Category: News and case studies

Our Medicines Management and Optimisation team has improved patient care by improving processes and automating tasks to ensure timely access to medications and maintain safety through competency assessments among healthcare professionals.

Background

Non-medical prescribing (NMP) refers to the practice of prescribing medication by healthcare professionals other than doctors or dentists. It plays a crucial role in the NHS Long Term Workforce Plan, aiming to improve patient care by providing timely access to medications and advice, reducing waiting times, and enhancing the skills of the broader healthcare team. NHS Midlands and Lancashire (NHS ML) is a key partner in supporting NMP governance procedures and processes within integrated care boards (ICBs).

Action

Over nearly a decade, the NHS ML Medicines Management and Optimisation team has worked closely with stakeholders to develop NMP services, focusing on improving the safety and quality of prescribing. This collaboration has involved joint efforts with our IT Cloud Development team to automate processes for analysing data and compiling NMP competencies.

This service to ICBs includes customised quarterly reports shared directly with individual NMP prescribers and their mentors. These reports facilitate reflective practice and ongoing learning while identifying any potentially unsafe prescribing activity.

The main automated activities include:

• Adding/removing NMPs with the NHS Business Services Authority (NHS BSA)
• Auditing practice data
• Obtaining NMP competency declarations
• Analysing and providing regular reports on prescribing against competencies (safe prescribing reviews)
• Generating reports for practices and mentors
• Providing policy and governance support

Looking ahead, we will conduct further analysis of data to understand prescribing activity against competencies and controlled drugs, while also scaling up to support wider ICB systems.

Impact

The implementation of NMP services has significantly influenced healthcare delivery, aligning with the NHS Long Term Workforce Plan’s objectives to improve patient care and streamline access to medications and advice. Led by our Medicines Management Optimisation team, these services have become integral to ICBs, contributing to patient safety, quality of care, and professional development within the healthcare workforce. Here is some of what we have achieved so far:

Lancashire and South Cumbria ICB

• NMP competency register of approximately 800 prescribers
• Approximately 260 prescribers added/removed annually with NHS Business Services Authority (NHS BSA)
• Approximately 450 individual prescriber reports produced and disseminated

Black Country ICB

• NMP competency register of approximately 900 prescribers
• Approximately 680 prescribers added/removed with NHS BSA from February 2023-24
• Compliance with declarations: Nearly all NMPs in Wolverhampton (97.7%) submitted their yearly declaration confirming they can prescribe medicines safely.
• Prescribing within skills: Among those who made this declaration and prescribed medicines, 83% prescribed at least one medicine they weren’t authorised to prescribe, which could pose risks.

Birmingham and Solihull ICB

• Approximately 100 prescribers added/removed annually with NHS BSA

Feedback

We really enjoyed working on this project with NHS Midlands and Lancashire team. There was a strong sense of partnership at every stage, and the team genuinely valued everyone’s contributions, ideas, and suggestions. Jatinder Saimbi | Senior Medicines Optimisation Manager | Lancashire and South Cumbria ICB

We developed an innovative, interactive dashboard that has significantly enhanced the delivery and effectiveness of frailty care in Lancashire and South Cumbria, fostering system-wide improvements through comprehensive data integration and analysis.

Background

To enhance service delivery for the ageing population with frailty, the Lancashire and South Cumbria (L&SC) Integrated Care System (ICS) initiated a project aimed at building system-level improvement competencies and rethinking service design. In partnership with the University of Cambridge’s Engineering Design Centre, health and care providers from L&SC participated in the ‘Engineering Better Care’ programme, employing system thinking and co-design methodologies to innovate their approach.

A principal goal of this initiative was the creation of a system-wide platform for timely and standardised access to critical frailty data, enabling the tracking of progressive improvements.

Action

A subset of the programme focused on establishing a robust measurement framework. NHS Midlands and Lancashire CSU (MLCSU) embarked on the co-creation of a custom interactive dashboard. The MLCSU, as an integral part of this team, engaged closely with health and care specialists to develop a dashboard that integrates multiple data sources. This tool was designed to offer a comprehensive view of frailty conditions and to evaluate the effectiveness of key processes in the L&SC region for identifying and aiding the ageing frail population.

