Cheshire and Wirral Clinical Commissioning Groups (CCGs) has made the decision to eliminate paper based processes in the Continuing Healthcare (CHC) Assessment process and instead automate workflow processes to drive productivity, increase speeds in decision making, and in turn, improve the patient experience.
Patients under Continuing Healthcare and Complex Care are often the most complex and vulnerable patients. They have needs that have arisen as a result of disability, accident or illness, so it is vital that their cases are assessed, reviewed and case managed in a timely manner according to The National Framework.
The NHS England target is for 80% of patients to receive a decision in relation to NHS CHC eligibility within 28 days to ensure individuals receive the care they require in the appropriate environment and without unreasonable delay. A year ago, Cheshire and Wirral CCGs were not reaching this target but today is a different story. Within two quarters, they increased from 68% to 82%, a marked improvement and excelling targets.
There were several points of access with inconsistent handling and a paper based world meant that there could be lost referrals and sometimes no oversight on who was waiting for assessment.
Cheshire and Wirral CCGs needed to drive greater integration in health and social care, from acute care to community health providers so transparency was key. They knew they needed a paperless system so therefore decided to work in partnership with IEG4 to develop a cloud-based end to end digital solution called CHC2DST.
The system itself is a web based referral portal which includes the Department of Health checklist, web based workflows and assessments and decisions. All stakeholders involved in referral and assessments are created as users of the software, i.e. Social Workers, Community, Hospital and CCG staff all utilise the platform to create referrals, assessments, upload documents and collaborate for the MDT to agree on the funding recommendation. The transparency of the process has improved dramatically and for their stakeholders has improved collaborative working and that in itself has improved the efficiency in the process.
With the previous way of working, patient details would have to be handwritten manually – taking up 15 to 20 minutes each time – and this might then happen multiple times. As such, the paper-based process from referral, assessment and review could cause extensive delays in processing. They can now completely automate this process. This means processes are easier for staff so they can do more, in less time.
Karen Smith, Service Lead, NHS Continuing Health Care and Complex Care at Cheshire and Wirral CCGs said: “CHC2DST has allowed a more consistent assessment process meaning that decisions can be made on the same day. We also have an audit trail of decisions made with ability to record the rationale for the decision.”
Overall, Cheshire and Wirral CCGs have achieved a consistent thorough approach and time saved on administration tasks has allowed for better resource allocation.
By pioneering this, they have shown how performance can be turned around in a very short time frame and highlighted to other CCGs considering the CHC2DST implementation that it can be done. Allowing staff to speed up decision making, in turn improves the patient experience, which is paramount for the CCGs.
Smith concludes: “Technology has been key to us on our transformation journey, but the engagement of staff has been critical. By involving them from the start and letting the IT follow our ways of working to deliver service in line with the National Framework, we have created an innovative approach that is clearly working.”