NHS reforms

06.12.16

NHS and social care leaders urged to embrace ‘whole system flow’

Improving the flow of patients, information and resources within and between NHS and social care organisations can drive up service quality and productivity, a new report has argued.

‘The challenge and potential of whole system flow’, written by the Health Foundation and the Advancing Quality Alliance (AQuA), aims to help NHS and social care leaders to reduce delays and duplication, two things it says should be given added impetus in the context of STPs and current financial challenges.

The report encourages leaders to embrace ‘whole system flow’, a co-ordinated approach across organisations which focuses on improving the pathway that patients take through the NHS and social care system.

David Fillingham CBE, chief executive of AQuA and one of the authors of the report, said: “Understanding and improving the flow of people and resources should be a major priority, not just for colleagues working in the NHS, but also those across the wider health and social care landscape.”

“Whilst the report’s findings may not offer the ‘magic bullet’ to solving flow that some may seek, it provides a framework, insight and case studies on how we can work together to tackle this complex challenge, and so secure better outcomes for patients.”

The joint report found that poor flow is not only wasteful but can also cause harm to patients and staff. It cites common examples of this such as ambulances queuing outside hospitals, stretched A&E and mental health departments and delays in patients getting referred to hospital by GPs.

While the report argues that STPs and financial pressures present an opportunity to improve system flow, it also accepts that the challenges shouldn’t be underestimated due to culture clashes arising from how different organisations are governed, funded and regulated.

The authors of the report have therefore urged local and national leaders to give frontline NHS and social care staff the room to invest in long-term improvement initiatives to change organisational culture rather than forcing them to chase easy solutions.

Penny Pereira, deputy director of improvement at the Health Foundation and co-writer of the report, said:  “We need to look well beyond seeking just quick fixes for A&E. Extending work on flow to span whole health and social care economies takes time and investment.

“If every organisation in each health and social care economy were able and willing to work collaboratively to design services that optimise flow, it could lead to major improvements in patient and service user experience and outcomes, as well as improved productivity.”

The report outlines eight building blocks that need to be in place to improve ‘whole system flow’, such as good IT, leadership at all levels, and staff and patient involvement in service re-design.

One solid improvement was made by Sheffield Teaching Hospitals NHS FT which reduced the length of time between patients’ care being completed and their being discharged to home support from 5.5 days to 1.2 days due to the Health Foundation’s interventions.

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