Impact

The outcome was an interactive dashboard, not only displaying improvement trends but also enabling the analysis of diverse measures. This facilitates a deeper understanding of variations and best practices in primary, community, and secondary care settings. This tool is now instrumental in guiding and assessing the effectiveness of various system-level improvement initiatives within the L&SC health and care system. Notably, these initiatives include the implementation of a standardised clinical frailty score and a unified care plan template. The dashboard has become a vital asset in monitoring the reliability of these interventions and in gauging their broader impact on our healthcare system.

Feedback

“Working with MLCSU on this exciting piece of work has been a fantastic experience and having their expertise and advice throughout the journey has been invaluable.  This has demonstrated the impact of working together as a system and what can be achieved if all of the right people are engaged and sat around the same table.  We look forward to continuing to work alongside MLCSU as we continue to develop this dashboard and new standardised data set adopted across L&SC as part of this work.”

Kurt Bramfitt | Senior Associate Director of Continuous Improvement | Lancashire Teaching Hospitals

Blog by Scott Johnson, Business Intelligence Lead, MLCSU

What are these game-changing tools?

GitHub: the hub of collaboration

The NHS Midlands and Lancashire Commissioning Support Unit (MLCSU) Business Intelligence team is no stranger to innovation. Among our various initiatives, we run Knowledge Sharing Networks (KSNs) aimed at fostering learning and best practice within the organisation.

One such KSN, focused on data science, has spearheaded the development of two technical tools that are essential to increase productivity: an organisational GitHub account and an R package specifically tailored for MLCSU. This blog post aims to introduce these collaborative tools, delve into their purpose, and discuss the strides we’ve made in their development.

The first tool is the MLCSU GitHub account. GitHub is a free platform that serves as a repository for code, facilitating version control and collaboration. As Henry Ford aptly put it, “Coming together is a beginning, staying together is progress, and working together is success.”

Given the vast geographical expanse that MLCSU covers and the diverse projects our Business Intelligence teams are engaged in, it’s crucial to have a centralised platform. GitHub allows us to share automated and reproducible procedures, aligning with NHS Digital’s guidelines on Reproducible Analytical Pipelines (RAP).

We are not alone in this endeavour. In setting up an organisational GitHub account we are following in the footsteps of leading NHS data teams such as:

NHS-R Community
The Strategy Unit
NHS Digital

We’ve already gained valuable insights from our colleagues at the Strategy Unit, which is part of MLCSU, further emphasising the power of collaboration.

MLCSU R package: the efficiency multiplier

The second tool in the pipeline is the MLCSU R package. If GitHub is the vehicle for collaboration, consider the R package as the fuel that powers it.

Designed to streamline the workflow for R users within MLCSU, this package embodies the principle that “You should consider writing a function whenever you’ve copied and pasted a block of code more than twice,” as stated by Hadley Wickham & Garrett Grolemund in their book, “R for Data Science.”

Currently, the MLCSU package includes a function that allows users to directly read data from the MLCSU Business Intelligence SQL server. While this might save only 30-60 seconds per use, the cumulative time-saving potential across multiple users is significant.

Looking ahead: the journey continues

We’re at the nascent stages of our journey into the world of RAP. These tools, although simple in their current form, represent stepping stones towards a more streamlined and collaborative future. The learning curve is steep, but as the saying goes, “small progress is better than none.”

Get involved

If you’re intrigued by our work and would like to contribute to the growing suite of collaborative tools developed by the MLCSU Business Intelligence team, please don’t hesitate to contact Scott Johnson at scott.johnson2@nhs.net.

We are delighted to share that our customer finance team has been awarded the globally recognised ISO 27001 and ISO 9001 accreditations, demonstrating their commitment to exceptional quality and robust information security management.

The ISO 27001 certification is the international standard for Information Security Management Systems (ISMS). It provides a framework for managing information security risks, including legal, physical, and technical controls that involve an organisation’s information risk management processes. The team’s achievement of ISO 27001 accreditation testifies to their dedication to ensuring the security and integrity of the confidential data entrusted to them. We understand the importance of robust information security systems, particularly in the healthcare sector, and we are proud to have met these rigorous international standards.

On the other hand, ISO 9001 is the international standard for a quality management system. This accreditation affirms that the team is committed to providing a high level of quality in their services and are continually seeking ways to improve. Our quality management systems comply with the stringent criteria set out in the ISO 9001 standard, providing a clear demonstration of our commitment to customer satisfaction and continuous improvement.

We believe these certifications are not just recognitions but also responsibilities that reaffirm our commitment to maintaining the highest standards of service delivery and information security. We would like to express our sincere gratitude to our dedicated customer finance team whose hard work and commitment to quality and information security have made these achievements possible. We also want to thank our clients for their trust and assurance in our services.

