New Care Models – The Answers Are Out There

With the election put to bed and with a five years of stability now guaranteed (ahem…) NHS England have free rein to push forward on implementation of The Five Year Forward View (FYFV). Indeed the word on the street is that the pace of change is likely to become faster and more radical. This is service transformation on steroids and new care models (NCM) are the new black.

At the recent NHS Confederation Conference, NHS England and its partners published the ‘Five Year Forward View: Time to Deliver’.

If nothing else it was helpful to have the scale of the challenge re-stated. If anyone was in any doubt then we all now know what these challenges are and what the new care models are intended to achieve. A useful aide memoir might be ‘mind the gap’ because as Time to Deliver reminds us we need to:

  • Close the health and wellbeing gap
  • Close the care and quality gap
  • Close the funding and efficiency gap

Once read the first thing I did was to issue to all staff at Sollis. My message was simple: if we want to continue to engage with the NHS and be taken seriously then our value proposition had better have something that helps our customers and prospects close those gaps. Sollis has to be part of the ‘making things better’ story.

I exhorted my colleagues to conduct an immediate review of their current work activities. In the politest terms possible I advised that if their current work programme didn’t offer solutions that addressed these challenges directly then they should stop what they were doing and do something that did!

You can’t escape the primacy of new care models in the FYFV narrative. If you haven’t counted the number of references in Time to Deliver then I’ll save you a job. There are twelve. Yes twelve. I think Mr Stevens is serious.

This is important, particularly to someone running a health analytics company with a focus on population health management (PHM) and population health analytics. Mine is a simple and consistent mantra here at Sollis. I have long held the view that the value of analytics and business intelligence in general is to be found in how it helps make things better… in this case how it helps improve the health and social care system. For commissioners the value of the analytics is to be found in the quality of the decisions taken by CCGs and how it helps them deliver service transformation.

Put another way. It’s about the interventions, stupid.

When we talk about new care models we are essentially talking interventions and in this context FYFV pushes hard on the role of the 29 Vanguards.

But as the FYFV readily concedes, ‘One size will not fit all’.

There are plenty of good examples of new care models being developed now without a Vanguard in sight. The Wandsworth CCG PACT (Planning All Care Together) Programme is just one of many examples here in the UK.

Over the pond there are surely lessons to be learnt from initiatives such as Guided Care. The issue of growing numbers of an ageing population with complex health needs (co-morbidities) is of course not unique to the UK. The Guided Care model is borne out of the US and was established to address the problems of inefficiencies and high costs when servicing the needs of patients with chronic illnesses or co-morbidities.

Its implementation has already been the subject of a number of evaluations and peer reviews. This is important because when implementing a population health management strategy an important component of that strategy must be to evaluate outcomes. It is vital we determine the effectiveness of the intervention.

Research shows that the Guided Care model – which places a strong emphasis on chronic disease self-management – can help empower patients to become more informed and active in their own health care, resulting in improved quality of life and lower health care costs.

The findings seem to suggest that Guided Care might have a positive impact in helping to close those gaps associated with health and wellbeing, care and quality, and efficiency.

From where I sit, and with the FYFV challenges in mind, this sounds like something worth exploring, not least because the Guided Care model is shaped by the lessons of 30 years of research in chronic care.

In my long experience of working with the NHS I don’t think it too controversial to assert that the service has a questionable record in learning from best practice elsewhere in the system, be that at home or abroad.

In the rush to create the new, sometimes it pays to step back and consider what is working now.

Some of the answers at least may already be out there.