ICS Update March 2022

Insights for ICSs from Liaison Group

In our first ICS Update of 2022, we’re looking at how systems can benefit from the launch delay, reporting to quickly identify staff shortages, the digital transformation strategy, and the feeling of déjà vu for CHC teams as they again are challenged by funded targets. We also provide a summary of our latest People Analytics research, conducted with the members of the HPMA.

We hope you find this month’s update 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

How can ICS leaders benefit from an additional three months until launch?

When it was announced that the official launch date for ICSs was being shifted by NHS England from 1st April 2022, to three months later, on 1st July 2022, many ICS leaders may have found themselves looking for the positives for their system. Whether an ICS is already running, or still finding their feet in system working, the additional weeks before formal launch does offer some opportunities.


by Andrew Armitage, CEO, Liaison Group

…the delay may be used to ensure that essential programmes, education and support can be put into place to allow for smoother transition to collaborative working.

Many senior leaders within ICSs, and particularly those with clinical commitments, are likely to have found themselves again in need of prioritising the treatment and care of Covid-19 patients over the set up of system collaboration. As the most recent wave of the pandemic shows signs of easing, the delay provides recovery time to refocus on the needs of the ICS.

The delay in formally launching the ICSs creates problems in empowering ICB and ICS leaders to manage a place’s health needs, with CCGs unable to be phased out, as well as an anticipated issue of creating two year-end periods, just three months apart.

However, the additional time does allow for further collaborative conversations to take place, ensuring that all parties within the system, both hospital- and community-based, are fully aware of processes and requirements.

All NHS leaders will be all too familiar with the difficulties of embedding new technology and processes within trusts. It can be expected that processes and platforms will be required to change in at least some partner organisations within a system, and so the delay may be used to ensure that essential programmes, education and support can be put into place to allow for smoother transition to collaborative working. In those systems where more than one CCG is required to come together, the delay allows a potentially messier move more time to be supported and transitioned.

The delay also allows ICS leaders to continue to focus on the system architecture, and with many still planning to be up and running by 1st April regardless of the delay, the date shift creates a period of shadow operation to enable testing. With that, the system will be in place and running by 1st July, with the staff, contract and ledger transfers taking place on that date.

A delay is never ideal, and not what ICS leaders will want when facing the transition from CCGs to broader system working, and the challenges that the process creates. However, where benefits – or silver linings – can be found, we would hope to see the transition become advantageous for everyone involved, from management to patient.

Plan published for ICS digital transformation

At the end of 2021, NHSX, now part of the NHS Transformation Directorate, published its strategy for digital transformation across the NHS.


…there is an emphasis on providing support to empower ICS leaders to actively develop digital transformation within their systems and ultimately achieve a universal baseline-level of digital maturity…

The plan, it states, is intended to describe what is being commissioned, and ‘what is being delivered when’, to enable frontline leaders to ‘plan with confidence’ and to provide ‘an understanding of the change being undertaken centrally’. Upcoming commitment milestones given in the plan include:

  • By January 2022, to have a digital people strategy for the workforce ‘which recommends the utilisation of existing, nationally provided tools that enable cross-organisation working, reduces the burden on frontline staff and allows staff to work more efficiently and flexibly’.
  • Also, by January 2022, for target architecture to be developed which will ‘enable providers to develop and refine the capabilities required to deliver services which will help to reduce inequalities, enhance efficiency and productivity and value for money’.
  • By February 2022, through collaboration with NHSEI, ICSs will ‘use Population Health Management analytics to make data driven decisions’ to support ‘COVID recovery and future system planning which will reduce health inequalities’.
  • By March 2022, ICSs are to be given a ‘place support offer’ to help them implement the What Good Looks Like guidance and produce a three-year digital transformation programme.

As can be seen through these commitment milestones, there is an emphasis on providing support to empower ICS leaders to actively develop digital transformation within their systems and ultimately achieve a universal baseline-level of digital maturity, including digitised health records, cyber security, skills, and connectivity.