We will continue to strive for service excellence and improve our processes, always putting our clients and their information security at the heart of what we do.

At NHS Midlands and Lancashire CSU, we take pride in delivering the highest quality services to our clients while ensuring robust information security. These ISO accreditations represent a significant milestone in our continuous journey of excellence and improvement.

Jules Harrhy, Deputy Director of Finance AT NHS Midlands and Lancashire CSU said:

“Securing the ISO 27001 and ISO 9001 certifications is a significant achievement for my customer finance team. These accreditations are a clear testament to the commitment we have towards delivering exceptional quality of services while ensuring the utmost security and confidentiality of information. As the Deputy Director of Finance, I’m proud of our collective efforts and perseverance. This success sends a strong signal that we are dedicated to continuous improvement, thereby instilling greater confidence in our stakeholders. As we move forward, we remain committed to maintaining these high standards and working tirelessly to offer our services still wider to serve our local population.”

We increased the coverage of First Contact Practitioner (FCP) services from approximately 3% to 15% and improved communication and reporting, resulting in a significant positive impact of the FCP pilot programme. We also developed a regional FCP pack to increase awareness and replication of the programme in other regions, leading to improved delivery of FCP services across the regions.

Background

The First Contact Practitioner (FCP) programme aimed to bring physiotherapists into Primary Care to support General Practitioners (GPs) with the increasing number of patients seeking MSK care.​

The NHSE/I North Elective Care team initiated six pilots and the MLCSU’s Improvement Unit was approached to support the team, as they reported low FCP coverage and no clear reporting structure.​

Action

​We developed a three-stage plan to address the issue. ​

Stage 1 – Current position was evaluated, and communication and reporting between the national programme, NHSE regional teams, and STP/ICS developed pilots were improved. ​

Stage 2 – Other FCP delivery across the North was investigated to achieve the national target of 15% FCP coverage. ​

Stage 3 – Success of the FCP programme was celebrated, and a regional FCP pack was developed, enabling regional conversations on FCP delivery.​

Impact

The impact of the FCP (First Contact Practitioner) pilot programme has been significant, with a number of positive outcomes achieved. The pilots’ position has been improved through the establishment of clear engagement channels with all pilots. This has ensured that their feedback is heard and acted upon, resulting in increased confidence in the programme.​

The coverage of FCP across the regions has increased from approximately 3% to 15%. This increase in coverage has been achieved through the engagement of more practices and the standardisation of reporting methods, which has increased confidence in reporting FCP pilot figures from the systems.​

There has been a clear oversight of the FCP programme from the National FCP Programme, which has provided support and guidance to the pilots. This has been important in ensuring that the programme is successful and achieves its objectives.​

The success of all types of FCP delivery has been championed across the two NHSEI regions, and a regional pack has been developed and delivered to the regions. This has increased awareness of independent pilots reporting FCP delivery, with ten additional pilots recognised and eight developing deliveries.​

The success of the FCP programme has increased awareness across the region of the national programme and how to deliver FCP pilots. This has been important in ensuring that the programme is sustainable and can be replicated in other regions. Overall, the impact of the FCP pilot programme has been positive, with significant achievements made in improving the delivery of FCP services across the regions.​

We undertook a diagnostic review that optimised the underutilised features of a risk management system and simplified data capture, resulting in improved risk and incident management for the Acute Trust. We also developed dashboards and trackers for each module within the system and provided a user-friendly guide for enhanced system utilisation.

Background

MLCSU was approached by a North West Integrated Care Board (ICB) to provide specialist support to an Acute Trust. The trust had received a ‘Requires Improvement’ notice following a Care Quality Commission (CQC)visit earlier in the year. An improvement plan had been formulated, and the Trust required the capacity and capability to accelerate progress in several key areas of improvement.

Requirement: To support Datix management, manage data entries and understand the capability and functionality of the system. MLCSU commenced support in September 2022.

Action

An MLCSU workstream lead, armed with specialist expertise, conducted a comprehensive diagnostic assessment to identify key concerns and suggest recommendations for enhancement. As a result, a strategic 6-week immediate action delivery plan was developed, encompassing the following objectives:

Optimise the underutilised features of the Trust Datix system to enhance incident and risk management.

Streamline and simplify the incident data capture form for improved user experience.

