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How digitalising continuing healthcare service helped our CCGs meet the national target


By Karen Smith
4 December 2018

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Cheshire and Wirral CCGs, including South Cheshire; Vale Royal; Eastern Cheshire; West Cheshire; and Wirral, realised that using the national paper forms made it difficult to manage the continuing healthcare (CHC) assessment process efficiently.

They therefore made the decision to eliminate paper-based processes and automate workflow to drive productivity, increase the speed of decision-making and improve patient experience.

Karen Smith, service lead, NHS Continuing Health Care and Complex Care at the five CCGs explains why the change was implemented.

The problem

Patients under CHC and complex care are often the most vulnerable patients. They have needs that have arisen as a result of a disability, an accident or illness, so it’s vital that their cases are assessed, reviewed and managed in a timely manner and according to the national framework.

NHS England’s target is for 80% of patients to receive a decision in relation to CHC eligibility within 28 days to ensure they get the care they require in the appropriate environment and without unreasonable delay.

A year ago, we weren’t reaching this target but today it’s a different story. 

The solution

There were several points of access with inconsistent handling and a paper-based world meant there were sometimes lost referrals and no overview when it came to who was waiting for assessment.

We needed to drive greater integration in health and social care, from acute care to community health providers, so transparency was key.

We knew we needed a paperless system so we decided to work in partnership with IEG4 – a company that provides software solutions – to develop a cloud-based system known as continuing healthcare end-to-end digital solution (CHC2DST).

The system is a web-based referral portal, which includes the Department of Health and Social Care checklist and web-based workflows, assessments and decisions.

All stakeholders involved in referral and assessments can use the software, including social workers and community, hospital and CCG staff. They all utilise the platform to make referrals and create assessments, upload documents and collaborate with the multi-disciplinary team to agree on the funding recommendation.

The challenges

As this idea was the first of its kind, the team met with IEG4 to look at digital assessments they had developed for other public-sector organisations to see what had been made possible for them.

The company soon realised that it was able to develop a digital process that would be suitable for our needs and came up with a proposal for an eight-month development phase. This was submitted to the SBRI Healthcare competition – an NHS England initiative that promotes UK economic growth – and the CCG collective won a small amount of funding for the project.

At the end of the initial development period we had a product ready for implementation but still worked with IEG4 to resolve roll-out issues and continue to develop the product based on user feedback. 

The results

By digitising paper-based processes, we have achieved a reduced admin burden, improved service speed, quality, and reliability and boosted assessment productivity and staff morale.

Within six months, we increased the percentage of patients receiving a decision in relation to NHS CHC eligibility within 28 days from 68% to 82% ’ – exceeding the 80% target.

With the previous system of working, patient details would have to be handwritten manually, taking up 15 to 20 minutes each time, and this might then have happened multiple times.

As such, the paper-based process – from referral through to assessment and review – could cause extensive delays in processing. Staff can now completely automate this process, which means they can do more in less time. With the support of IEG4, CHC2DST has allowed a more consistent assessment process, which means decisions can be made on the same day.

Overall, we have achieved a consistent and thorough approach. Time saved on administration tasks has allowed better resource allocation and allowing staff to speed up the decision-making process improves patient experience, which is paramount for us.

Service lead, NHS Continuing Health Care and Complex Care at Cheshire and Wirral CCGs

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