Sustainability And Transformation Plans Research Articles

Were the hospital bed reductions proposed by English Clinical Commissioning Groups (CCGs) in the sustainability and transformation plans (STPs) achievable? Insights from a new model to compare international bed numbers.

A new model for hospital bed numbers which adjusts for end-of-life care and age structure is used to demonstrate that England has 20% fewer occupied beds than the other countries in the United Kingdom. It also shows that occupied beds in English Clinical Commissioning Groups (CCGs) lie parallel to a line of equivalence with New Zealand and Singapore. This is despite New Zealand and Singapore having invested many years into developing integrated care, while England has not. In addition, England has around half the number of nursing home beds per death available in these two countries. Large bed reductions proposed in the sustainability and transformation plans were likely to have been manipulated to meet financial cost-saving targets rather than a result of genuine modelling of demand. The ways in which bed demand models can be manipulated to give whatever answer is required are discussed. Trends in occupied acute medical beds in England over the past 20 years show no real reduction, despite a large reduction in available beds. This has resulted in daytime occupancy for adult beds being close to 100% and with resulting queues to admission. The ways to improve the small-area application of the model including the use of deprivation or social groups are discussed.

Eating for Eye Health: Engaging patients with dry age-related macular degeneration in community cookery to support lifestyle change and positive health

There are limited treatment options available upon diagnosis of dry age-related macular degeneration (AMD), a leading cause of blindness in older people, which progressively threatens central vision and quality of life. Community engagement has the potential to support 'positive health' of individuals with untreatable eye conditions. Eating for Eye Health is an award-winning public-engagement project that aims to raise awareness of research suggesting that nutrition might help protect against progression of AMD and to encourage patients to cook and eat antioxidant-rich food in a community environment. The project engaged patients who had a diagnosis of dry AMD through a focus group and a community cookery day organized in partnership with the healthy food outlet, Pod, and the Manor Gardens Community Kitchen Project, Islington, London. A focus group highlighted participants' potential barriers to engagement with research about lifestyle modification and identified that a co-designed community cookery project could help to address unmet needs for support. Individuals with dry AMD reported increased levels of confidence in cooking skills after participating in the community cookery day. The combination of these methods within the context of AMD highlights how a focus on patient needs and expectations can establish and grow mutually beneficial relationships. There is potential for Eating for Eye Health, or similar community kitchen approaches, to be implemented within the community setting through NHS 'social prescribing' initiatives. In conclusion, Eating for Eye Health is unique in its combination of elements of community consultative and collaborative forms of engagement. These methods could be adopted as part of Sustainability and Transformation Plans (STPs) in local health policy development in the community.

Growth in NHS admissions and length of stay: A policy-based evidence fiasco

Growth in NHS admissions and length of stay: A policy-based evidence fiasco

Sustainability and Transformation Plans: occupational therapists and physiotherapists can support GPs.

Forty-four Sustainability and Transformation Plans (STPs) were introduced in NHS planning guidance in December 2015. Draft STPs were published in late 2016. The plans bring together providers, commissioners, local government, and third-sector organisations to develop and deliver new models of care.1 These models aim to improve the quality, efficiency, and sustainability of healthcare services, across England over the next 5 years.2 Concerns have been raised about the impact of STPs on GP provision,3 on patient groups,4 and on the number of hospital beds.5 The purpose of this study was to identify the detail relating to rehabilitation, occupational therapy, and physiotherapy in STPs. Occupational therapy and physiotherapy are two of 12 professional groups that make up allied health professionals (AHPs). AHPs are the third largest workforce in health and care in England. A recent AHP strategy from NHS England6 has provided a blueprint by and for AHPs to contribute to future services, including STPs. The Chartered Society of Physiotherapy7 has promoted STPs to move towards a model of health prevention and a rehabilitation system that supports collaboration and integration across local systems; for example, NHS trusts and local authorities. The Royal College of Occupational Therapists8 agreed that STPs can provide a vehicle for occupational therapists to deliver early action, prevent admission to hospital, and implement a reabling approach that improves patient outcomes and saves money. …

