Kent’s transformation journey began in 2013 with the establishment of three programmes on care pathways, optimisation, and commissioning. This example of a local initiative forms part of our managing transfers of care resource.
Work focused on making better use of systems and embedding the culture of promoting service user independence, while establishing the foundations for further transformation.
Phase 2 started in 2014 with two programmes, access to independence, and acute hospitals optimisation.
Data analysis had shown that pathways from hospital to residential care placement were deemed appropriate only in about 11 per cent of cases. The aims for the acute hospital optimisation programme were therefore to:
- enable a greater number of service users to access the right service to help them achieve a more independent outcome
- give families confidence that an alternative to short or long-term beds would promote a better outcome
- provide case managers in the hospital team with additional knowledge and capability to make more appropriate placements promoting independence
- better evidence improved outcomes resulting from an improved process.
To achieve these aims the programme focused on:
- improving decision-making at the point of selecting a short-term pathway
- identifying and selecting the best outcome for each person
- understanding and addressing the biggest issues preventing the most appropriate outcome
- escalating issues for area and county-wide action
- improving accessibility and availability of services that might be required
- tracking and feedback of the effectiveness of short-term pathway options to supplement decision-making processes
- achieving financial benefits through reduced spend on short and long-term beds.
Daily wash-up sessions help staff to identify and resolve blockages and issues, and also act as a mechanism for applying an evidence-based method of approaching cases to achieve the best outcome for patients or service users.
Staff work to an improvement cycle of:
- discussions and data capture at wash-up meetings – supporting daily decision-making and accurate recording of information • data analysis – identifying the best outcomes and biggest blockages
- actions – identifying who can solve the problem at a weekly improvement cycle meeting
- problem solving – getting the best outcomes.
Across the county, the transformation programme has seen a 59 per cent reduction in long-term residential placements and a 54 per cent reduction in short-term beds. Further information about the genesis of the programme can be found in the LGA publication Efficiency opportunities through integration.
Contact
Anne Tidmarsh
Director, Older People and Physical Disability
Kent County Council
[email protected]