Themes:
- Patient data
- Provider collaboration
- Clinical decision-making
Background
The South West Provider Collaborative (SWPC) delivers a shared approach to the commissioning and delivery of specialised mental health services. The Devon Partnership NHS Trust (DPT) is the lead provider, hosting the provider collaborative on behalf of its partners.
Provider collaboratives are a national initiative that have been around almost seven years. The SWPC was one of 10 national pilots and commenced in shadow form as a new care model in October 2016, formally established in 2020.
The SWPC covers a large geography, spanning the majority of the south west region from Cornwall to Gloucestershire (excluding Dorset), and serving a population of over five million. This collaborative partnership commissions a range of specialised mental health services, bringing together NHS and independent sector providers and a community interest company with a focus on ensuring people receive high quality care as close to home as possible.
As health and care organisations have moved to more system-based models of working, the SWPC has begun to benefit from working together in collaboration and at scale.
One of the key enablers of this collaboration has been simplifying and consistently managing the flow of patients through care pathways. The SWPC has implemented a single patient flow management system, used by all their providers. The system only contains patient data that is required as part of the information sharing agreement which has been signed by all partners, in line with General Data Protection Regulation (GDPR) articles six and nine. This supports the patient journey and provides an overview of capacity and demand to support prompt referral, and discharge. This ensures patients are cared for in the right setting for their needs and supports quality assurance, clinical decision making and more efficient use of resources – contributing to improved patient outcomes.
If you can’t measure it, you can’t improve it
All providers, within the provider collaborative geography, are now utilising and reporting information on patient flow, bed occupancy and capacity in the same way. Having clear, consistent, meaningful and robust data, in real time, has enabled partners and clinicians to have an accurate oversight of the patient journey, ensuring patients receive the right care and treatment in the right place at the right time.
Emma Wright, SWPC project manager, said: “Having an accurate picture of the patient journey, in real time, together with a picture of demand and capacity, means we can support clinicians to make more informed decisions around people’s care and treatment. We can now take a consistent approach to quality assurance and improvement and help support people being cared for in the best place for them, based on their needs.”
The SWPC patient flow system has supported and enabled reduced length of stay in inpatient settings and more care being delivered in less restrictive community settings.
Interoperability; the importance of consistency
All the providers within the SWPC use the patient flow management system.
Emma continued: “The system was developed in collaboration with partners, so it had the functionality and features that were required to support the best care possible for patients and was easy to operate and use.” A ‘bottom-up’ approach has meant users of the system find it easy to operate as well as meeting their information requirements to support clinical decision making and having a real time view of the patient journey.
Reducing length of stay, finding efficiencies and improving outcomes
Having an effective patient flow management system has delivered substantial gains in patient experience and outcomes and has delivered efficiencies across the region.
Since it has been operational, the SWPC has made great strides in reducing out of area placements. It has successfully brought back a number of young people who had been placed in services far from home back into the region, closer to friends and their families. Also, when SWPC was first established, over 50% of adult low and medium secure mental health patients were treated out of area. At the end of 2022, the figure was closer to 15%, most of whom are now treated within a natural clinical flow.
As a result of its work, the collaborative has successfully reduced average length of stay and supported people being closer to family and friends. This, in part, has allowed the SWPC to use inpatient capacity more effectively and to invest in community provision and services within its existing commissioning allocation.
The system has been extended to include inpatient care for the most complex and serious (Tier 4) child and adolescent cases (CAMHS) as well as regional commissioning responsibility for inpatient eating disorder services.
Next steps
The patient flow management system within the SWPC is now well established and is gaining in maturity and functionality, which in turn can support clinical decision making.
The next steps will be to continue to improve the system for the benefit of patient care and to improve the user interface for clinicians, supporting improvements in flow management which will benefit patient quality, care and treatment.