ICS Update April 2022

Insights for ICSs from Liaison Group, April 2022

Welcome to our latest ICS Update, in which we look at The Institution of Engineering and Technology’s new report for achieving interoperability in the NHS, turning why’s into how’s to improve CHC in ICSs, and the vital role of voluntary organisations as ICS partners.

This month, April, was due to be the month that ICSs formally launched, and as this has now been delayed, we continue to provide consultancy, technology, and solutions to assist ICSs to set up, establish consistency, and make necessary changes to move to their new structures. If we can support your ICS in this endeavour, please drop me a line.

We hope you find this month’s newsletter useful, and would love to hear your thoughts, feedback or experiences on any these subjects. Please share them with us at info@liaisongroup.com.

ICS Update - Andrew Armitage

New report provides recommendations to achieve interoperability in the NHS

A new report, published by The Institution of Engineering and Technology (IET), has put the focus back onto the interoperability of health and care records.

…the publication of this report on the journey to achieving the goal of interoperability will be welcome news.

The report aims to position interoperability as essential to digital transformation of the NHS, and highlights five key recommendations, which it states are necessary for a national initiative to achieve interoperability.

The recommendations include:

  • The introduction of legislation to underwrite agreed national data standards, and mandate NHS organisations and social care bodies to use them for patient records
  • Extension of the 2024 deadline for NHS trusts to achieve a “core level of digitisation”, taking account of the impact of Covid-19
  • Publication of a technology implementation plan for health and care, including a budget with clear milestones and measurable actions for achieving full interoperability
  • The provision of seed funding for accelerated trials of the Trusted Research Environment model
  • Commissioning a data security team to help NHS trusts meet the Cyber Essentials Plus standard.

Speaking after the report’s publication, Dr Lisa Cameron, MP and Chair of the All Party Parliamentary Group (APPG) on health, stated:

“The interoperability of medical records in the NHS is a very daunting task. Obstacles arise including the sharing of highly sensitive personal health information. Shared health record systems have to conform to the UK’s strong legal protections for patient confidentiality and link up technologies developed within a complex network of organisational silos.

“I would like to sincerely thank the IET and all contributors for constructing this report. It highlights key elements of a framework for interoperability.

“There must be robust protections for patient confidentiality; national data and content standards; localised delivery of integrated patient records; and development of the health informatics profession and I support the IET’s work in this area.”

As work continues to move towards interoperability for patient records, and the report’s recommendations are actioned, a framework for implementation will benefit ICSs through consistency and support. With access to records a recurring pain point for patients and their families, the publication of this report on the journey to achieving the goal of interoperability will be welcome news.

Turning Why into How to improve CHC across ICSs

Recently, an ICS in the north of England asked us to help them answer some of the questions they were facing, as they considered how to bring their CHC teams closer together…

…The drive to better understand WHY things are happening and WHY such differences occur is something that ICSs recognise they need to address partly for financial oversight and control, but primarily to improve decision-making and patient experience.

  • Why do we have such a wide discrepancy in the numbers of assessments being requested across our region?
  • Why does eligibility vary so greatly place by place?
  • If management is ‘standardised’, why do we see so much difference in team outputs?
  • One of our places does things very differently from the others – how do we make sure we are seen to be impartially reviewing our processes as we capture and embed ‘best practice’ across the region?
  • What triggers can we identify to explain why relationships with Local Authority partners vary from ‘very integrated’ to ‘fully at arm’s length’, with the strength of those relationships differing from ‘very warm and close’, to ‘distant and verging on hostile’?
  • Why do our fast-track referrals vary so much from Acute to Acute?

Do any of these questions sound familiar?

At Liaison Care, when we talk to individual CCGs and latterly places, we may sometimes discuss the quality of a service with them, and how we can best support them with deliverable-oriented consultancy support. But, more frequently, we find ourselves talking about a lack of supply to meet growing CHC and care demand, which inevitably veers far more towards supporting the organisation with clinically-experienced capacity.

