The role of interoperability in ICS digital transformation

Have you sat in a development meeting for your ICS recently and heard the phrase, “our systems should be interoperable”? Maybe you nodded in agreement, but aren’t really sure what that means, or how it applies to your system? If that is the case, hopefully we can help to make things a little clearer…

What does ‘interoperability’ mean?

Interoperability is the ability for computer systems and software to easily exchange and make use of information. Within healthcare, effective interoperability allows for increased collaboration and system working to enable streamlined processes and effective sharing of resources and data. NHSE describes this as “key to the delivery of the future vision of care in England.”

Why is interoperability important?

NHS organisations are now required to align their in-patient, emergency care, mental health discharges and outpatient letters to nationally published specifications, as detailed in the NHS Standard Contract.

This states that healthcare providers should ensure that their IT systems allow clinical data, such as the documents listed above, to be accessible to other providers of services as structured information, in accordance with Open API Policy.

NHS organisations seek choice in the systems they use and for their data to be transferrable between those differing solutions without the need for manual intervention and re-entry.

Therefore, the solutions available should offer true interoperability in order to ensure that they align with other digitised solutions via Open APIs. In doing so, NHS organisations benefit from subsequent time and financial savings being redirected into other areas, including patient care.

What are the challenges?

A lack of standards mandated by the NHS has inhibited widespread system interoperability, meaning that not all systems are compatible for the transfer of data.

However, Liaison Workforce has worked with NHS Digital to provide the protocols and standards to enable interoperability between NHS Workforce Deployment systems. These standards have also been made a mandatory requirement of the Health Systems Support Framework (HSSF).

Interoperability in action

Our temporary staffing interface allows Roster Managers to identify the need for additional temporary staff in a roster, raise a request directly from the roster itself, and have this vacancy filled, via mii Flexible Workforce’s integrated solutions. Once a candidate has filled that vacancy through bank or agency, the successful candidate will appear on the roster alongside the regularly rostered staff.

We have used NHS Digital’s Data Model 4.0 standard to build this interface with partners, allowing organisations throughout the NHS to benefit from interoperable systems, and releasing staff to focus on more value-adding tasks.

Similarly, we have also recently developed a fully integrated working API within mii Tasks, whereby data on lateral flow staff testing is brought into our data warehouse so that we can offer enhanced reporting to our clients. This allows us to benchmark trusts against each other for ongoing monitoring and improvement, whilst we can also use it to check data for invoicing purposes.

Going forward

Covid-19 accelerated digital uptake across the NHS, with collaboration and interoperability being more important than ever before in providing greater opportunities for a new way of working.

Liaison Workforce is committed to developing and implementing interoperability which is truly fit for purpose, and which helps forward-thinking ICSs to generate cost-savings and improve the use of their workforce, ultimately leading to overall improvements in patient care.

To find out more about how Liaison Workforce can support your organisation’s interoperability efforts, please get in touch at info@liaisongroup.com

Workforce Planning “At The Heart of Solution” to Burnout

Workforce planning is “at the heart of the solution” to workforce burnout and resilience, MPs on the Health and Social Care Select Committee have said in a new report.

The report, which follows the Committee’s inquiry into workforce and staff burnout in the health service, has concluded that workforce burnout across the NHS and social care has reached an emergency level and poses a risk to the future functioning of both services. It adds that only a “total overhaul” of workforce planning can provide a solution.

The Committee has noted that Covid-19 has had a huge impact on workforce pressures, but says that witnesses told them of staff shortages across the health service prior to the pandemic. It adds that such shortages are the biggest driver of workforce burnout.

On workforce planning in the NHS in particular, the report says:

  • Available funding is generally the driver behind planning, rather than the level of demand or staffing capacity needed to service it.
  • Witnesses generally agreed that the NHS workforce was overstretched and had been for some time. The Committee heard that the current approach to workforce planning was “incoherent” and that the current level of funding for education and training was “inadequate”, with the NHS reliant on overseas recruitment.
  • Staff shortages are “endemic” across the NHS and not restricted to one area of health and social care. The report noted the high levels of vacancies immediately prior to the pandemic, including the need for 40,000 extra nurses in England alone.
  • It concludes that without adequate funding, the NHS People Plan’s aspirations will not become reality and its delivery will depend on the level of resourcing allocated to it. It also concludes that annual, independent workforce projections would help provide the health service with the clarity required for long-term workforce planning.

In the report, the Committee has recommended on workforce planning that the Department for Health and Social Care publishes regular, costed updated along with delivery timelines for all of the proposals in the People Plan. It has also called for objective, transparent and independently-audited annual reports on workforce projections that cover the next five, ten and twenty years including an assessment of whether sufficient numbers are being trained.

Chair of the Committee, Jeremy Hunt MP, said: “Workforce burnout across the NHS and care systems now presents an extraordinarily dangerous risk to the future functioning of both services.

“An absence of proper, detailed workforce planning has contributed to this, and was exposed by the pandemic with its many demands on staff. However, staff shortages existed long before Covid-19.

