New report shows the way ahead to tackle delays and duplication across health and social care

Report argues that STPs and current financial challenges provide added impetus to improve the flow of people and resources

The Health Foundation and the Advancing Quality Alliance (AQuA) today (Tuesday) publish The challenge and potential of whole system flow, a guide to help local NHS and social care leaders to work together to improve productivity, patient experience and the quality of services.

‘Whole system flow’ is a coordinated approach across organisations that ensures people, information and resources are in the right place at the right time, to reduce bottle-necks, duplication and avoidable waits.  It focusses on improving the pathway that patients take through different parts of the NHS and social care system.

The report says poor flow not only wastes time, energy and money, it can hurt patients and is deeply frustrating for people working in health and social care. The report cites common examples of poor flow: ambulances queuing outside hospitals; stretched emergency departments; problems getting a GP appointment; and mental health patients being transferred hundreds of miles for a bed.

The report argues that the current context for health and care providers – including significant financial pressures and the emergence of new local partnerships (the Sustainability and Transformation Plan partnerships in England) –present an opportunity for a serious focus on tackling flow across NHS and social care systems.

While the benefits from improving whole system flow are substantial – in terms of productivity, quality of care and patient experience - the authors warn that the challenges involved in improving current processes shouldn’t be under-estimated.

The report says that because organisations in an area are governed, funded, inspected and regulated differently, this reinforces cultural differences between those working in hospitals and those working in community and social services. The authors calls on local and national leaders to give frontline staff the space and time to invest in long-term improvement initiatives and to foster the right skills and culture needed to do so.

David Fillingham CBE, Chief Executive of AQuA and one of the report authors, said:

‘Understanding and improving the flow of people and resources should be a major priority, not just for colleagues working in the NHS, but also those across the wider health and social care landscape.

‘Whilst the report’s findings may not offer the ‘magic bullet’ to solving flow that some may seek, it provides a framework, insight and case studies on how we can work together to tackle this complex challenge, and so secure better outcomes for patients.’

Penny Pereira, Deputy Director of Improvement at the Health Foundation, co-wrote the report. She said:

‘At its heart, improving flow is about tackling the delays and duplication that are frustrating for all those in the health and care system.  Getting flow right is critical to the delivery of new service models, improving quality of care and productivity. But it’s the impact it will have on the daily experiences of service users and staff that matters most.

‘We need to look well beyond seeking just quick fixes for A&E. Extending work on flow to span whole health and social care economies takes time and investment. If every organisation in each health and social care economy were able and willing to work collaboratively to design services that optimise flow, it could lead to major improvements in patient and service user experience and outcomes, as well as improved productivity. It is for these reasons that flow should be a top priority.’

Whole system flow outlines the approaches and skills needed to improve productivity and the experience people have of accessing care when they need it.

The report provides:

• A checklist of the eight building blocks that need to be in place to improve whole system flow, including good IT and information, leadership at all levels within each local partnership organisation and co-production of service redesign with staff, patients and service users.
• A five stage process map to guide local leaders on how to analyse and improve whole system flow
• Examples of tools and concepts useful in improving flow
• Case studies from organisations in the UK and abroad who have successfully improved flow.

Media Contact

Creina Lilburne
Creina.lilburne@health.org.uk
Tel: 020 7257 8027