Circle Opinion

Challenges facing NHS Trusts – and how to tackle them

Susan Brooks

Delivering better patient outcomes and value, while meeting targets and anticipating future needs, can be a challenge for NHS teams. There is constant pressure to do more with less, and with a high demand for service, quality is under intense scrutiny.

Even before the pandemic, waiting lists for elective treatment were growing. But by the end of 2021, 6.07 million patients were on waiting lists – the largest number since records began. As of September 2021, there were between 7.6 million and 9.1 million missing referrals of patients for elective care, and between 240,000 and 740,000 missing urgent referrals for suspected cancer.

“People will face serious health consequences as a result of delays in treatment, with some dying earlier than they otherwise would, and many living with pain or discomfort for longer than they otherwise would,” stated a March 2022 House of Commons report.

Tackling elective care challenges

The government expects the NHS to deliver around 30% more elective activity by 2024/25 than it was before the pandemic and has allocated £13.9bn in additional funding  to tackle the elective backlog.

NHS Trusts are now exploring how they can access support to meet their targets, improve the patient experience and bring down waiting times. Digitisation is being seen by many as the silver bullet that will help solve their problems.

Over the past 20 years, elective care performance has been measured primarily through wait time targets, but changes to how the NHS monitors performance has seen the advent of new activity-based targets. The pandemic enabled a level of digital transformation that might otherwise have taken several years, and Trusts are looking to capitalise on this to deliver on these activity-based outcomes.

The Elective Care Recovery Fund is a £1bn pot of government money helping the NHS get back up to speed, and to aid different healthcare systems in working closer and more collaboratively.

Funding is awarded based on performance (i.e. increases in activity such as appointments or procedures). In order to utilise the funding, Trusts need to understand where there are opportunities to increase activity, make changes to create these increases, and be able to evidence them.

Data analytics can enable them to do this through forecasting, hypothesis testing and real-time analysis of wait times and patient journeys. Any activity above 95% of 2019/20 levels is reimbursed at 120% of tariff.

Digitisation of NHS services

Remote appointments are one key element of the patient journey where savings can be made. NHS England aims for up to a third of face-to-face outpatient appointments to be avoided by 2024 – saving £1.1bn and 30 million hospital visits.

In Norwich, a virtual ward launched in 2021 has saved nearly 2,000 bed days. The ‘ward’ enables patients to receive remote care from their own homes, with up to 20 patients a day being treated. Vitals such as temperature, blood pressure and oxygen are monitored via a strap around their arm and staff carry out virtual rounds through daily phone or video calls.

More than 80% of integrated care systems (ICS) now have a digitally-supported virtual ward, and these innovative forms of patient care are demonstrating how digital technology and data systems can enable Trusts to release capacity and deliver more efficient services.

Helping Trusts invest and utilise funding

Finding a different way through the pathways and exploring where the bottlenecks are and where there is capacity in the systems, is another crucial step forward, as is access to funding.

In April 2022, a new NHS payments system was introduced that enables an agreed local plan to be put in place between ICS members, targeting volume and case mix. A provider can earn a higher tariff for activity that exceeds the levels in the plan and for scoring highly on their CQUIN indicators.

Data insight is crucial to help NHS organisations plan, operate and continually optimise resources, services, and staffing – ensuring better theatre utilisation, staff rostering, waiting list reduction, capacity planning and operational management.

Advanced data analytics also enables NHS organisations to access the right available funding to help with a holistic recovery. Optimising data enables Trusts to explore opportunities, evidence these, and show changes being made – helping Trusts plug gaps and improve the patient outcome.

Next steps for Trusts

To meet the challenges currently facing the NHS, Trusts should be considering how to augment and optimise their data capabilities. A key step is to access and consolidate data from a variety of sources to inform deep and actionable insight about patients, services, and demand.

NHS Trusts will all be at different stages of their digital journey, but any additional funding they can optimise will be crucial. To do so they will need to understand where there are opportunities to increase activity, how to make changes to create these increases, and be able to evidence them.

CACI’s solution can help Trusts get the best outcome from the new NHS payment system and additional funding, and deliver the outcomes you need. We’re proud of our long-standing relationships with many NHS organisations across all care settings. We have hands-on experience of the pressures and opportunities facing your NHS organisation and the need for trustworthy information to support transformation and sustainability. Plan a call with one of our NHS experts today and take the first step towards optimising your organisation’s data provision. Visit our website. 

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

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Susan Brooks