Ekta Mehta, Author at CACI

How can care management software underpin outstanding person-centred care?

Posted on: 24 October 2024

Person-centred care planning and delivery is the backbone of any outstanding care service. It’s something that the CQC actively looks for when conducting inspections, a hallmark of quality care services. From planning and delivering to putting your clients in control of the care they receive, how can you best deliver person-centred care? Download a copy of The top seven features you need from your care management software now.

Person-centred care starts with the person

It’s obvious to point out, but the best way of delivering person-centred care is by involving them. Understanding each client’s medical and care needs is one thing, but how involved are they in the process of the care they receive?

A central record for each client is essential. A care management system can support you in this by providing an easy to create and easy to edit record for every client. When they enter your service, being able to understand their medical record and the exact care they need collaboratively with them is imperative. You can then provide this information to your care workers ahead of and during visits, ensuring that the right care is administered at the right time.

But people’s needs evolve over time. From new prescriptions to changes in preferences, keeping the care you provide to each client up to date is vital. It is also important to be able to share their data with third parties and other providers for any care they receive outside of your services. A care management system can support you in easily and securely sharing relevant data in line with data protection regulations.

The needs and desires of your clients may also change over time. In a lot of care settings, aspects such as end of life often need to be considered. Putting your clients in control of this process is essential. Every client deserves a bespoke care plan and the dignity and respect to make their own decisions.

Involve their loved ones in their person-centred care

In a lot of cases, your clients will have loved ones who are actively interested in the care you provide to them. Reassuring them of upcoming and completed visits, the activities and tasks undertaken, as well as any actions to be taken, is a great way of involving them and evidencing how person-centred you are being.

This can be achieved through the provision of a friends and family portal. Your care management software should support you in establishing this, making simple, secure logins available to authorised users to access a client’s care plan. This is also a great way of getting feedback from your clients on the services they are receiving from you.

Users logging on to the portal can see upcoming and completed visits and obtain information such as medication administered and to be administered. A portal is also a great way of receiving input from family members too, where small details or observations around tweaking your care planning can prove really transformative for the person you support.

Understanding clients’ preferences

A simple way of going above and beyond in providing person-centred care to your clients is to understand their preferences. The CQC notes that these should be recorded once and shared with relevant stakeholders across your care service to avoid duplication of questions with clients.

This helps to add a human touch to their care. If, for example, you have someone who owns cats, this could be something that could be discussed with them during their visits.

Also, if they have upcoming life events, such as a birthday, prompting this information to your care workers means that it’s easy for them to mention and take into consideration. Understanding your clients and sharing this type of understanding with your care workers can deliver excellent outcomes.

Your care management software can help you with the provision of a mobile app for your care workers. They can access visit information and see details such as birthdays and interests in the app as they go about their visits.

Continuity of care is another important means of providing person-centred care. Clients will naturally establish relationships with certain care workers. By rostering care workers consistently to clients, you can provide this continuity.

Again, your care management software should help with this. Making rostering easier, technology can suggest ‘best fit’ allocations of care workers to care plans, considering not only relevant skills and experience, but also factors such as them having a positive relationship with a care worker.

Conclusion

There are several factors that play directly into providing outstanding person-centred care. From understanding the client and their medical needs, to sharing this information with your care workers and rostering the right staff to the right clients, person-centred care requires research, effort and consistency.

Care management software can underpin this process. Creating a central record of each client makes understanding them and their bespoke needs easier. Equally, a central record of each care worker facilitates smoother alignment of your care plans and your staff rosters.

It’s one thing providing person-centred care, and another evidencing it. When CQC inspections inevitably come around, being able to display your care planning, rosters, client visit history and records of communication, you can more easily demonstrate to external stakeholders that your care service puts its clients first.

Every client deserves their own bespoke care plan. Every client deserves to be treated with dignity and respect. Ensuring this happens can be easier than you might think.

We’ve covered this and more in our latest white paper which outlines the top seven features the best care management software should provide to you. It’s free to download, so why not take a look?

The Care Show 2024 – the evolving role of care management technology

Posted on: 17 October 2024

There are several issues at the forefront of the minds of those involved in the care industry right now. From managing CQC inspections to coping with increasing vacancies in the sector, there are several key issues to traverse. Throw in data security and the need to digitise care records and it can appear an overwhelming to do list. Alongside evolving concerns, however, are evolving solutions. There is an increasingly prevalent role being played by care management technology in the care sector. We wanted to round up a few key issues from the 2024 Care Show and look at how they can be addressed.

