The NHS is an enormous institution covering multiple services and organisations throughout the country. Determining where and how to apply resource to give the best care to patients and value for money to taxpayers is no easy task.
Add to this the ever-changing nature of medical technology and best practice, and you're left with a tricky tangle to unravel. Thankfully, the NHS also has access to a great deal of clinical data that can inform and direct your decision-making on managing current patient-care pathways and determining future models.
Cost information needs to describe the whole pathway, not just each organisation’s view. This means the data and methodologies for costing must be consistent and comparable across the settings, as the reliability of data in non-acute settings, such as community services, is just as important as in-patient data in this new world.
To support you in taking a holistic view to patient data, we've been working with the Healthcare Financial Management Association (HFMA) to improve the quality of the data the NHS can use to describe patient care and determine accurate national and local costs.
The HFMA professional body for finance staff working in healthcare is a charitable organisation that promotes the highest professional standards and innovation in financial management and governance across the UK health economy through its local and national networks. It's provided independent support and guidance to its members and the wider healthcare community for over 70 years.
The association analyses and responds to national policy and aims to exert influence in shaping the healthcare agenda. It also works with other organisations with shared aims in order to promote financial management and governance approaches that really are ‘fit for purpose’ and effective.
Among the most-valuable data available to the health service is patient-level cost information. This was highlighted by recent consultations on proposed policy changes, which have also signalled that patient-level data will play a greater role in the funding and management of patient care.
Moving from costing based on averages to costing the actual care individual patients receive is now critical to delivering value. This provides detailed information about how resources are used at patient level and supports the reduction in unwarranted clinical variation. For example, extra staff, unused drugs and unnecessary diagnostic tests.
Still, the NHS is finding challenges with sourcing the right data at the patient level. The HFMA’s Healthcare Costing for Value Institute recently surveyed its members on issues with clinical data. The survey highlights issues in three key areas:
A lack of robust activity data for community and mental health services means Integrated Care Systems (ICS) will struggle to understand the use of resources across patient pathways. The move to collaborate and integrate pathways across providers and systems is a key part of the recently proposed NHS reforms.
Issues about the quality of the data for auxiliary clinical systems, such as theatres, pathology and medicines, will also make it hard to plan future models of care.
Concerns about some of the quality of workforce and infrastructure data, including fundamental information on where clinical staff spend their time.
We know from our work with the NHS that producing accurate clinical and cost data is vital to providing the right care to the right patient in the right place. This has never been more clear than during the events of the last 12 months.
COVID-19 has fundamentally changed the NHS and accelerated digital transformation, overhauling urgent care-pathways, and necessitating the introduction of zoned spaces in hospitals. The quality and depth of costing data will be critical in supporting the NHS as it restores services, resets system financial baselines and responds to future challenges.
Our firm's work across multiple sectors has shown us that management information improves when boards and leaders understand the importance of data quality and governance, particularly the part they have to play in it.
Accurate, available intelligence is essential for clinical leaders to make informed decisions, and it's becoming increasingly clear that the NHS faces challenges in this area. We hope our work with HFMA will support the health service in levelling-up their data utilisation.
Over the next few months, we'll be continuing our work with the HFMA and partner trusts to provide practical support in improving clinical and costing data in key areas. We'll publish a second joint briefing outlining these solutions once this work is completed.
For further information on optimising NHS data collection, contact Howard Davis.