Readiness Assessment Tool: Strengthening Implementation of Integrated Care

Introduction: Optimity Advisors has developed an evidence-based Readiness Assessment tool to inform the implementation of an integrated health and care system and enable rapid system-wide sense-making in the context of high degrees of complexity. This tool was presented at ICIC 2016 and empirical data on application as a baseline assessment was provided. Delivering a sustainable integrated care system (ICS) is complex and challenging. The Readiness Assessment tool can support the initial phase of creating an ICS and assess the readiness of all provider partners to become an ICS. This tool identifies levels of integration by assessing the system against evidence-based criteria categorised into domains: Purpose and understanding: Partnerships Scope Population and patient focus Governance Finance & contracting Professional practice Care coordination Workforce Health Information Development of the tool: Last year we identified next steps for the tool including refining the risk scale, validating the domains, defining the metrics and expanding the tool. Building on the previous evidence reviews, over several months in 2016 our team of researchers have worked to refine the risk scale and validate the domains. Refined Risk Scale: When using the tool, the qualitative and quantitative data collected for each domain is reviewed and scored based on a risk scale. The risk scale has been reduced from 6 levels to 4 as testing it with clients showed 6 was making an artificial distinction resulting in unnecessary complexity. The scale of 1 – 4 is used to summarise the result of assessment. High scores reflect high levels of integration readiness. With this in mind, the progress descriptions have been reviewed and updated to reflect each domain’s specifics. Based on these changes to the risk scale, we now have a platform from which we are currently defining the metrics – this work will be ready for presentation in May 2017. Validating the Domains: We recognised in 2015/16 there was a potential for overlap between domains that may impact important interdependencies or duplications. The two domains that have been removed include Resilience and Cultural Readiness. Resilience was removed as it is an outcome of integration rather than a critical success factor. Cultural readiness was found to be assessed by other domains. Case Study: In 2016 Optimity Advisors used the Readiness Assessment toolkit when supporting the development of one of the Sustainability and Transformation Plans (STP) in South East England. This was the first time 15+ organisations in this footprint had worked together. The readiness assessment tool was used to do a rapid system assessment of the state of readiness across the footprint and to inform the implementation planning required by NHS England. The readiness assessment was conducted over 8 weeks with input from key stakeholders, using qualitative and quantitative data collection including participant observation, document review, population data analysis and stakeholder co-production. The outcome was shared with the STP delivery team and formed the basis of an actionable and prioritised programme of work to deliver the triple aim for the health and care economy. One of the areas that was identified as high risk and requiring significant investment in implementation was the in the domain of patient and population focus. Engagement with the local population and current health and care users was very limited. Without considerable effort in this area, the partners risk designing integrated services without reference to the patient and service user other than on paper. We will share the early implementation lessons of this programme of work and how the readiness tool has informed this at the conference in May 2017.

STPs ‘not ready for implementation’

Academics have released a damning report on sustainability and transformation plans (STPs), claiming that none of them is ready for implementation.

Integrated services: the plan for the future.

Sustainability and transformation plans (STPs) represent a move away from the purchaser-provider relationship adopted by the NHS in England to plan its services.

STPs: it's not too late to have a say.

Sustainability and transformation plans (STPs), the 'secret' ideas for the NHS in England that will mean huge changes to local services, are now out in the open, and people in the know are worried.

Understanding the aims of sustainability and transformation plans (STPs) and what they mean for pharmacy

Understanding the aims of sustainability and transformation plans (STPs) and what they mean for pharmacy

Declining length of stay and future bed numbers

British Journal of Healthcare ManagementVol. 21, No. 9 Money MattersDeclining length of stay and future bed numbersRod JonesRod JonesSearch for more papers by this authorRod JonesPublished Online:24 Sep 2015https://doi.org/10.12968/bjhc.2015.21.9.440AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Advisory Board Company International (2009) Next-generation capacity management: Collaborating for clinically appropriate and efficient inpatient throughput. Available at: https://www.advisory.com/International/Research/Clinical-Operations-Board/Studies/2010/Next-Generation-Capacity-Management (accessed 27 August 2015) Google ScholarJones R (2009) Emergency admissions and hospital beds. BJHCM 15(6): 289–96 Google ScholarJones R (2009) Length of stay efficiency. BJHCM 15(11): 563–4 Google ScholarJones R (2010) Benchmarking length of stay. BJHCM 16(5): 248–50 Google ScholarJones R (2011) Does hospital bed demand depend more on death than demography? BJHCM 17(5): 190–7 Google ScholarJones R (2011) Hospital bed occupancy demystified. BJHCM 17(6): 242–48 Google ScholarJones R (2011) A&E performance and inpatient bed occupancy. BJHCM 17(6): 256–7 Google ScholarJones R (2011) Bed occupancy – the impact on hospital planning. BJHCM 17(7): 307–13 Google ScholarJones R (2011) Factors influencing demand for hospital beds in English Primary Care Organisations. BJHCM 17(8): 360–7 Google ScholarJones R (2011) A paradigm shift for bed occupancy. BJHCM 17(8): 376–7 Google ScholarJones R (2011) Volatility in bed occupancy for emergency admissions. BJHCM 17(9): 424–30 Google ScholarJones R (2013) Optimum bed occupancy in psychiatric hospitals. Psychiatry On-Line Available at: http://www.priory.com/psychiatry/psychiatric_beds.htm (accessed 27 August 2015) Google ScholarJones R (2013) The NHS England review of urgent and emergency care. BJHCM 19(8): 406–7 Google ScholarJones R (2014) Medical bed occupancy and cancelled operations. BJHCM 20(12): 594–5 Google ScholarJones R (2015) Is length of stay a reliable efficiency measure? BJHCM 21(7): 344–5 Google Scholar FiguresReferencesRelatedDetailsCited byWere the hospital bed reductions proposed by English Clinical Commissioning Groups (CCGs) in the sustainability and transformation plans (STPs) achievable? Insights from a new model to compare international bed numbers11 December 2020 | The International Journal of Health Planning and Management, Vol. 36, No. 2 2 September 2015Volume 21Issue 9ISSN (print): 1358-0574ISSN (online): 1759-7382 Metrics History Published online 24 September 2015 Published in print 2 September 2015 Information© MA Healthcare LimitedPDF download