CQC inspections

Finding a popular regulator in any industry is difficult, but there’s a widespread challenge across the care sector in understanding the Care Quality Commission’s (CQC) single assessment framework (SAF).

The outbreak of the global Covid pandemic saw a shift to a risk-based approach. The number of completed CQC inspections is yet to reach pre-pandemic levels. This has left some care providers with a rating of ‘requires improvement’ hanging over them for a number of years. This has a knock-on effect on client confidence and the wider business.

When it comes to inspections, it was clear across the Care Show that there’s dissatisfaction and misunderstanding of the SAF, too.

How can care management technology help?

Whilst care management technology can do nothing to alter the rate of inspections, it can help care providers get into position for them. If all your care plans, records and outcomes are recorded in a central system, it makes the process of presenting evidence to the CQC much easier.

When it comes to answering specific questions, having all the information easily available reduces the effort in answering them.

Digitising social care

“70% of providers have digital social care records. This is expected to reach 80% by March 2025,” says Peter Skinner, programme director, digitising social care at the NHS.

Technology is accepted as having a crucial role for care providers and their clients. More links need to be established between care providers and the NHS. Care management technology is a key enabler in getting people back into a residential setting following hospital visits. It’s also a key enabler in equipping NHS staff with the right information and context on a client when they have to visit hospital.

The NHS has built standard data capture, the market now needs to understand how it can be used. It’s a two-way journey: admissions info for NHS staff and discharge info back to providers. Joining these up will create efficiencies and a better process for people receiving care. The standardised data set exists at a national level, making it easy to access for everyone with a single access point.

It’s important to maintain standards for providers accessing technology. The NHS is driving interoperability and providers needs to understand what they’re buying.

How can care management technology help?

This is an obvious area in which care management technology is imperative. Maintaining paper records is inefficient and risks vital information going missing. Being able to share the digital information captured with stakeholders quickly and accurately improves care quality. Failing to act on the point of digitising care planning and records will see providers left behind.

If you’re still working manually, it’s time to speak to a care management software provider. Equally as important, you also need to understand what you’re buying and the impact it will have on your business.

Cyber security

This is perhaps another obvious area for technology, but cyber security is a genuine concern in the care industry. The process of caring for people necessitates the handling and processing of sensitive information. Such information is valuable to criminals. So, how can you best protect yourself?

One of the points raised across the Care Show was the need to continually educate your staff, from administrators to care workers. Your cyber security is only as good as your weakest link. If someone clicks on a malicious link, that can be enough to cause chaos.

How can care management technology help?

Partnering with a care management technology provider is an opportunity to gain real peace of mind with your data security. An obvious starting point is to check their security certificates for things like Cyber Essentials and ISO27001. This offers assurance that your care management technology partner is certified to the highest standards.

There are other factors to consider, such as where your data will be stored. For example, CACI use AWS to store Certa’s data. This helps to leverage Amazon’s significant security expenditure for your data.

The care workforce

There is general dismay at the attitude towards and treatment of care workers in the UK. “They are underpaid and underappreciated,” said Karolina Gerlich, CEO of The Care Workers’ Charity. “Recent pay rises of 10p per hour are unacceptable. Care workers are considered low skilled and those arriving from overseas don’t enjoy benefits such as being able to bring their own families with them.”

There is little surprise that care workers are being easily tempted away by other industries. They get similar or better pay and less stressful working conditions. It’s therefore unsurprising that vacancy rates are so high in the care sector.

Beyond that, there was discussion at the Care Show around how providers can better support their care workers. It is widely believed that more support is required, in terms of communication and specialisation. This comes back to understanding your workforce. Assigning care workers to areas that they’re really good at and really interested in is an effective way of keeping them engaged. Further focussing training for them on those areas is another positive.

Training was mentioned as something that needs to go beyond just mandatory refresher training, to courses that expand people’s professional profiles, offering them career development.

Communication is another vital thread. Considering the impact of new technology on care workers and involving them in the decision making process helps to make them feel appreciated and involved. Bringing them closer to the central team improves connection and the sense of involvement. Ultimately, if you look after your care workers, you reduce your expenditure on recruitment, especially at a time when there are more vacancies than care workers. Having a happy, consistent team of care workers will also ensure the ongoing quality and consistency of care you provide to your client.