Develop a range of dashboards tailored to support reporting based on incident type and specific domains, such as StEIS and Clinical Audit.

Design a user-friendly Datix guide for staff to facilitate efficient system utilisation.

Impact

Identified the underutilisation of Datix system functionality for improved risk and incident management through diagnostic review.

Simplified data capture through redesigned Datix forms, resulting in improved data quality, enhanced compliance, and reduced administrative time for clinical staff.

Provided recommendations for ensuring the sustainability of the Datix system through an options appraisal for future development or alternative solutions.

Developed trackers and dashboards for each module within Datix, supporting the Trust in enhancing its monitoring and management of risk and incidents.

Produced a user guide for the Datix system, promoting greater utilisation of the system across the Trust.

We helped reduce mental health crisis rates and optimise user flows by introducing a new data capture tool, evaluating existing digital tools and implementing a service redesign which resulted in a cost saving of £1.7m within six months of introducing changes.

Background​

Mersey Care NHS Foundation Trust began using MaST within its community mental health teams to help frontline staff make better decisions about the resources they use to provide safe quality care. With rising caseloads and increasing numbers of service users with complex mental health needs the staff have had to prioritise managing risk and keeping people safe with limited time to deliver recovery-based care.​​

The MaST software platform uses predictive analytics which draws on clinically relevant information from multiple sources to support healthcare professionals in better managing caseload and care. It can predict a person’s likelihood of requiring crisis care, enabling clinicians to effectively manage caseloads and ensure more people get early support to help avert admission to the hospital.​​

The Health Economics Unit was commissioned by the Innovation Agency, Academic Health Science Network for the North West Coast, to evaluate digital technology. The aim was to assess the impact it had on service user flow, management of mental health crisis in the community, quality and safety performance indicators and caseload management as well as resource use and cost savings.​

Action

The Health Economics Unit worked to understand what the intervention was looking to solve and how it fit within the bigger picture. We undertook a pathway mapping exercise and logic model to understand the outcomes of interest and identify key metrics and data needed for analysis.

We produced an evaluation framework and analysis plan to help guide the evaluation, before carrying out a descriptive analysis and regression analysis (a technique to understand the relationship between two variables) to examine the effect of MaST.​
Impact
A new data capture system, COVID-19 and a service redesign meant that showing the effect of MaST was challenging. Despite this, our analysis showed that mental health crisis rates began to decline during the introduction of MaST and continued falling with a reduction in the length of stay in the hospital. This shift in activity is estimated to have resulted in a cost saving of £1.7m in the six months following its introduction. ​

As a result of the report, our client has been able to see the effect of the software on user flow, management of mental health crisis, quality and safety performance indicators and caseload management, as well as the effect on resource usage and whether there were any cost savings. Our client could understand any benefits and make an informed decision on the costs and benefits of its continued investment. The outputs from the report were used in business cases to help provide evidence-based findings to support requests to implement the system.​

By analysing the results from stakeholder decision conferences along with the STAR tool, we empowered ICSs to efficiently allocate resources for COPD patients and maximise value within limited funding constraints.

Background

Integrated Care Systems (ICSs) face the challenge of allocating resources to better meet the health and healthcare needs of their population. This requires ICSs to understand the value of different interventions across the entire disease pathway, including interventions for prevention that affect the wider determinants of health as well as treatment. The Health Economics Unit used the STAR tool, a publicly and freely available tool, to empower ICSs to understand and undertake their own stakeholder-inclusive, in-depth allocative efficiency analysis for COPD so that they can reallocate resources to the best effect.

Action

We brought together patients and stakeholders involved in providing and receiving care on a pathway to participate in decision conferences. These meetings were typically the first time that all who provided care on the pathway met in the same room at the same time and were designed to identify the interventions that could reasonably be taken forward by the ICS to improve the value of the COPD pathway. ​

We provided estimates of the activity and associated costs of each intervention and searched the literature for estimates of their health benefits in quality-adjusted life years (QALYs, a way of measuring how an intervention lengthens and improves a patient’s life).

Further decision conferences allowed stakeholders to agree on estimates of the relative benefit, informed by the literature. We then combined this with the costs of each intervention to understand an intervention’s value. This was then plotted in easy-to-interpret visualisations of where the value lies and used to facilitate conversations as to what improvements could be made.​

So far, we have undertaken decision conferences with three ICSs and are producing a comprehensive report for each of them, detailing which interventions deliver the highest value in their ICS.

