• Led by King’s College Hospital NHS Foundation Trust, partnered by Guy’s and St Thomas’ NHS Foundation Trust, and South London and Maudsley NHS Foundation Trust. 
  • Based at King's College Hospital in three services: cardiac, liver and stroke.
  • Introduced a system that uses ‘value’ – health outcomes divided by cost – as the key performance metric.
  • Aimed at measuring and reporting the value of what services do, rather than focusing on process, financial and quality targets.

The NHS faces great pressures to save money, change models of care, restructure systems and join up services. However, change projects in the NHS often focus more on process targets and financial measures than on care outcomes.

A team at King’s College Hospital NHS Foundation Trust has developed a system that uses ‘value’ – health outcomes divided by cost – as the key performance metric. The team’s central proposition was that management based on value drives faster, better innovation and unites the interests of payers, providers and patients.

The key components of the project were the development of a new method of value data capture, a set of value-based reporting tools and a value-based management system.

The approach enabled trusts to access data that are more meaningful and comparable, less at risk of distortion, and could account more effectively for clinical and patient-specified outcomes.

Cardiac, liver and stroke were established as those areas upon which to initially focus. Outcome measures were developed for all three conditions, along with cost data analysis following the whole care pathway. Activity and value stream maps for each condition were also drawn up to understand how patients flow through the system.

The project has enabled remarkably effective collaborations between finance, management and clinicians, with each professional group developing greater knowledge, understanding and appreciation of the others’ work.