Liaison Group CEO, Andrew Armitage, comments:

“Whilst the aim of reaching digital maturity across systems has long been an aim of NHS leaders, it is positive to see a plan and intentions come to fruition to help this become a reality. Digital ability and capability varies across systems, and the opportunity to work from such a plan will enable greater local collaboration and ultimately deliver better efficiency for staff teams.”

 

You can find the Digital Transformation in Health and Care delivery plan here

Daily staffing report proves invaluable in easing the pressure of understaffed wards

A few weeks ago, a Trust came to us with a common problem… they were finding that they were only able to find out about the staffing shortages within their wards and departments retrospectively, meaning that teams were often left short-staffed for shifts and individuals were faced with the pressure of covering for staff absences whilst also completing their own tasks and providing care.


…we understand which wards and staffing groups you would most like to monitor are prioritised within the data, to ensure it has the most impact on planning and recovery…

Using the data they provided, we were able to produce a report, the Daily Staffing and Unavailability Look Forward report, which is proving invaluable in saving staffing teams considerable daily administration time and allowing them to quickly act on upcoming staffing challenges.

The report validates data from existing workforce systems, proving a snapshot of staffing shortages today, tomorrow and the following day. Teams are then able to action the gaps identified at speed, accessing their staff float or collaborative bank to fill shortages before shifts begin.

We all know that staffing pressures have long been an issue across the NHS, and with the current anticipated challenges of mandatory vaccination meaning that staff may be lost or need redeploying, the strain of ensuring that shifts are filled and care is provided at safe levels for both staff and patients has never been felt more.

The Daily Staffing and Unavailablility Look Forward report is available for use across systems and NHS organisations, and is completely bespoke to their needs of the trust or ICS. It can be adjusted to ensure that we understand which wards and staffing groups you would most like to monitor are prioritised within the data, to ensure it has the most impact on planning and recovery.

At a time when the NHS continues to face staffing issues exacerbated by Covid-19 and its ongoing fallout, the report allows systems and workforce leaders to take a step towards getting on top of workforce shortages and accessing fast information to ease the pressure on staff, and allow the focus to remain on providing high quality patient care.

To view an anonymised version of the Daily Staffing an Unavailability Look Forward report and discuss how it could benefit your organisation or system, please get in touch at info@liaisongroup.com

Déjà vu for CHC across systems

Are Continuing Healthcare (CHC) teams feeling a sense of déjà vu? It wouldn’t surprise us, as they face similar pressures to last year’s year-end with 2021’s Covid-19 backlog now replaced by Discharge to Assess (D2A) and all the challenges that it brings?


Phil Church, Managing Director, Liaison Care

…making use of an experienced CHC managed service, such as Liaison Care’s specialist team, who have the skills and expertise to support with either D2A or day-to-day reviews and who can do so quickly and efficiently, will help CHC teams to get back to business as usual…

In Q4 of 2020-21, CHC teams found themselves in a rush to meet funded targets for 3- and 12-month reviews backlogged by the temporary suspension of CHC during the first wave of the global pandemic. As a result, a lot of in-house resource went towards meeting these targets before the 31st March deadline, possibly at the expense of incoming routine reviews. This led to some pretty acute short-term resource issues, with many CCGs and systems turning to external providers, including Liaison Care, to help manage needs and meet expectations.

Jumping forward to this year’s Q4, and the pressures on CHC teams look remarkably similar. Across the NHS, and within individual ICSs, there is a need to rapidly turnover beds to help manage growing waiting lists – again exacerbated by the latest Covid-19 wave – with extra bed capacity needed for both Covid patients and to support higher elective recovery.

To enable the increase in bed spaces, many systems have looked to place some elective procedures with the private sector, as well as utilising collaborative working practices to optimise use of the trusts which have greater capacity within a system. Additionally, trusts have looked to make full use of D2A: sending medically optimised patients out of hospital ahead of completing the usual pre-discharge procedures of establishing care needs, available funding, etc.

D2A is currently funded from central funds for four weeks and is very closely monitored and measured, and is again putting CHC resources under strain. Therefore, teams are again facing similar pressures to the previous year, as a payment regime places an artificial drain on resources, and a necessity to redirect resources to meet D2A requirements and assist in the freeing up of essential bed spaces.

