Kings Fund 4 October 2018
- This report explores how three different organisations (the Royal Free London NHS Foundation Trust, Bolton NHS Foundation Trust and Bradford Teaching Hospitals NHS Foundation Trust) are attempting to improve the value of the services they offer to patients. It examines how they have developed organisation-wide strategies to improve value, and on how individual clinical services or teams have pursued value improvement.
- The report is based on a literature review to assess current approaches to improving value in the delivery of high-quality health care in the United Kingdom and other comparable health care systems. and a roundtable discussion where nine representatives of NHS hospitals and national bodies shared their experiences of value improvement.
- The organisations’ value improvement strategies and operating context:
- Developing shared clinical pathways across different hospitals. The recent formation of the Royal Free London Group of hospitals has catalysed the development of new clinical pathways that aim to deliver the best possible outcomes for patients at the lowest cost possible. Services are being redesigned across sites through clinical practice groups (CPGs), which bring together medical and finance staff to develop the best models of care across a clinical pathway, such as community-acquired pneumonia.
- Using Lean methodologies and making them more value based. Following a long history of using Lean methodologies at Bolton NHS Foundation Trust, and given the continued financial pressures facing the Royal Bolton Hospital, the hospital has developed a focus on activities to improve the financial position of the organisation/reduce costs, while maintaining the quality of care delivered to patients. The hospital has a central programme management office (PMO) that co-ordinates these activities.
- Codifying and systemising a ‘virtual ward’ approach to cover as wide a range of hospital services as possible. Bradford Teaching Hospitals NHS Foundation Trust has brought together separate ‘virtual ward’ approaches (which allow patients to receive consultant-led care in their own homes) and developed these into its value improvement strategy.
