In 2017 it was taking an average of 14 days for the Northern Care Alliance (NCA) to produce its monthly statutory RTT reporting with validators spending 11 working days every month consolidating, reviewing, and re-checking reports. In the booking department, teams were trawling through Excel spreadsheets, relying on their eyes as the only standard of accuracy for compiling PTL reports.  Not surprisingly, an over reliance on manual processes was slowing things down and ultimately impacting client care.

The NCA was concerned that an inability to correctly track and monitor every patient accurately through every step of their care journey was undermining the quality of care it provided, potentially allowing patient issues to go undetected and letting some patients fall through the cracks.

As its first step the NCA approved a Standard Operating Model for pathway management. Insource’s Patient Pathway Plus (PP+) was selected as the technology platform and deployment began across Salford in 2017.

Extrapolating the insights gained from the first deployment at Salford created a compelling case to undertake a complete standardisation of RTT pathway management across the Group and for step two of the project NCA worked closely with Insource to build a change and transformation programme that helped achieve the desired outcomes across the North East Sector (Pennine) and focused on the three key areas of transformation: people; process; and technology.

Norther Care Alliance (NCA) quickly achieved significant improvements in their processes at Pennine, delivering on the identified project objectives in the first three months.

Patient Care

Implementing PP+ identified over 5,000 patients that were not visible in the old PTL and tracking lists.  While these patients were still receiving care, no proper tracking made it impossible to properly manage capacity, resulting in an inefficient system unable to identify opportunities for faster patient care.

Proactive RTT Management

Taking data directly from the PAS/EPR system now applies business rules directly into the solution highlighting data errors early. Now NCA validators, trackers, schedulers, and managers can better manage their RTT position by pro-actively tracking and planning the progress of pathways, rather than focusing on fixing issues.

Confidence in Data Accuracy

PP+ generates a true pathway position daily, eliminating the risk associated with validating out-of-date data and making it possible to actively work on reducing waiting list and breach positions.

Improved Efficiency

PP+ gives accurate visibility of where patients are, across the board, in real time, a critical benefit for an organisation that updates and changes records daily. The Trust now sees its true PTL position and manipulate pathways as necessary, saving valuable validation, tracking, and booking time, providing:

  • Clarity on what action is necessary to safely progress pathways
  • Time back from manual and inefficient processes to act on the above
  • Affirmed ownership of activity

Financial Impact/value for money

The Trust has quickly achieved significant efficiency savings, which is being re-invested into proactively manging RTT activities. Re-investing over 80 hours per month due to considerable time saving on statutory reporting.

Despite great success in highlight operational errors, updated legacy processes that were inefficient and eliminating the clinical risk of inaccurate patient pathways, the technology focus of the implementation incurred some resistance and slowed the uptake of the solution, with many benefits not realised.  Based on insights from the initial deployment, the Trust knew that technology alone would not deliver the change required to implement the Standard Operation Model for the North East Sector and it needed process improvements to deliver the benefits required.

For implementing PP+ across all Care Organisations in the North East Sector, the Trust and Insource lead the project focusing on People and Process, undertaking an operational and transformation project enabled by technology, rather than a technical implementation.  Placing a higher priority on staff engagement ensured greater enthusiasm, contributing significantly to a successful implementation, quickly achieving the target benefits and sustainable use in ‘business as usual’.

The initial successes have already improved the Trust’s standing with the Commissioners, who are more assured of the accurate RTT position.  The NCA plans to expand this level of accuracy and insight to a regional level as it looks to manage elective care waiting lists across the greater Manchester area.

Process Improvements:

  • NCA now invest 138 days saved annually through efficiencies into proactive activity – doing more with existing resources
  • Devolved responsibility for validation into the operational teams has increased delivery volume, empowering those teams to see the impact of their input and make improvements in real time
  • 11 working days a month in time saved by the validation team is being reinvested to address other important data quality issues and tracking patients much earlier in the process to prevent breaches over 18 weeks
  • Data and reporting needed for all access and performance meetings is now accessible daily in one place, avoiding unnecessary manual processing of information
  • Reports are generated automatically or at the click of a button, saving over 15 hours a week in producing reports
  • Teams are moving from reactive pathway validation and data quality issue resolution to proactive tracking patients through their pathways

PP+ has delivered a five-fold increase in productivity through:  reduced costs; validator time reinvested in proactive services; daily accurate PTL reports that expedite and democratise decision making.

This project has also increased patient safety.  By eliminating data quality issues, the Trust now has full confidence in the actual size of their waiting list, dramatically improving the quality of tracking and validation and reducing the risk of patients being ‘lost in the system’.

Feedback to date is positive, with acceptance that technology can make people’s lives easier operationally and administratively for elective care pathway & RTT management. Demonstrating how the new technology could overcome everyday frustrations – like spending up to 10 minutes saving and re-opening a shared document to get the latest information – provided users a chance to see how much more efficient their jobs would become.