Impact

Our work on the COPD pathway will enable each ICS to align their pathway to deliver the most value for the limited funding available – providing the right amount of the right care. It will enable them to build consensus in the ICS on the future funding of the COPD pathway. ​

Additionally, we’ll be publishing a national report to share our learning and make recommendations on how resources should be allocated to deliver the most benefit to patients.​

Tools and training materials will be made available for the NHS more widely so that others can use the technique.

“I think it was a really helpful discussion and helped to set the scene for how we make plans for next year. I think this will be widely celebrated and taken on across the system.“

Komal Gorania – Senior Commissioning Manager – Northamptonshire ICS

As part of the NHS Midlands and Lancashire CSU’s Green Plan and commitment to reducing our carbon footprint, we have dedicated workstreams cutting across all aspects of how we operate.

This includes IT Procurement, which is working with suppliers and manufacturers to develop a way of assessing the carbon journey of the equipment we use – from manufacture to shipping.

As part of this, IT Procurement Manager Tracey Yates and her team have been asking suppliers for their Green Plan and requesting the Carbon Data Factsheet for each product. This information is then compared against that from alternative manufacturers and an assessment is made on the suitability of products based on their carbon output.

But it doesn’t end there. The IT Procurement team also assesses the Total Cost Ownership, which means the estimated carbon cost of using equipment. For example, the power required to run a typical staff computer and monitor for eight hours results in greenhouse gas emissions equivalent to around 70g CO2e. A standard laptop and monitor, operated over a five-year period, creates a carbon footprint of around 755Kg CO2e. It is important to bear in mind, however, that 85 per cent of this results from manufacture and shipping, while just 15 per cent is from electricity consumption.

Tracey said: “There is a lot to think about and assess when making green decisions in IT procurement, but it is very interesting to understand the carbon cost of different types of equipment. When we consider the full lifecycle impact of providing and using IT, we need to consider both the upstream impact of supply and the downstream impact of disposal.

“For example, there is a significant difference between the carbon impact of a desktop and a laptop, mainly due to people wanting to replace the laptops more frequently. Therefore, the option to re-use/repair/upgrade should be considered wherever possible, before the decision is made to scrap, and buy new.”

Tracey’s team has also looked at using one larger screen monitor as a greener alternative to running two smaller monitors – thus reducing power usage and the need for a docking station. They have included social value and net zero questions in tenders and assess the suitability of suppliers on a wide range of environmental factors, including the use of an electric-powered fleet and non-plastic packaging. And the team has also embarked on carbon literacy training and started questioning the need to purchase equipment when an upgrade or repair is more suitable.

Tracey said: “Given that 85 per cent of carbon output is in the manufacture, if we don’t need to buy something, we shouldn’t.”

Staff from across the Midlands and Lancashire Commissioning Support Unit was deployed to support a national programme for oxygen, ventilation, medical devices and clinical consumables which ensured that sufficient ventilators were procured at a time of huge global demand and that all patients had access to oxygen when required.

Background
The COVID-19 pandemic led to an urgent requirement to build a national stockpile of ventilators, medical devices and clinical consumables, whilst also ensuring that the oxygen infrastructure in place had the capability and capacity to support the increased demand.

The Covid-19 Oxygen, Ventilation, Medical Devices and Clinical Consumables Programme was established to fulfil this requirement. Led by the Department of Health and Social Care (DHSC), the programme employed the knowledge and skills of staff from a wide range of clinical and non-clinical disciplines across the NHS, Ministry of Defence, Deloitte and PA Consulting. This was a UK-wide programme that worked closely with colleagues in all the Devolved Administrations and Crown Dependencies.

Action
An MLCSU associate director  with specialist procurement expertise joined the cross-government team in the role of Deputy Programme Director for the first six months. He acted as a first point of contact for workstream leads with specific support and input to programme governance, international logistics and UK storage and logistics.

Programme delivery was split into four phases. Members of MLCSU’s Improvement Unit and other teams supported with programme management expertise throughout the phases.

* Phase 1 (March-June 2020) ensured the NHS had sufficient supplies of ventilators, oxygen and consumables to meet Coronavirus demand.
* Phase 2 (June-December 2020) focused on improving the quality and availability of devices, solidifying consumables system and stockpiles, establishing a ‘new normal’, and reducing reliance on complex supply chain systems.
* Phase 3 (January-March 2021) focused on solidifying and maintaining the outcomes of Phases 1 and 2.
* Phase 4 (April-September 2021) focused on transition activities towards medium to long term operational arrangements and the programme closure and transfer into the Medical Technology Directorate of the DHSC.