How can care management technology help?

Care technology can support care workers in several ways. Simple additions to your care management technology such as a care worker app can help to clearly communicate with care workers and enhance lone worker safety.

It can also help you in understanding your care workers and their expertise. What do they specialise in? What are they good at? Which clients do they get on with? How can you make their day efficient and effective? How can you ensure they have all the information they need for each visit?

Care management technology can support this. You can then better roster your care workers and provide appropriate training opportunities. In the same way that no two clients are the same, nor are two care workers. They have different interests and specialities. Providing them with the opportunity to enhance their careers with you will make them more likely to stay.

The cost of recruitment is only going up and with more vacancies than care workers there is ample opportunity for care workers to explore other opportunities. Simply treating them fairly, involving them and offering training and progression is a great way to go about keeping them.

Conclusion

There were several points of interest across the Care Show. If you’re affected or concerned by any of the issues raised here, we’ve designed Certa to help you. Find out more by visiting https://www.caci.co.uk/software/certa/

The SEND improvement plan and reshaping EHCPs

Posted on: 15 October 2024

One of the suggestions of the recent SEND review was to overhaul EHCPs, something that is being continued under the SEND AP improvement plan.

The Department for Education (DfE) commissioned the SEND Review in 2019. The aim of this review was to explore the challenges faced by children and their families with identified special educational needs and disabilities (SEND). In March 2022, after much consultation, a green paper was published which puts forward several suggestions as to how the SEND process can be better administered to improve efficiency and, ultimately, improve outcomes for those children and their families. In amongst the plethora of suggestion sits one around EHCPs (education, health and care plans).

Despite delays to parts of the implementation of the recommendations laid out in the SEND green paper, the SEND Alternative Provision Improvement Plan seeks to press on with revised EHCPs; “This will include delivery of digital requirements for EHCP systems to improve experiences for parents, carers and professionals, decrease bureaucracy and improve the ability to monitor the health of the SEND system.”

What does the DfE want to do with EHCPs?

In short, the DfE wants to streamline EHCPs. As things stand, there is a loose outline for EHCPs but the level of detail within them is at local discretion. This has resulted in inconsistencies at local and national levels, leading to inconsistent responses to them. This is particularly acute where professionals work across two localities: getting to grips with two interpretations of EHCPs takes time and increases the manual, administrative burden upon professionals.

As the SEND green paper notes; “There were inconsistences in the structure, length and formatting of EHCP forms, with the samples included in the analysis ranging from a maximum of 40 pages in one local authority to between 8 and 23 in another. The EHCPs produced by the local authorities in the sample would take approximately 50 minutes on average to read aloud to a child. This lack of consistency means that partners who work across multiple local authorities must navigate multiple processes and templates, reducing their capacity to deliver support and adding to their administrative burden… We therefore propose to introduce standardised EHCP templates and processes.”

Sounds sensible, how will it work in practice?

The central hook upon which EHCPs will be hung going forward will be via a template provided by the DfE – a standard EHCP template with supporting processes and guidance is expected in 2025. This will standardise the information captured, simplifying the interpretation of the information within them and making it easier to input appropriately into each child’s journey.

Another rule that the DfE is seeking to implement around EHCPs is that any changes to them will need to be signed off by the parents of the child. Their increased involvement is seen as central to the success of the SEND process going forward.

The fundamental change to the management and administration of EHCPs is that the DfE is looking to fully digitise them. This will make the process much more efficient and transparent, reducing bureaucracy, since each EHCP will have a fully auditable trail of activities and inputs. This will make interpreting each EHCP much quicker, too, since a complete record of professional and parental input will be visible to schools, professionals and parents.

Creating a central record will enable for greater control, ease of access and interpretation of data for everyone concerned. Children with identified SEND necessarily find themselves in a multi-agency scenario, so tying their record together digitally makes interpreting and understanding their journey easier.

This indicates that information sharing regarding identifying SEND beyond the boundaries of administering education support and placement is vital. For example, youth justice practitioners often identify unmet needs and have contextual and relationship information to contribute to a complete view of the child. Having rich information from multiple sources to consider in the SEND process is key to formulating practical support for their journey and enabling their future life achievements.

