Two of our mental health provider clients shared an ICS, and a goal between them was to develop consistently good services across the patch. Their challenge, therefore, was to optimise investment into services, focused on community services in particular, by addressing unwarranted variation.
Value for money can only be determined by balancing cost with outcomes. The Efficacy and Value for Money module compares cost per case with both positive outcomes (step down success 6 months post-discharge) and negative outcomes (on-caseload crisis presentation rates). It was agreed that clinical & service leads would be allowed to compare & contrast every other community service across organisations to guide value-for-money thinking.
Using the suite of views in the module to explore operating model variation, trust leads were able to design an optimised model for all services to adopt, with key features like increased time limited interventions and the correct staff-mix. Tools in the Efficacy module were used to successfully identify long term trends & correlations, and to confirm hypotheses, such as over-treatment.
Using the linked Savings Diagnostic, an automated report created through the Real World Health Data Science Platform, operating model variation was translated into quantified savings opportunity. Given most community services do not have systemised care models, it was found that the high-cost per case services across the ICS invariably were not delivering better outcomes.
Across community services, this resulted in large multi-million pound savings opportunities for both Trusts, which they are now working towards as a result. By aligning operating models with a peer, both organisations were able to further expand access without additional WTE investment.