Industry voice: Delays in transferring patients out of the acute hospital setting to continuing care have hit the headlines during a difficult winter for the NHS. Resources are stretched to the limit, but digitising key processes which can facilitate this transfer of care could save millions and vastly improve the patient experience, says IEG4’s Paul Tomlinson
IEG4 is working with five trailblazing clinical commissioning groups (CCGs) to digitise and automate the process of helping people move from hospital to other settings where they can be assessed to ensure that their continuing health care needs are met.
Many hospitals operate a Discharge To Assess policy, but once discharged to another location the task of assessment in a remote location may just have become trickier for the professionals assessing. Patients need to be visited by trained assessors who examine their needs from both a health and social care perspective.
The majority of these assessments are currently paper based and completion and communication of them is time consuming - causing delays in decision making and uncertainty for patients and the system.
The five Cheshire and Wirral CCGs have been working with IEG4 to digitise a key part of this transfer of care, the Continuing Healthcare Checklist (CHC) and Decision Support Toolkit (DST). Digitising this process provides an opportunity to not only smooth and speed up the path from hospital to home for patients, but also unlock significant savings for those tasked with undertaking these assessments.
“All five Cheshire CCGs are collaborating to provide Continuing Healthcare in the region, working in partnership with IEG4,” says Tracey Cole, who led the project for the Continuing Healthcare service in Cheshire and Wirral CCGs. “There are efficiencies in doing this to scale and working together to provide services around Continuing Healthcare and Complex Care. It means it’s done once - and done well.
“We need to drive greater integration in health and social care, from acute care to community health providers, and IEG4’s solution is an enabler for doing that.”
Developed in conjunction with the NHS, CHC2DST uses the same national domains and scoring criteria as in the paper process but, crucially, applies intelligence to drive the workflow and maintain the pace and transparency of the assessment completion.
From day one of roll out the software created a single point of entry for new patient referrals into the system and increased transparency of the workload for staff. The first step, confirming eligibility for NHS funded care, can now be completed within hours of receipt, speeding up decision making and communication to those who are ineligible.
For eligible patients Cheshire and Wirral CCGs case managers use CHC2DST to exploit office automation tools – for example, meetings can be scheduled in electronic calendars with the system automatically creating and dispatching email to stakeholders.
Multi-disciplinary team meetings can also be attended virtually by accessing the secure cloud hosted environment. The overall reduction in expense and travel time is clear, enabling health and social care professionals to progress more cases without the added workload burden of the previous paper based process.
Meanwhile, an automatically recorded audit trail shows that due process has been conducted and, with the assembled assessments and evidence all in one place, speeds up verification of decisions.
Independent economic assessment calculated that a CCG could make administration and process efficiency savings of between £600,000 to £900,000 a year – and that’s before looking at the impact on reducing delayed transfers of care from hospital. One NHS trust supported by users of CHC2DST recently came top for performance out of 151 trusts, with the lowest Delayed Transfer of Care rate they had ever achieved.
Indeed, the scale and value of CHC2DST’s impact within the health ecosystem is compelling. Being cloud based it supports ‘Discharge To Assess’ strategies and allows professionals to conduct assessments wherever the patient is.
With the elimination of paper, transparency and productivity increases; as does service quality and the consistency of decisions. Patients are receiving faster decisions and a better service at a time when they are vulnerable. Experienced staff are freed up from mundane admin, able to dedicate time to more valuable activities for the benefit of the NHS and its patients.
At a recent Yorkshire & Humberside AHSN event where CHC2DST was showcased one commissioner commented: ‘“This is a no brainer. It will pay for itself within a month.”
NHS England estimates that 25% of the delays in transfers of care from hospital are down to the inefficiencies in the CHC process and they have prioritised - and incentivised - CCGs to tackle this block.
CHC2DST lets CCGs consign the old paper based assessment process to the bin, meet targets and take another step closer to NHS England’s NHS Paper-Light 2020 Business Vision.