Care delivery

18 weeks… and counting

When evil mastermind Blofeld announced that there was only one minute remaining before the onset of war between the world’s superpowers, deep down you knew that despite the countdown, James Bond would battle past a mob of burly henchmen to defeat his arch-nemesis and save the day with seconds left on the clock.

Turning the clock forward from the cold war era to 2008, the new countdown to be faced in the NHS is the 18-Week Referral to Treatment (RTT) target. The challenge of ensuring that all patients start their treatment within eighteen weeks of referral is perhaps one of the NHS’s most revolutionary improvement plans.

When referral to treatment times in England come down to this level at the end of 2008, we will see a level of access to care never previously achieved in the NHS.

So, what are the issues faced by Trusts not only to guarantee RTT compliance but also to ensure timely patient progress and the best possible access to care?

The mission: timely delivery of care

With NHS trusts required to meet the 18-week RTT timeframe, resources will have to be made available within a matter of weeks of the hospital becoming aware of demand.

It is precisely this ability to adapt capacity to demand that is one of the biggest challenges for clinical managers. Trusts need to be able to forecast movement along pathways of care. An outpatient appointment can no longer be viewed as an isolated event, but as part of a complete pathway with all the repercussions its scheduling may have.

In order to meet performance targets, trusts must be able to make the vast quantities of prospective and retrospective data currently retained and trapped in disparate data sources readily available at the highest quality for both operational and management use, at the same time as achieving other strict targets, above all regarding financial performance.

Preventative measures

Being able to simply identify pathways is no longer enough. Under the new initiative, NHS trusts must be able to flag up pathways that are drifting into trouble at an early stage, to avoid potential breaches.

Predictive reporting tells managers where resources need to be deployed to ensure timely patient progress, and to be able to provide additional capacity where required.

The pace and quality of everyday decision making also ultimately determines performance; therefore trusts need access to accurate and reliable data in order to aid the decision-making process and enable clinicians and managers to carry out their work more effectively.

Taking a more intelligent approach

Business intelligence solutions can turn mountains of data into meaningful information, so trusts can make informed decisions from viewing a snapshot of performance reality, quickly turning insight into action.

Such solutions allow trusts to access accurate, reliable and timely information about patients, resources, financial flows and key performance indicators.

As well as boosting overall performance management, business intelligence solutions also help trusts to meet specific directives such as RTT, by identifying and flagging up any early signs of slippage while there is still time to make a difference — after all, there is little point to discovering in week 17 that a patient is about to breach the 18-week limit.

Using data more effectively means a better flow of patients, enabling managers and clinicians to plan and manage their workloads more effectively and deliver an improved level of service.

Mission accomplished ahead of time

Dudley Group of Hospitals NHS Trust is one trust that has taken definite steps towards transforming the way it manages Referral to Treatment times. By having the right business intelligence tools in place, the Trust confidently expects to hit the 18-week wait target up to six months ahead of the December 2008 national deadline.

Dudley is using Pathway Manager to monitor patients’ progress against the 18-week clock, address the deployment of resources and to understand potential risk, as well as supporting the development of long-term financial modelling.

Pathway Manager allows Dudley to take a prospective look at waiting times rather than retrospective, meaning they can proactively measure and monitor the patient’s journey through the Trust and predict potential problems as quickly as possible.

Paul Assinder, Director of Finance at Dudley points out that: “The eighteen week wait is a key driver in improved business performance and income performance going forward.”

To him it is clear that good information tools have a major role to contribute in achieving the goals his Trust has set itself: “Our success in delivering the eighteen week maximum wait target is key to our success as an organisation. I think the Pathway Manager solution puts us in a very strong competitive position to demonstrate to the outside world that we can deliver a sub-eighteen week wait.”

Opting for a business intelligence solution simplifies access to patient data for clinicians and managers, as all the information is on one search engine instead of multiple sites. With its focus not just on overall pathways but on key event stages, it enables those in charge at Dudley to make informed operational decisions by presenting streamlined and relevant data to help them carry out their work more effectively.

Case closed

With the 18-week clock ticking ever louder, business intelligence tools offer trusts a means of meeting RTT regulations by harnessing data from across the PCT to aid and speed up the decision-making process.

Better access to relevant data means more informed operational decisions — which not only improves overall performance management but also ensures timely patient progress and the best possible access to care.

Let’s face it, didn’t Bond always make use of the latest technology to save the day when faced with a tight deadline?

And with the clock ticking, surely business intelligence software is the smart technology choice to help NHS trusts meet the RTT deadline.

David Beeson, Marketing Director, Ardentia.