“Staff face unacceptable pressure with chronic excessive workload identified as a key driver of workforce burnout. It will simply not be possible to address the backlog caused by the pandemic unless these issues are addressed.

“Achieving a long-term solution demands a complete overhaul of workforce planning. Those plans should be guided by the need to ensure that the long term supply of doctors, nurses and other clinicians is not constrained by short-term deficiencies in the number trained. Failure to address this will lead to not just more burnout but more expenditure on locum doctors and agency nurses.”

In response to the report, the Royal College of Nursing’s Acting General Secretary, Pat Cullen, said: “The unprecedented demand on nursing staff during the pandemic has had a huge impact on their own wellbeing. But, as this report shows, the cracks in the systems designed to look after nursing staff appeared years ago.

“The Department of Health and Social Care needs to prevent more nursing staff ‘burning out’ or leaving the profession entirely by boosting recruitment and retention.

“The forthcoming Health and Social Care Integration Bill provides an important opportunity to address this by making population-based workforce assessments and overall safe staffing levels of the whole health and care system a legal duty for the Health Secretary.”

Liaison Workforce Managing Director, Judith Shaw, agrees: “We are hearing time and time again about the necessity to have effective workforce planning in the short, medium and long term in order to address staff shortages and avoid staff burnout. This is so essential across all levels of staffing for the everyday wellbeing of staff, many of whom find themselves covering gaps or ‘making do’ without support and were doing so before Covid, the pandemic has just exacerbated the situation.

“We continue to offer the solutions and expertise to help. For example, our workforce demand and risk planning tool – mii People Planning – facilitates a digital conversation with managers on a regular basis, allowing them to actively identify critical issues associated with the fair and equal management of talent, addressing skills gaps, retention and performance challenges. The use of such a tool connects the HR function directly to frontline health and care, enabling better and long-term workforce planning across an integrated care system.”

To find out more about mii People Planning, or to discuss how Liaison Workforce can support your trust’s workforce planning requirements, please get in touch at info@liaisongroup.com

Where does CHC fit in the ICS structure?

Continuing Healthcare (CHC) can and will play an important part in the transition for ICSs to focus on home- or community-first healthcare provision.

Currently, CCGs are the legal entity responsible for CHC, but given the ever-expanding requirement for community-based long-term care, should ICSs be thinking bigger and bring CHC under their holistic remit to allow them to enjoy the wider benefits of integration?

CHC already represents a major outlay in an ICS’s annual budget, and so must be a key part of the journey from local control to ICS. So how can ICS leaders position CHC to ensure it sits as a key part of the ICS structure, to benefit both the system and more crucially, their patients?

Standardising CHC across the system

Requirements have already been laid out for CCGs to standardise CHC to the same high quality of care across a system, thereby increasing efficiency and improving the patient experience. This includes closer integrated partnerships with social care, primary care and the third sector to improve links between community-based care and CHC. The aim of such formalised partnership agreements should be to ensure consistency and quality of approach and delivery of care where required.

CCGs, and more widely, the ICS, should of course look to continue to make better use of technology – such as video conferencing, which has seen a far higher take up across all health services throughout the pandemic. We now know that ‘remote’ reviews allow CHC teams to work effectively for the benefit of patients and their families. They can structure their workload to diary and conduct assessments and reviews differently, thus improving efficiency and reducing review backlogs for the team, and potentially reducing costs for delivery of the same or better services.

Whilst these are seemingly simple transformation steps, they may provide a starting point for the wider transformation and integration of CHC within a system, reducing or removing any suggestion of ‘postcode lottery’ around eligibility, and leading to improvements in both spend and care, with overall benefits both to the ICS and to patients.

To find out more about how Liaison Care can support ICSs and CCGs to transform and improve their CHC services, please get in touch at info@liaisongroup.com

 

How virtual wards can help reduce the NHS backlog

Our partners at Infinity Health have been looking at virtual wards and how they can be used to reduce the NHS backlog, cut delays in hospital discharge and free up hospital beds. To read more, please visit their website here.

In Conversation With… Patrick Mitchell, HEE

Catch up with our latest In Conversation With, with Health Education England’s Patrick Mitchell. From the role of informaticians, to the impact of having a data-led workforce, Patrick and Julia Tybura, Non-Executive Director of Liaison Group, explore how the NHS can use data to design the NHS workforce around the needs of the patient.

Available as a video, podcast and transcript for your convenience, you can find it here.

News & Views

  • NHS England has asked integrated care systems to develop ‘fully staffed’ long covid treatment plans in the next month, and is providing £70m to enable them to do so. Read more.
  • Andrew Fenton, Transformation Director at NHS South, Central and West CSU, reflects on a re-energised NHS focus on health inequalities, and the vital role of ICS and place-level partnerships. Read more.
  • Lou Patten, ICS Network director at the NHS Confederation and chief executive of NHS Clinical Commissioners, comments on the ICS Design Framework. Read more.