Transforming Access, Using Allied Health Professional Referral to Treatment Times to Deliver Improvement

Warwickshire Community Health

NHS Warwickshire Your Health, Our Concern

Transforming Access, Using Allied Health Professional Referral to Treatment Times to Deliver Service Improvement

Transforming Community Services – Beyond Transfer to Transform

Melanie Griffiths

Head of Service Improvement

Chris Howell

Deputy Director of Operations AHP Services

Adam Powell

Head of Information Skills



National/Local Drivers

TCS

Community Information Project

National AHP RTT


Background to AHP RTTMandate: Collection and reporting of AHP RTT data from April 2011 Framing the Contribution of AHPs (DH, 2008) Operating Framework 09/10 and 10/11

Aim To understand the lengths of waits experienced by patients

to access AHP services To understand the reason why a clock has stopped To publish nationally AHP RTT data for benchmarking of

services For patients to use the data to make informed decisions

when choosing which AHP service to access

NHS Warwickshire


AHP RTT as an enablerCommunity Information Project

Allied Health Professionals Referral to Treatment Waiting Times Interim Pilot Sites Report Jan 2011

…development of effective commissioning, …the development of community tariffs, ...the introduction of choice for community services patients via the

Any Willing Provider model (as set out in the White Paper), … will enable front line clinicians to measure and improve their

outcomes, productivity and improve patient safety




Organisational \ Operational Context

Historical long waits

Staff anxiety about the waits

Paper based management information

Poor quality cPAS (IPM Fleming) information

Complaints \Involvement of CEO

Local targets

Needed a focus for AHP service improvement


RTT Pilot Study – setting the seed Pilot Site Winter 2009 All AHP services Executive Involvement Impetus to focus on fact rather than anecdote Information Analyst engagement Service Improvement engagement

Waiting list management Demand and Capacity

Need for easily accessible management information



NHS Warwickshire



Joint Definition Of

Information needs

• Waiting List numbers

• Waiting list profiles

• Demand (Referrals)

• Activity

• Capacity

• Lost Capacity

• Local testing with Teams

• Data cleansing & Validation

• Monitoring by managers

Joint Development of draft Information Tools

Testing with all service managers & teams

Organisational Mainstreaming

• Electronic

• Central

• Easily accessible

• Up to date

• Flexible

• Validated

Our Approach

•Information analyst time

•AHP manager Workshops

•Prototypes

•Access to central repository for information reports (Evolve)


Waiting List ToolsInitial information developed


Demand and Capacity Tools Initial information developed:



Mainstreaming

Stand alone excel reports time intensive

Existing platform for information reports

AHP information technophobes

Analyst support – invest to save



Interactive Waiting List tools now available

1.Filter by Service2.Filter by Team \ s3.Filter by snapshot date



Same filters apply

Very visual cue





Very motivating profile for managers to share





Very motivating profile for managers to act on


Combined AHP services waiting list

NHS Warwickshire


All AHP services - Jan 2010 v Feb 2011

0

50

100

150

200

250

300

350

400

450

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52

Number of Weeks Waiting

Numb

er of

Patien

ts

Number of Weeks Waiting - Jan 2011 Number of Weeks Waiting - Feb 2010

NHS Warwickshire


All AHP Services - % of patients waiting longer than 18 weeks

NHS Warwickshire



Demand and Capacity Tools•Tools to interpret waiting list patterns and manage services

•Same filter principles as waiting list tools

•Accessible, up to date









Successes Workshops for managers

Managers from all AHP services Service improvement, business management &

Information engagement Group support Regular public checking Friendly competition in safe place Hard work and enthusiasm from managers & their

teams Improved understanding \ ownership of waiting lists Improved Information confidence and independence

Because AHP Managers were actively involved within the planning process, the information that is now available to them is relevant and applicable to what they need to see and is hence very popular



Help from Service Improvement Team Demand & Capacity Waiting List Management Mediate between clinicians and information team Help with analysing data

Engagement with Information team 2 way process Information team felt appreciated Clinicians felt listened to Mutually beneficial



Project Benefits Waiting lists have reduced

Data cleansed & reliable

Information is now SMART and transparent

Clinical Managers spend less time collecting \ analysing \ interpreting data

Close monitoring of waiting lists at all times

Demand and Capacity analysis is now the norm

Reduced adhoc requests for information to information analysts

Consistency of information –reviewed \ analysed \ challenged by Management

Changes in the pattern of referral and activity easily monitored – Myths challenged

Business cases \ option appraisals becoming information driven


The Future•Continue to develop current tools further

•Add additional demand and capacity tools

• Roll out the tools to all services – Community & Acute

• Use Statistical Process Control (SPC) charts

•Use this approach for the development of future

management information tools

NHS Warwickshire



Take Home Messages

Although AHP RTT is a mandatory requirement it should be seen as an opportunity for future service improvement involving collaborative working with your Information department.

Don’t underestimate the power of clinicians & information working together in a developmental capacity

Documents

Transforming Access, Using Allied Health Professional Referral to Treatment Times to Deliver Improvement