Integrated Community Services Transformation – Lancashire Care NHS FT
Community
The Adult Community Services network within Lancashire Care NHS Foundation Trust faces increases in demand and a reduction in commissioning funding. The team faced a challenge to be 10% more efficient within year for the Integrated Community Service pathway.
The network wanted to know if this could be achieved without affecting quality and safety of patient care. They chose WRaPT to model the workforce transformation.
The Challenge
WRaPT was tasked with establishing:
- The proportion of staff time within the service that was patient facing.
- The impact on activity if efficiency was not improved, but funding was cut – i.e. what would the situation be if they stayed as efficient as they were.
- The financial impact (workforce cost) of moving activities between bands through a skill mix review.
- Whether ideas for increasing the efficiency of clinical care would be enough to meet the challenge.
Our Approach
WRaPT collated Workforce, Activity and Driver data as follows:
Initially, merged finance data and ESR data was collated to accurately reflect the workforce of 443 staff members. This highlighted to the network that an ESR data cleanse was required.The data cleanse was completed and a direct download from ESR was uploaded into WRaPT following a data cleansing exercise by the network.
The clinical activity data from new hand held devices was considered and then discounted due to technical issues during implementation which impacted activity data accuracy.Through discussion with service managers and team leader’s, it was agreed to use the following accurate recorded activity data:
• The number of minutes of clinical care
• The number of minutes of travel time
• The numerical count of all clinical activity
Driver data was apportioned for all staff through workshops with service managers. The flexibility of WRaPT enabled differences between teams to be incorporated into the model. The driver data was also used to reflect the fact that not all activity data could be collected. Lack of data ranged from 5 – 20% of each role,
The Outcome
- What proportion of staff’s time within the service is patient facing? WRaPT demonstrated that 91.7% of staff are patient facing and that 94.3% of time was spent being engaged in clinical activity. This highlighted a lean structure at a clinical and administrative level.
- If the establishment was reduced to generate 10% of efficiency savings, what would the impact be on activity levels? WRaPT highlighted that a 10% cut in funding would result in the loss of 122,155 clinical contacts.
- What would be the financial impact of moving activities between bands through a skill mix review?WRaPT demonstrated that a proposed down banding by 10% of clinical activity only delivered 10% of the required cost saving. This number triangulated predictions made by the finance department.
- What is the impact of increasing the efficiency of clinical care? WRaPT demonstrated that a 10% increase in the efficiency of clinical activity would result in delivering 45% of the required cost saving.
“ WRaPT has been instrumental in ensuring evidence based decision making for workforce transformation as part of the integrated community services redesign programme. Once we had worked with the WRaPT team to identify suitable workforce, activity and driver data sets, WRaPT was able to model scenarios quickly to demonstrate the most effective way of realising savings across the service. This has informed our approach to transforming the workforce and we are now engaging with front-line staff to identify how we can increase efficiencies in clinical care whilst maintaining quality of service.”
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