Q&A: How Cheshire CCGs improved the CHC process for patients

One year ago, five Cheshire CCGs were struggling to hit targets set by NHS England which state that patients must be processed through a CCG’s care in 28 days. However, by working alongside software company IEG4 they have digitised paper-based processes to deliver efficiencies and improve patient care.

Here, DHA speaks to Karen Smith, service lead, NHS Continuing Health Care and Complex Care, who talks about how the CCGs have used technology to deliver efficiencies for patients with complex and ongoing needs.

Q: Could you tell me about the reason for installing CHC2DST and what it was like working with IEG4 on the solution?

KS: NHS England states that 80% of patients must have a decision regarding their eligibility 28 days following screening. A year ago, this was not the case for us. However, today, we are achieving these NHS targets. Within the first two quarters of 2017/2018, we improved from assessing 68% of patients in 28 days to 82%, a marked improvement, excelling targets. The turnaround was down to us changing our Continuing Healthcare (CHC) Assessment approach.

Historically, the process relied upon email and paper referrals across multiple stakeholders, however, hitting targets, automation efficiencies and service quality improvements have been supported by us digitising. With the support and expertise of IEG4, who provide digital services in the public sector, IEG4’s cloud-based continuing healthcare end-to-end digital solution (CHC2DST) software was developed and we can now digitise the forms used in the national framework and automate workflow processes to improve patient service and boost productivity in the CHC area. We have a strong partnership with IEG4 and it is one of the best providers we have worked with as they have fresh ideas, challenge our way of thinking and are totally flexible.

Q: How quick were you to notice the difference in patient processing once CHC2DST was installed?

KS: We saw improvements almost immediately in the quality of data. From day one in fact. For example, it could take seven to 10 days usually for a GP surgery to fax patient summaries back, with CHC2DST it took one surgery just 15 minutes after we sent the online link to them. With CHC2DST, they are able to click on the link, add the information needed and send back to us straight away. CHC2DST has really sped the process up and streamlined our approach. As mentioned, the turnaround has been dramatic in the space of six months. We now assess 82% of patients in 28 days compared to 68%, this is a marked improvement in such a short time frame.

Q: How is the system being used to support decision making and what benefits to patient care are there?

KS: CHC2DST has allowed a more consistent assessment process meaning that decisions can be made on the same day. We also have an audit trail of decisions made with ability to record the rationale for the decision.

Q: Do you think this system should be introduced across other CCGS in the UK?

KS: Yes, definitely, and we know that others are planning to implement it too but we don’t want to announce the news on their behalf! From our point of view, by pioneering this, we have shown how performance can be turned around in a very short time frame and highlighted to other CCGs, considering the move to a paperless environment, that it can be done. Allowing staff to speed up decision making, in turn improves the patient experience, which is paramount.

Q: How likely do you think it is that the NHS will meet the Paperless NHS 2020 target?

KS: We can’t speak for the NHS as a whole but we like to think that it is likely. By implementing systems such as these, there is no reason others cannot follow suit. Realistically speaking perhaps, the NHS as a collective will be extremely paper light, if not paperless.

Q: How important is it that patients needing complex and continuing care packages are processed efficiently without delays?

KS: Our patients funded by Continuing Healthcare and Complex Care are often our most complex patients. They have needs that have arisen as a result of disability, accident or illness, so are very vulnerable and facing significant change such as not being able to return home. So, it is vital that they are assessed, reviewed and case managed in a timely manner.

Q: How much strain do basic admin tasks put on healthcare professionals and do you think digital technologies can help alleviate some of the pressure?

KS: Healthcare professionals are under an enormous amount of strain on the whole and do not need extra laborious admin tasks to add to their to do lists. By digitising paper based processes, it can reduce the admin burden, improve service speed, quality and reliability, boost assessment productivity, and, with it, staff morale.

Q: What barriers are there in the NHS in regard to digital adoption and particularly for linking systems?

KS: Not so much barriers but perhaps a cultural challenge. Historically, teams across the NHS have done things in their own way without a digital focus so now a shift is needed to encourage digital adoption. The culture change usually takes longer than the implementation itself but once staff understand the benefits, they actually come forward with new ideas on how to tweak the system or add new functionality which is brilliant. It goes without saying that interoperability is also very important and that all new systems must talk to whatever you have in place already to enable data flow and integration.With that said, interoperability should not slow down the implementation.We saw tremendous value in eliminating paper, increasing transparency and automating workflow within the CHC assessment area itself.Our approach has been to fix that first to drive productivity, improve the speed and quality of our service and to improve the quality of information which is being passed to other systems.Automated interoperability will come in time as requirements are better understood, but, all stakeholders are far better off now.

Q: What other technologies and systems do you think are needed to help reduce pressures on the organisation?

KS: Anything that reduces admin time for healthcare professionals and frees up their time to spend with patients, improving their experience. The success of a patient’s journey is pivotal and truly hinges on how well we function behind the scenes.



Reece Armstrong is a reporter for Digital Health Age. Coming from the North East of England, Reece has an MA in Media & Journalism and a BA in Popular & Contemporary Music from Newcastle University. Reach him on Twitter or email via: reece.armstrong@rapidnews.com


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