Circle Insights

Why NHS costing systems can’t stand still

Susan Brooks

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.

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Susan Brooks