Impact

For patients

* Due to action taken early in the pandemic, sufficient ventilators were procured at a time of huge global demand, to ensure that all patients had access to one when required.
* Oxygen usage was monitored daily, allowing for interventions to take place as soon as any potential issues were encountered, meaning that all patients had access to oxygen when required.

For staff

* The programme issued detailed guidance on correct use of ventilators and oxygen management via the e-Learning for Health website.

For trusts

* There were clear processes for ordering equipment, and for urgent clinical need cases, deliveries were made within 48 hours.
* Thanks to the support of multi-disciplinary teams, trusts were supported to better manage their oxygen supplies and, where necessary, urgent works were undertaken to upgrade old pipework and install new oxygen tanks.

Robert Moorhead, Deputy Programme Director, Department for Health and Social Care, said: “Thanks to the work of the Programme, no patient in the UK went without oxygen or a ventilator who needed it.” 

In December 2021 the programme won a Civil Service Award recognising excellent collaboration across organisation boundaries. 

We reduced the time it takes to process essential financial planning templates by 50% and established a data warehouse for financial reporting.

Background

Previously, the financial planning process at Midlands and Lancashire Commissioning Support Unit (MLCSU) involved individual working files for different services. To submit the planning template to NHS England and Improvement (NHSEI), the finance team was required to collate information from 40 different places and then cut this data multiple ways to complete the template. It took two full working weeks of staff time to collate and manipulate the data.

Once the detailed plan was agreed, it had to be uploaded to the ledger for reporting for the full financial year. This required going back to the individual working files and assigning codes based on top-down assumptions. The process used to take approximately 50 hours.

Action

We produced a standard template that automated the coding and categorisation of the costs to support the completion of the NHSEI template and the internal reporting requirements.

We implemented a database and invested resource in developing the reporting. The information was uploaded into a data warehouse, and this allowed it to be easily manipulated and collated to complete NHSEI reporting on time.

As all the data was in one place, it was also easier to create the journals for uploading to the ledger.

Impact

We have streamlined the process for completing the NHSEI planning templates by 50% and invested the time saved in adding value to the data rather than data collection and collation.

The process for uploading the plan to the ledger has also seen efficiencies by reducing the time needed by 75%.  This was driven by having all the data in one place which made it easier to collate, complete the template and identify and resolve discrepancies.

An added benefit of the collated data is support for other decision making processes, which has made the finance team more responsive and allowed them to invest more time in added value activities.

Lyn Tallentire, Deputy Finance Director, MLCSU, said:

“Investing in the data warehouse and this approach has delivered benefits in the planning process itself and further benefits on how we use this data on an ongoing basis.” 

We halved the time it takes to load the financial forecast into the ledger and reduced the risk of errors.

Background

The Midlands and Lancashire Commissioning Support Unit (MLCSU) used a manual process to load the financial forecast into the ledger by changing each subjective code line by line. This process was extremely time consuming for the following reasons:

* It was necessary to run multiple reports from the ledger to extract the data to create the forecast journals
* Checks had to be made to ensure the journals had achieved the desired position and we could make corrections if necessary
* The risk of errors was high due to the reports having opposite signs to the journal entry requirements.

Action

The bulk upload template is Web Applications Desktop Integrator (Web ADI) and allows for multiple lines (or cost centres) to be amended in one go.

The Forecast Out Turn uploader tool ensures that there are no errors prior to the upload as there are control checks embedded within. The tool also populates the income the correct way so that when a report is downloaded, this is captured and mirrored in the accurate way.

The tool was initially tested, and a procedure note produced so the knowledge could be shared across the team.  Based on experience it was identified this was only effective if you were changing multiple lines (or multiple costs centres) as downloading the Web ADI can take some time.

Impact

Within the first month the tool was implemented there was a 50% efficiency achieved despite the learning curve of implementing.

This approach has also been embedded into month-end processes and is providing ongoing benefits.

“This review of the process allowed us to use technology available to quickly streamline and improve the process.  Driving efficiency allows us to invest time in adding value.”
Lyn Tallentire, Deputy Finance Director, MLCSU

We are extremely pleased to announce that we won the Finance Team of the Year award at yesterday’s Healthcare Financial Management Association (HFMA) West Midlands Branch Annual Conference.