Technology supporting the single view

“We think the case is clear for all SEND services to move to digital systems for EHCPs. Digital systems can deliver better experiences for both families and professionals and enable them to continuously improve their services – focusing staff time on working with families rather than being hampered by partial understandings and disconnected bureaucracy.”

A number of different system and technology solutions exist across the education domain, so there’s no chance of every authority and school deploying the same software. Where the DfE will want the systems to work better for children is regarding consistency and interoperability.

Most systems have potential to support interoperability for a standard set of data fields curated by the DfE and to communicate with any third-party systems to send and receive as well as extract information. Whilst there are always challenges defining best practice categories through suitable consultation this will be vital in achieving earlier intervention and better SEND outcomes through the EHCP process.

Conclusion

A standardised response to EHCPs will make the entire process more accessible and easier to manage. The response to SEND should not depend upon where you live and the process should be transparent and consistent for everyone.

As a longstanding and experienced provider in the education domain, we have long seen the benefit of extended access to information as well as standards for interoperability with third party software. The ability to send and receive data seamlessly creates more accuracy and efficiency in the multi professional collaborative process that will ultimately benefit of children and families with identified SEND.

Creating a rich, single view of every child can only be beneficial in collating data for understanding behaviours and tracking responses. We too often see information, systems and processes and practitioners siloed and struggling to tackle the challenge of improving outcomes for the diverse needs of all children. So, this intervention from the DfE is welcome and so as a supplier we will be proactive in supporting this.

Certa from CACI is a complete care management software system designed to support outstanding care delivery

Posted on: 14 October 2024

Connecting, confirming, caring: Certa from CACI is being launched to help care providers deliver outstanding, person-centred care to their clients. Certa puts all the tools that care providers need in one place, helping to handle the background administrative duties and leave managers and care workers to the task of exceptional service provision.

Leaning on more than 25 years of experience in the sector, CACI is delighted to launch Certa. Certa provides an affordable, all-in-one solution for homecare providers of all sizes, supporting them in achieving the goal of delivering outstanding person-centred care.

What is Certa?

Certa is a complete care management software solution designed for care providers. It supports the planning, delivery and management of outstanding care services with tools across care planning, rostering and financial management.

Put those you support first with smart tools to deliver person-centred care planning, whilst removing paper from your service with Certa’s digital care records. Personalise your rostering using advanced matching rules and optimisation to deliver care worker schedules through a mobile app. Record timesheets automatically to drive accurate pay and billing processes. Understand and react to service activity with Certa’s dashboards and alerting. Evidence your quality statements with Certa’s real-time reporting.

Connecting: access Certa anywhere through web and mobile, with confidence that you are working on a single source of the truth. Communicate with everyone involved at every step of the journey via messaging, apps and portals.
Confirming: have assurance that you are matching needs and preferences with the right people in the right place at the right time, are informing your care workforce effectively and are recording a true picture of activity in the field.
Caring: ultimately, you need to deliver exceptional care to those you support; Certa gives you the tools to do this allowing your service to be tailored to individual needs and highly responsive as changes occur, as well as allowing you to evidence the high quality care you provide.

Who benefits from Certa?

Clients: benefit from a fantastic, responsive service that is mindful of their needs, delivers when expected and allows easy interaction as necessary to achieve wellbeing.
Care workers: spend less time on admin and more time delivering exceptional care with tools that inform, support and protect their work.
Schedulers/Administrators: update records and match clients and care workers optimally and efficiently, whilst reacting to exceptions and alerts in an informed and responsive manner.
Managers: connect with all service stakeholders, gain insight into every area of your organisation, make decisions based on fact, be confident with your finances and evidence high quality services.

For more information regarding Certa please visit www.caci.co.uk/certa.

Royal Borough of Greenwich to use CACI’s Impulse Nexus as its education management information system

Posted on: 24 September 2024

CACI is delighted to announce that its Impulse Nexus education management information system has been chosen by the Royal Borough of Greenwich to underpin and support the delivery of its education services.

Following a competitive tender process in the spring of 2024, the Royal Borough of Greenwich has awarded the contract for its education, inclusion and early years case management solution to CACI.

We are delighted that the Royal Borough of Greenwich has chosen our Impulse Nexus system to support vital service delivery,” says Phil Lucy, director of CACI’s Children & Young People division. “We’re excited to be partnering with them on this comprehensive project and supporting their services for many years to come.

