The challenge and potential of whole system flow Improving flow across whole health and care systems

In all parts of the UK there is an increased emphasis on health and social care organisations working together to tackle the quality and productivity challenges that all systems are facing, and to ensure that care is ‘genuinely coordinated around what people need and want’.

Improving the flow of patients, service users, information and resources within and between health and social care organisations can have a crucial role to play in coordinating care around the needs of patients and service users, and driving up service quality and productivity.

Poor flow is not only a source of significant waste and delay, but it can also be devastating for patients and service users and deeply frustrating for people working in health and social care.Most flow-related initiatives to date have focused on a small segment of the patient or service user journey, usually within hospitals. There is a need to look beyond the hospital and to give attention to every team, service and organisation that patients and service users encounter.

This report outlines an organising framework and tested methods that local health and social care leaders can use to improve whole system flow. It draws on case studies and other examples of work in this area from across the UK and internationally. The report also describes the steps that policymakers and regulators at a national level need to take to create an environment that is conducive to change at this scale.

This is a joint publication by the Health Foundation and the Advancing Quality Alliance (AQuA). Improving flow on a whole system basis is a field in which both organisations have a long-standing interest.