ICSs will be shaped by analysis of comprehensive data on the populations they serve, writes Brian Waters
The UK health and care system is rapidly planning and organising for a return to a world where traditional priorities come back fully into focus, alongside an acceptance that covid is probably here to stay. In the short term at least, there will be no “business as usual”.
The system is confronted with the awful task of waiting list prioritisation on an unprecedented scale. This is taking place against a backdrop of the reorganisation of services across whole Integrated Care Systems, soon to be given a statutory footing.
Complete system insight
However, the plan for working as complete systems across much wider populations does present the opportunity to use data and insights as part of the process like never before. This is essential.
The waiting list problem, on top of longstanding issues such as unwarranted variation in care and overtreatment, cannot be solved by simply doing more of the same. Human resources are finite, and the interruption to many health and social care services will have disproportionately impacted certain groups, including the elderly and those economically disadvantaged.
The financial and social impacts of the pandemic mean that the underlying demand for services is also set to rise as a consequence of increased unemployment and the knock-on impact that has, particularly on mental health. Knowing who these disadvantaged people are in an ICS or wider region will be key to predicting demand, targeting resources and planning the way forward.
Using the most current data to understand and track very targeted local measures and wider health factors across their regions will ensure that the new organisations are able to operate in an agile way, adapting and scaling up new services as demand changes
System leaders know how important the overall co-ordination of a system-led response will be to the most “in need” cohorts of people. As Professor Helen Stokes-Lampard, chair of the Academy of Medical Royal Colleges, pointed out in her response to the government’s new White Paper, legislation itself won’t make collaboration happen. But specific action agreed on the basis of a real understanding of a population’s health needs can be the tool for nascent NHS Boards and Health and Care Partnerships to drive progress in integrating services across the care community. Using the most current data to understand and track very targeted local measures and wider health factors across their regions will ensure that the new organisations are able to operate in an agile way, adapting and scaling up new services as demand changes.
The response to the pandemic has already delivered pragmatic clinical and digital innovation at pace, such as selecting and enrolling patients on virtual wards and other monitoring programmes. Using data to target those most likely to be at risk has been the key. More conditions could benefit from remote monitoring and patient engagement apps. The use of “step down” virtual wards could also be more widely used for supported discharges, with an integrated team consisting of social care staff, consultants, nurses and GPs being on hand to look after the full needs of the individual.
Using this approach across a whole population and a full spectrum of health issues is now a real possibility and an opportunity that cannot be missed. Benefits will include the improved efficiency of the service itself and a more holistic approach to meeting the, often complex, health needs of the people it treats.
System leaders are well aware of the stresses of the last year and their impact on many key staff groups. Planning the full-scale resumption of services using increased intelligence could also be informed by modelling staff availability. A well-resourced and managed work load will be key to supporting the wellbeing of staff and delivering excellent care.
As ICSs form, mature and take on a statutory footing they will need to be shaped by analysis of comprehensive data on the populations they serve. This will help them move forward as one, with a common understanding of the task in hand and a shared focus.