Community health service planning: High-quality data is the starting point

The quality, relevance, and availability of data has always been a challenge for community services. Working in silos and a block-funding mechanism that doesn’t incentivise the need to understand granular activities is compounded by the shifting of community contracts between providers struggling to implement standards across an organisation. Many community trusts have developed ways of working and capturing information and data that don’t align either with their peers or national standards, such as the community services data set (CSDS). In many cases different parts of the same provider will adopt different standards or ways of working that make data incoherent or incomparable.

Community data is often inconsistent, with the local configuration of clinical systems allowing these problems to be perpetuated. This leads to challenges in measuring activity, patient outcomes, and productivity alongside soft metrics, such as workforce wellbeing, resulting in investment cases or savings plans that don’t have an evidence base. The historic reporting asks from commissioners have added to the inconsistency rarely aligning to one another or national counting rules. This is compounded in ICBs where funding is being more centralised, and as other providers vie for the same resources and financial pot they’re rightfully questioning where investment should be prioritised.

Block contracts which haven’t been updated to reflect changes in demand post-COVID-19 haven’t supported the necessary mindset to truly understand the value of community services and their future potential. NHS England are publishing new currencies for use in 2025/26, signalling a move to a more standardised approach to using data to inform funding for community care, and if latest reports are to be believed, the Government is favouring a return to competition and choice to drive up standards. 

The financial incentive provided by Payment by Results (PbR) drove improvements in acute data in the decade preceding COVID-19. However, the need for high-quality data extends far beyond financial motivations, as illustrated in the graphic below. Delivering the 10-year plan will require a better understanding of community services at the national, regional, and local level. Good quality data puts the patient at the centre of decision making. 

Clinical system optimisation

To support their clinical teams, trusts need to ask if their systems are optimised and structured to make life easier for them and make data-capture a byproduct of their decision making. Are systems designed to create structured data using simple forms or codified fields rather than lengthy narrative or journal information which make reporting impossible? One example is using a standardised wound-care template that consistently captures pertinent information, supports improved management, and returns data that can be used for improving patient experience and provides clinical improvement opportunities.

Structured simple forms with defined clinical entries supports ease of use and standardisation that yields consistent data aligned to accurate reporting definitions. There are scenarios where nurses have had options to record over 280 different referral sources, many of which were irrelevant, incorrectly spelt, or not adhering to the data dictionary. These systems need to be owned by the clinical community so success can be delivered by strong clinical information teams who are integrated into the service.