Trust (NBT) was asked by NHS England to host the new NHS Nightingale hospital being built at the University of the West of England’s (UWE Bristol) Frenchay campus. In addition to hosting the Nightingale Bristol, they needed the ability to fulfil both operational and financial reporting and the statutory submissions of core Inpatient Commissioning Data sets.
As a valued customer of CACI and large user of the CACI NHS Data warehouse InView, NBT turned to our Business Intelligence (BI) team to implement a solution that would meet the statutory requirements within a critical timescale. The solution would need to produce key statutory reporting as well as integrate with the trusts existing processes and reporting toolset.
Implementing the right solution in a small timeframe
To meet the requirements and timetable, CACI knew the best solution would be to implement a version of the trust’s data warehouse environment, specifically for the Nightingale Bristol data. This solution would provide a consistent set of data structures that trust staff understood and allow for the re-use of existing outputs already in use.
Taking this approach would mean using InView, which CACI had been appointed to implement in 2017 and had been successfully live at the trust since 2018. As InView is modular by design, CACI could quickly implement all of the key elements need to meet the functional requirements for the Nightingale Bristol.
As CACI maintains InView to national standards, this would give the trust the ability to group the data as standard and produce statutory CDS submission out of the box. Alongside this, by using the same data structures to the trust’s data warehouse, the solution would be able to re-use existing processes for processing SLAM files and reporting data, using the trust’s current reports and dashboard applications
The CACI BI team managed the implementation of the project on behalf of the trust and provided the support through the user testing process.
What NBT have to say
Based at UWE Bristol’s Exhibition and Conference Centre, the NHS Nightingale Hospital Bristol is hosted by North Bristol NHS Trust (NBT) and staffed by people from many NHS organisations across the south west as well as volunteers. It will provide up to 300 intensive care beds for people with COVID-19, if local services need them.
Speaking to the CACI team about the project, David Hale, Assistant Director of Informatics: Business Intelligence (NBT) told us:
“As part of hosting the regional Nightingale response, North Bristol NHS Trust engaged CACI to support the development of our statutory data processing and reporting via their InView platform. CACI’s response was immediate and comprehensive. CACI representatives formed part of an expert virtual team – spanning multiple organisations – working solidly for three weeks to enable the Nightingale Bristol facility to become operationally ready on time. The success of CACI’s involvement emphasises the importance of excellent relationships and close collaboration when faced with an urgent need. We thank CACI for their valuable support and partnership as part of North Bristol NHS Trust’s Nightingale response.”
You can find out more about our work with NBT here, or to find out more about the actionable insight solutions we provide across the NHS, visit our healthcare page.