About Impulse Nexus

Impulse Nexus is a modular education information management system that supports councils and local authorities in delivering education services. Impulse Nexus can be used to support some or all of an authority’s education services. Portal functionality enables easy and secure messaging between schools, authorities, parents and professionals involved in a child’s education journey.

With a transparent and complete record which stays with a child throughout their educational journey, Impulse Nexus helps to join the dots in every child’s education, helping to improve outcomes for everyone.

How Walsall uses hosting from CACI to support its use of ChildView

Posted on: 23 September 2024

Walsall Youth Justice Service has been using ChildView from CACI since 2014. ChildView supports the youth justice team in its vital work supporting vulnerable young people and their families across the council. In September 2022 Walsall made the decision to take advantage of CACI’s hosting services.

“We made the decision to remove some of the barriers that hosting the ChildView system internally created,” explains Stephen Evans, Administrative Officer (Specialist) at Walsall Youth Justice Service. “I’d have to say that it’s been excellent. There were no issues transferring the system and data across and we’ve been able to resolve any issues much faster. Before, we used to get errors and would have to go through server re-sets – this has all but been removed with near to instant fixes.”

This has resulted in more efficient use of ChildView for Walsall Youth Justice Service. “Now, we raise a call, someone from CACI’s support team logs on and fixes the issue. Previously, we had to get a VPN code, which was a faff. Having the system hosted by CACI has proven to be much more efficient.”

Another area which has been more efficient for Walsall Youth Justice Service has been in updating ChildView. “Absolutely, the impact of ChildView updates has been reduced,” says Stephen. “Updates previously had to go through our internal ICT team, to our team, to CACI then back to our ICT team. Upgrades could take all day. Now, CACI can fix errors immediately and run updates for us. Where the system could be down for a whole day before, now the worst case scenario is half a day.

“Another significant factor for my team has been the availability of ChildView at the weekend, too. When ChildView was hosted internally, we very rarely had seamless access to the system at weekends due to servers being shut down. It felt like it never worked at the weekend, which negatively impacted our services. Obviously, we need to access the system at the weekend because our work doesn’t stop. The move to CACI hosting has been excellent in terms of system uptime and availability.”

Data security is at the forefront of everyone’s minds these days. Youth justice teams process a vast amount of sensitive personal data, so security is of the utmost importance. “We always felt that our data was secure before, but there’s definitely an added layer of peace of mind in having our data hosted by the supplier,” explains Stephen. “It’s in the supplier’s hands now, so it’s one less thing to worry about. We also know that we have extensive and regular backups of our data with CACI, so if anything does go wrong, we can get back up and running pretty quickly.

“We also have, as a result of the increased uptime, better access to our data. We always use ChildView’s full case data exchange and it’s certainly easier to use now. We sometimes experienced issues with it before, when the servers weren’t working, but now it’s always up and running which means we can leave data exchanges up and running in the background.”

Overall, CACI’s hosting of ChildView for Walsall Youth Justice Service has facilitated the council having smoother, more efficient and more seamless access to the ChildView system and its data. “One final point I’d like to add is around the support we’ve received from CACI as well,” concluded Stephen. “Whenever we have issues, they get fixed pretty much instantly. It’s a very good part of the hosting service we’ve received from CACI.”

For more information on CACI’s hosting service, please click here.

A Readiness Package for North Bristol Trust’s (NBT) Power BI Tool Migration – pt1

Posted on:

Background

When North Bristol NHS Trust (NBT) was tasked with enhancing their business intelligence (BI) system within a specific timeframe while simultaneously futureproofing their service, optimising their data, and aligning with emerging ICS standards, they turned to their trusted and proven partner, CACI, for best-in-class support. Having worked with CACI for several years for data and analytics support, NBT was confident that CACI could help them with their discovery and engagement project.

Project hero

David Hale, Assistant Director of Informatics at NBT, leads NBT’s data and analytics strategy and is responsible for delivering analytics to the board, clinicians, operational leads and business managers, and informatics teams across the ICS.

Project mapping & planning

Planning how to navigate from where NBT was to where it aimed to go was not a simple task, especially considering the constant evolution of technology and how people adapt and respond to it. Engaging a broad group of clinical, operational, and senior stakeholders, each with their own priorities and expectations, increased the complexity of the project. Among technical teams, the most substantial challenge was achieving a balance between blending considerable in-house knowledge and partnering with service and technology organisations to implement and fulfill their strategic objectives.