Our discussions with ICS CHC leads are the exact opposite of that, with some debate about resourcing – usually linked to backlogs, budgets, and other risks inherent in those across the region. Far more regularly, we hear a subset of the questions above, many of which have their origins in capability. The drive to better understand WHY things are happening and WHY such differences occur is something that ICSs recognise they need to address partly for financial oversight and control, but primarily to improve decision-making and patient experience.

That is not to suggest that the CHC teams we work with day in and day out are not capable – far from it! We see examples of excellence every day. However, the changing workforce, regularly updating protocols, the introduction of agency and part time staffing solutions, the lack of time for induction and training in best practice, and the real lack of good and insightful management information, means there is a widespread lack of knowledge of HOW things are done at place level, which results in inconsistency.

And with that, the discussion quickly turns to the HOW? How do they ensure that all parties know that their ways of working are being fairly, compassionately, and impartially reviewed? How do they defend and tackle variation whilst identifying best practice? And HOW do they plan for best use of scarce resources?

We took a decision a long time ago as Liaison Care that we would invest, wherever possible, to grow a specialist team of experienced senior clinical nurses and social workers to deliver our capacity; and support them with in-house consultancy when and where that is required.

We take all new team members through a long and intense induction, because we want them to work from their first case as if they have been with us for ever. We also layer Quality Assurance on top of what we do, and hope that our customers notice the difference in the work they receive back from us. Feedback suggests they do – and so we continue to build on this.

In doing this, we have developed a team who are valued by the CHC teams they work with across the country, developing and refining continuing healthcare for the benefit of patients and their families as the NHS’s new structure comes into play. Our team understands the need to move from the WHY to HOW, to enable CHC teams to increase efficiency within their own teams, and consistency across teams covering an ICS.

If Liaison Care can help to answer the questions your CHC team has, please get in touch with us for an initial discussion at info@liaisongroup.com

The vital role of the voluntary sector for ICS integration

Lord Victor Adebowale, Chair of the NHS Confederation, has written on the essential role the voluntary sector can play in enabling the successful integration of ICSs within the NHS.

…voluntary organisations should be able to build on the work they undertake and be treated as key partners in the delivery of health and care…

In recognising that millions of vulnerable people and families rely every day on voluntary organisations delivering huge amounts of care on behalf of the NHS or local councils, and that such organisations played a critical role during the Covid-19 pandemic, Lord Adebowale states that integrated care boards (ICBs) must engage in partnership with the voluntary sector to allow for the successful integration of ICSs across regions.

He writes that voluntary organisations should be able to build on the work they undertake and be treated as key partners in the delivery of health and care, and recommends the use of NHSEI’s published guidance to support ICBs through the implementation of partnerships.

Liaison Group CEO, Andy Armitage, adds:

“We have worked in partnership with NHS organisations for many years, providing support and expertise to help generate savings and help organisations collaborate through our workforce technology. We support these partnerships being extended to charities and voluntary organisations to provide additional care and assistance for patients and their families, and would be pleased to share our experiences in working with the NHS to help these partnerships be put into place.

“There are so many benefits to be gained from working together in the NHS, and we will continue to be supportive of these opportunities as ICSs are implemented.”

To find out more, please get in touch at info@liaisongroup.com

News & Views

A brief round-up of recent articles, guides and blog posts covering news and views on ICSs from healthcare experts…

  • A new programme led by Tim Ferris, director of transformation at NHS England and Improvement, to share ideas on recovering services, redesigning care delivery, and addressing health inequalities, is to formally launch. #SolvingTogether hopes to drive changes that can work across the country to amplify local, regional, and nationwide initiatives, with an aim to “capture, assess and test learning and ideas that can support the recovery of elective services.”
  • The Transformation Directorate at NHS England has published its ‘What Good Looks Like’ (WGLL) guidance specifically to support nurse leaders accountable for digital transformation. WGLL outlines seven success measures that set an established measure of best practice for ICSs and organisations to accelerate digital transformation: they should be well led, ensure smart foundations and safe practice, support people, empower citizens, improve care and work towards healthy populations.
  • The NHS Confederation has developed a set of principles based on conversations with their members and regulators, which they believe should drive the actions of regulators over this crucial first year of system regulation and oversight.