This award recognises the contribution that our Finance Team has made in the last twelve months to promoting and improving teamwork, innovation, collaboration, transformation and governance in the NHS finance community.

Tony Matthews, Director of Finance and Commerce at the Midlands and Lancashire Commissioning Support Unit, said:

“I am delighted that our Finance Team has been recognised by the HFMA and to win such a prestigious award as HFMA West Midlands Finance Team of the Year.

“To have been recognised by the HFMA in the West Midlands in amongst the many other brilliant NHS finance departments and to have been singled out is fabulous and recognition of the hard work and dedication the team displays each and every day for the NHS clients we support.”

In a year with many challenges, the team kept their high spirits and committed dedication to improving their staff, processes, performance and sharing best practice with the wider NHS.

With over 200 delegates at the event, two awards were presented by the West Midlands Branch of HFMA, which promotes the highest standards and innovation in financial management and governance across the UK health economy through its local and national networks. It is a huge honour to be recognised by this award – well done to our colleagues!

Blackburn with Darwen and East Lancashire Clinical Commissioning Groups (CCGs) have become the latest customers to sign up for our state-of-the-art room and hot desk booking system, UBook.

In Spring 2021 the CCGs’ corporate and estates leads approached the Midlands and Lancashire Commissioning Support Unit (MLCSU) as they were investigating new ways to promote agile, office-based working and realised that they needed a powerful and responsive booking system.

MLCSU’s Applications Development team is currently digitising the CCGs’ floor plans to populate the richly-featured interactive system which can be accessed from any browser, desktop, tablet or smartphone. UBook will be deployed across their sites during the summer of 2021.

Nine organisations have now subscribed to the system, which is currently processing bookings for thousands of rooms and desks. Across these clients some 10,000 members of staff are regularly using UBook to manage the booking of meeting and treatment rooms, hot desks, parking spaces, bike racks, projectors, pool vehicles and other physical resources.

The latest version of UBook, launched in 2020, was specifically designed for NHS organisations which needed efficient, easy-to-use administrative systems at a sensible cost.

The latest version of the system includes hot desk booking with social distancing and information-rich reports which can help to inform detailed estates planning. These new features have helped clients to manage the changing demands upon their resources during the COVID-19 pandemic, particularly around staff returning to work after lockdown restrictions were lifted.

Birmingham and Solihull Mental Health Foundation Trust signed up to UBook last year after deciding to introduce one simple booking system to replace several procedures across its sites. As the COVID-19 pandemic unfolded they took full advantage of the system’s flexibility, which allowed safety measures to be quickly implemented.

Their UBook pilot scheme, launched in October 2020, allowed bookable desks to be removed from the system to comply with social distancing regulations. The system’s interactive floor maps showed staff which desks were available at any given time and the system automatically locked out desks for 72 hours after each use to ensure that they were COVID-free before being used again. Other UBook clients tie this window into local cleaning rotas to ensure desks are cleaned after each use.

QR codes were also introduced at the Trust to allow staff to check in from mobile devices rather than the planned touchscreens.

Amanda Tierney, Project Manager at Birmingham and Solihull Mental Health Foundation Trust, said: “MLCSU have been exemplary in their commitment to making the system work for our needs. The admin staff find it extremely useful and very easy to use and the ward staff are all positive too.

“I’ve learned so much from working with you and I’m extremely grateful, I couldn’t recommend you highly enough. I think that UBook is phenomenal and will benefit any organisation or trust that uses it.”

MLCSU Application Development Business Manager, Bill Douglas, said: “At MLCSU we were delighted to assist the Trust in its move to a unified room and desk booking system. As ever, we captured new ideas from those who manage estates and clinical functions and built those into the latest feature set.”

The objective of the project was to streamline payments for joint-funded packages between MLCSU and Staffordshire County Council (the LA) by moving to a monthly electronic process. We previously used a paper-based process which in some cases could take over six months to reconcile due to disputes. As a result, the full payment would be withheld until there was an agreement on the full payment list, a process which was very resource-intensive.

How we helped

MLCSU currently uses adam for their commissioning and case management systems, so using the same system for this project was a good fit.

Project governance included weekly meetings between adam, MLCSU and Staffordshire project stakeholders. In these meetings the completion of project milestones was tracked and potential risks were raised. The category went live on time and the first payment was made within the agreed timeline.

This new category has been set up as a collaboration between MLCSU and Staffordshire County Council, where MLCSU use the new category to manage the reimbursement of the local authority for the payment of joint-funded packages of care.