“The challenge is to discern what the underlying rationale of any query, concern or requirement unearths, and document that in a way that speaks to the more strategic concerns that you hear throughout the engagement,” David elaborated. “This is uniquely where a third party like [CACI] can come in to cut through multiple and often complex sets of stakeholder feedback to truly establish what the underlying requirements might be for a successful transition and elevation in technology.”

Meets guide

According to David, the positive working relationship with CACI and proven expertise were key in significantly enhancing their readiness work.

“We’ve been very fortunate that we’ve had [the CACI team] who we’ve had a very professional and supportive relationship with for many years. We can talk openly about how existing products and services are working and what our needs and requirements are,” he explained. “It made perfect sense to also go to [CACI] for the next step in the journey because it’s about concluding the chapter that we were currently in and setting ourselves up for the next. Our relationship with CACI had been built over a number of years, so we were really able to unlock our shared knowledge and expertise.”

David went on to acknowledge that there will always be gaps in understanding the evolving tools and technologies, which is when a trusted partner can be critical to bridge any knowledge gaps.
“We look to you as experts in the field, so not just within healthcare, but as a gold partner for a number of other technical suppliers,” he continued. “We reached a point where we had to look not only at the commercials with our existing technology, but a more all-encompassing approach to how we might scale-up our technology in future. This approach was also in response to internal audits about our own data strategy, and how we respond and accelerate our use of information now that we’ve done our EPR system transition.”

Action

To execute these plans, CACI first analysed NBT’s existing reporting outputs and infrastructure to gain a comprehensive view of its architecture. CACI and NBT then engaged with NBT’s internal and external data analytics stakeholders on their needs and preferences to assess the board’s strategic data and reporting priorities. Aligning with NBT’s digital and data strategies followed this, coupled with the production of a blueprint for moving forward, which outlined new data architecture, data governance, licensing requirements and enablement.

This action within the readiness package bolstered NBT’s creation of a compelling business case, which according to David was “one of the fastest approved capital cases I’ve ever experienced”, with a turnaround time of around 10 days from submission to approval.

“By approaching our BI technology transition in this way, we’ve enabled the navigation of one of the often-held assumptions within the public sector and the NHS that it’s hard to get things done. With a clear vision and exceptionally good outputs, we’ve been able to move at a pace, which is not normally expected to be the case in an NHS setting,” David concluded.

Avoid failure

David shared that one of the most valuable outcomes for NBT was CACI successfully engaging a variety of internal and external key stakeholders and compiling their feedback and requirements.

“There is something much more compelling about engaging stakeholders through a trusted partner under the mandate of a board-approved digital strategy. This was enhanced by a combination of recommendations from our internal audits and building upon the momentum of the EPR (Electronic Patient Record) programme delivery to quickly understand peoples’ requirements, needs and concerns, and structure that into an approach that we believe would answer the majority of those concerns,” he explained. “We were confident that we would be able to do the right thing for the organisation. The key differential was the focused piece of CACI-augmented stakeholder engagement. It allowed people to see their concerns reflected back to them so they can understand that they have been heard, enabling you to create a far more compelling, effective case.”

Success

NBT succeeded in producing a detailed report of all quantitative and qualitative findings with CACI’s support. These findings helped NBT gain a newfound understanding of their existing functions and capabilities and the changes required to succeed in the future. According to David, the initial communications through to the report and presentation delivery were pivotal in ensuring NBT would be set up for success.

“[Our relationship with CACI] feels grounded in practicality… it’s grounded in addressing real problems, and this is the latest installment of addressing one of those real problems,” David concluded.

Power BI migration & implementation process & outcomes for North Bristol Trust (NBT) – pt2

Posted on: 16 August 2024

Background

When North Bristol Trust (NBT) was tasked with migrating their existing reporting tool to Power BI, CACI was their trusted partner that supported the successful production of a migration readiness package. This readiness package included a detailed report of all quantitative and qualitative findings, a newfound understanding of existing functions and capabilities, a reassessment of future requirements and definitive progression of next steps in the Trust’s migration from business case creation to sign-off.

NBT possessed over 100 reports in their pre-existing analytics platform, ranging from list-based for front line, operational workers to more backend, dashboard and analysis reports for email distribution. Once these reports needed to move from NBT’s pre-existing system to Power BI, the Trust wanted to understand and reconsider their design, particularly its contents and data structure.

