The challenge and potential of whole system flow

Improving flow across whole health and care systems

December 2016

David Fillingham
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Key points

  • Whole system flow is the coordination of all systems and resources, across a health and social care economy, to deliver effective, efficient, person-centred care in the right setting at the right time and by the right person.

  • Improving flow is seen by both practice leaders and policymakers as having a crucial role to play in driving up service quality and productivity, as well as improving the experience of care for patients and service users.

  • This report introduces methods that local health and social care leaders can use to improve whole system flow. It also describes steps policymakers and regulators can take to create an environment conducive to change at this scale.

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.

Further reading

Learning report

Improving patient flow

This learning report describes the work undertaken by two NHS trusts as part of the Health Foundation’s Flow Cost Quality pro...

Blog

Improving whole system flow?

It was when I read Gerard’s story that the importance of getting flow right really hit home to me. Gerard, a patient at South...

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