If D2A is not completed within the set four week timeline, the process could lead to the patient being unable to access ongoing care needs or facilities, which could then lead to further health issues going forward, a negative patient experience and further drains on the system.

Additionally, if a patient leaves hospital with a fully funded package of care, there can be an expectation set with that patient that their care needs will always be funded in that way. If their case is then not managed carefully and with proper communication, any changes to their care package once assessments are complete can lead to further disappointment, and a risk for future complaints and additional reviews as a consequence – again leading to more pressures for the CHC team.

Like last year, this leaves many CHC teams struggling to complete D2A assessments, as well as ‘business as usual’ reviews. The resolution for many teams will mean falling back on agency staff or short-term managed services to assist with the provision of reviews or to look after the day-to-day CHC Decision Support Tools (DSTs) which are again in danger of slipping into arrears, as they were the previous year.

Taking on agency staff to support the additional D2A requirements comes with its own consistency and training risks, and can add to variability in decision making and care management. Variations in quality will also add to the problems, with potential increase is patient funded who are not eligible, complaints and appeals. Therefore, making use of an experienced CHC managed service, such as Liaison Care’s specialist team, who have the skills and expertise to support with either D2A or day-to-day reviews and who can do so quickly and efficiently, will help CHC teams to get back to business as usual and again manage the pressures, hopefully lessening that feeling of déjà vu.

To speak to Liaison Care about support for systems and CHC teams, please get in touch at info@liaisongroup.com

People Analytics – A priority for NHS workforce leadership

In November 2021, the Chief People Officer for NHS England, Prerana Issar, published a report on ‘The future of NHS human resources and organisational development’. Within this, an action was identified for organisations and systems to have “high quality reporting of people data and insights, enabled through the use of digital services to support effective, informed decision making”.


…the report provides recommendations for the successful application of People Analytics at organisational and system level to benefit the NHS workforce.

At the same time, the Healthcare People Management Association (HPMA) and Liaison Workforce conducted a survey of HPMA members to establish where NHS organisations currently stand regarding the use of People Analytics, and the barriers and drivers to implementing a People Analytics platform for this.

The survey found that 97% of organisations who responded stated that People Analytics was a priority.

In the resulting report, the use of People Analytics is recommended to meet the Chief People Officer’s action to “establish data standards across multiple people digital systems to enable interoperability and informed decision making.” Overcoming the barriers within NHS organisations and systems to the implementation of People Analytics is essential to meeting this ambition, and the report provides recommendations for the successful application of People Analytics at organisational and system level to benefit the NHS workforce.

For your copy of ‘People Analytics: A priority for NHS workforce leadership’, please visit: https://liaisongroup.com/people-analytics-a-priority-for-nhs-workforce-leadership/

News & Views

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


  • The number of patients in hospitals who are ‘medically fit’ to leave has increased in January, despite NHS England targets for trusts to dramatically reduce the numbers. The increasing delayed discharges come amid ongoing high staff absence rates in the NHS and social care, with many care homes closed to new admissions due to covid outbreaks. Read more
  • The government’s preferred candidate to chair CQC, Ian Dilks, says it should not ‘sit in an ivory tower and dream up what it thinks good looks like’ when it starts rating ICSs. Read more
  • All ICSs are required to have a System Quality Group, focused on enabling quality improvement across the health and care system. The new guidance published on Friday 21st January replaces the National Quality Board’s previous national guidance on Quality Surveillance Groups.
  • Dr Neil Modha and Hashum Mahmood report on how Cambridgeshire and Peterborough CCG is aligning resource with need, not head count, in NHS Confederation’s latest blog: Resetting human and financial resource in general practice.
  • Louise Patten, director of the NHS Confederation’s ICS Network and chief executive of NHS Clinical Commissioners, publishes a new blog – ICS delay muddies leadership and threatens accountability, which states that poor communication about ICS delays hasn’t helped what can be an already difficult situation.