Staffordshire council has a provider (read-only) view of their joint funded packages of care, but is able to track changes to any particular package, such as a rate change, throughout the process.

Impact

The new process has resulted in:

* Quicker payments and improved cashflow
* Centralised online storage, records cannot be lost or damaged
* The system configuration has been set up and is ready to go
* Automatic Service Receipt (invoice) generation within the system
* The LA will benefit from transparency and visibility of packages of care
* The LA will view the same package details as MLCSU
* Full audit trail available, including an audit of any changes
* Improved reporting functionality available to the LA and MLCSU
* Payments can be made on a regular basis (monthly)
* LA and MLCSU can review the invoice files generated by the system before payment is finalised
* Any disputes can be removed from the invoice file and investigated separately
* Only disputed invoices will be withheld from payment

Before the project, the average time to pay invoices for the 2019/20 financial year was 376.6 days – the average payment time is now 30 days as standard. At the end of 2020/21 financial year there were no outstanding debts owed to the council for this cohort of packages – for 2019/20 there was a debt owed of £9.2million at the finance year end. The improvement in terms of cashflow and the time taken to resolve the level of queries and reconciliations has been significant.

Karen Webb, Joint Funding Lead at Staffordshire County Council, said:

“Cashflow has been significantly improved. Originally it could take up to 6 months to reconcile and agree any disputes before any payments were made to Staffordshire council. We now get paid monthly and any disputes do not stop payments from being processed.

“The implementation of this solution means there is full transparency over the data which means when the invoice files are shared, there is a significantly less amount of time we are spending reconciling invoices.”

Our work supported the recruitment of the bank and volunteer staff working at vaccination centres, at a time of high pressure in the NHS when work volumes were already extremely high, capacity was already strained, and staff were having to navigate difficult home lives because of COVID.

Background

Between January and June 2021, our project provided large-scale recruitment services to five NHS organisations which were supporting ICS/PCNs with the mass vaccination roll out. We supported the completion of around 2,500 pre-employment checks for volunteers and bank workers.

Action

We quickly recruited and trained 40+ recruiters to support an original small team of seven; we set up IT systems, provided a corporate induction, took project scope calls with area leads to determine support requirements and put in place processes that met data sharing regulations so that we could quickly source staff for vaccination centres.

We collated volunteer forms and converted them into applications and conducted remote ID verification calls and pre-employment checks, and processed checks for the Bring Back Staff Scheme. The team organised an alternative occupational health provider to support with fit-to-work and immunisation checks to relieve pressures on the existing occupational health team. We also pre-arranged immunisation sessions at a local GP practice for applicants.

The team supported Cheshire CCG while Mid Cheshire Hospitals NHS Foundation Trust hosted the bank, using volunteers and bank staff deployed to Cheshire PCNs and to the Cheshire Racecourse and Alder Hey vaccination centres.

MLCSU also supported with the recruitment drive for the Shropshire, Telford and Wrekin region. We quickly established a process to use the existing systems at St Helens and Knowsley Teaching Hospitals NHS Trust, East Lancashire Hospitals NHS Trust and Midlands Partnership NHS Foundation Trust to process applications on their behalf.

Impact

Over the last two years, MLCSU have built the capability to flex staffing requirements to meet NHS demands by developing a temporary staffing team who specialise in generating flexible workforce solutions such as bank and associate pools. This innovative private sector/agency-type model was a massive advantage when it came to deploying 40+ bank staff to work on this project at short notice.

Its streamlined processes and integrated systems allowed the team to provide services with little front-end set up, and by drawing on skill sets from the wider people services department, the model produced effective training and onboarding solutions for new staff.

Due to their speed and efficiency, the team have supported with the overall success of the vaccination rollout locally and nationally, processing approximately 2,500 applicants.

Phil Meakin, Programme Lead for COVID-19, Cheshire CCG, said:

“This has been an amazing system effort from the people of Cheshire, Trust staff, ICPs, CCG, Liaison Workforce, and MLCSU.

“The team from MLCSU provided us with daily updates of applicants’ process status and held weekly meetings to make sure our processes were working effectively. This helped us to understand the timings of when we would have enough resource to support Vaccination Centres.

“We are very grateful for their accurate and effective work of MLCSU in supporting people through a challenging process. Without all partners working together, it would have taken far longer to vaccinate the people of Cheshire.”