Our clients ask, how do we…
- Work more effectively with other care systems?
- Put the foundations in place for closely integrated care?
- Define key success factors and accountabilities?
- Ensure data and information is shared?
- Establish the leadership of our connected care system?
Before a group of organisations can implement an integrated care strategy, they need to agree how their individual care systems will work together. Properly connected care systems, joined by a shared vision, clear goals and accountabilities, are more effective in population health management. We work with groups of care systems to:
- Support them to work most effectively together
- Determine clear governance structures including overall leadership
- Understand workforce and capital considerations
- Determine clear ownership of change strategies, new systems and service models
- Define strategies for data sharing and digital transformation
- Create an environment to support improved patient experience
Common challenges include motivating leaders and managers to work outside of their organisational boundaries, establishing the goodwill to make change happen, and encouraging group-working when there are significant in-house challenges within individual care systems.
- System diagnostic Establishing the care system position on our maturity matrix, assessing capability to make change happen and making the case for change
- Strategic resource framework Establishing the finance, activity and workforce baseline for payors and providers, forecasting future resources (incorporating demographic and non-demographic factors), and modelling alternative scenarios
- Finance Optimising payment models to reinforce collective working and accountability across the local healthcare economy and developing outcomes-based contracting
- Information systems Defining frameworks for data-sharing and information governance including systems and policies, and guidance on electronic medical records and clinical decision support
- Organisational form Supporting work within legal frameworks and statutory functions for each care system, budget pooling options and capitated budget options
- Leadership and governance Assessment of leadership working, executive board development, and governance stocktake and advice
Five clinical commissioning groups (CCGs) with a combined annual budget of circa £2bn, serving 1.5 million people, commissioned CF to define a new organisation. They wanted to boost financial sustainability, encourage collaboration, and catalyse close partnership working across the different systems when relationships historically had been strained.
We led a programme structured around design and delivery, incorporating governance, management, financial strategy and commissioning strategy. Our work on governance delivered a joint committee, with £1bn of commissioning services delegated to it from the five CCGs. This outcome was driven by our expertise in board-level facilitation, input from legal and governance specialists, and incorporated financial modelling to calculate the value of delegated budgets.
Working with the CCGs governing body, we enabled the design of the executive management team which covered both structural and operational design, and the shape of the newly combined workforce. The commissioning strategy focused on collaboration and subsidiarity, maximising benefit across the CCGs, and driving synergy amongst the delegated functions within the joint committee.
As a result of the programme, the five CCGs were able to share scarce commissioning leadership, capacity and capability; jointly manage areas of change that required consultation or investment; commission at scale to support a large population, and drive more ambitions change and productivity improvement.
With a shared vision and consistency in the delivery of standards, they were also able to make tough decisions when resources needed to be reallocated to make the biggest difference to local residents.