Customer lead

Andrew Elliott, Head of Data Analytics at North Bristol Trust, has handled analytics platform outputs and has been a key player in the Trust’s Power BI migration.

Project mapping & planning

The first course of action identified for NBT was the need to improve efficiency when creating reports. This was a multi-step action, not simply addressing the speed at which reports are updated, but the efficiency and maintenance of data.

To achieve this, Andrew’s team revisited their hospital data analysis practices to ensure they would remain up-to-date, reliable and accurate.

There was also an emphasis on redesigning the data models that fed the reports to meet requirements. This required a substantial amount of analysis to understand where data was coming from and what NBT was doing with that data to display the report. Once this analysis was complete, NBT had to consider how it could be streamlined to become more efficient and recreate that logic in a new location within their data warehouse.

With these needs in consideration, Andrew’s team reached a consensus on the requirement for a new reporting database, as well as a redesign of the data models that would facilitate the moving of their reporting tool.

Action

This process took the Trust a lot of time and input from CACI to execute, as the initial input stages were focused on providing business knowledge and data understanding, with CACI possessing the technical knowledge. CACI’s Richard Brennan, Principal Consultant, worked on the mapping process and provided ongoing support to Andrew’s team.

Determining the best design for that data followed this. Andrew’s team had ambitions on what the Trust wanted to do with their data, one of which was knowing that through Power BI, other analysts from across the hospital could be brought on board. The board was an especially important and crucial factor as NBT approached the Power BI go-live date. For Andrew’s team, this included ensuring alignment on decision-making, gaining organisation-wide buy-in and keeping motivation up.

“We weren’t putting our head in the sand, we were very honest with any issues that we had and [the board was] immensely helpful in their responses, particularly around communication,” Andrew shared.

In the weeks prior to going live, Andrew’s team liaised with key individuals in the Trust across various departments and divisions on the status of upcoming reports. Power BI also began to be displayed on the intranet’s homepage of the intranet for collective awareness on Power BI going live. NBT followed an additional CACI recommendation of forming a Power BI developer group for regular meetings to take place on what Andrew’s team was doing, how they were using Power BI, encourage others to use Power BI and share best practises.

All licenses were in place and once the reports were signed off as tested, they were moved into the appropriate workspace apps for users. A soft launch using advanced functionality for several areas took place a week prior to go-live to ensure comfortability of using Power BI and iron out any final issues before eradicating their pre-existing BI tool. The final step was adding users to groups for immediate access and turning off the original platform.

By Friday afternoon, users were given access while the original platform remained available over the weekend, and by Monday morning, a blocking page prohibiting access was implemented, marking the official introduction of Power BI.

Supporting our customer

The diversity of requirements and revisiting the data design were two pivotal focal points to be reprioritised over the course of the implementation.

The ambition around optimised data design was initially obfuscated due to the comparatively little data available from various clinical divisions and departments across the hospital that used Excel. This prompted Andrew and his team to encourage the use of one cohesive reporting platform to ensure data sufficiency, accuracy and reliability, creating an environment that analysts would engage with and host their reporting on and unite users.

The immense size of this ambition quickly became clear to the Trust, particularly regarding the data scope, the systems it took from, the amount of available data and the data that was also being used by divisional analysts. The Trust also acknowledged the fixed date by which this project had to be completed. Upon further investigation into the data sources, an added layer of complexity came to be: rebuilding all the data sources into a new data model would not be possible to achieve by the stringent deadline. With CACI’s help, however, the situation took a positive turn.

“CACI provided helpful support and advice [during this time], even during times where I think our project had gone from a green to an amber stage where we were coming into the last couple of months,” Andrew shared. “CACI was incredibly supportive of the decisions that we were making, also contributing to those decisions themselves.”

Success

Richard’s Power BI configuration has set up Andrew’s team for a successful first few weeks of post-go-live, with the team receiving about 600 hits on reports in the first two days post-go-live and receiving approximately 60 support requests (mainly access requests or general functionality enquiries). While some minor accuracy issues with outpatients arose and were resolved quickly, the reporting has remained accurate and was very well received by the end users.

According to Andrew, Richard’s continued support in demonstrating any changes to the semantic models, identifying any issues with uploading data or explaining the environment’s functions has been particularly useful.

“We had Richard in the background with any small changes that we wanted to do with the data loads or semantic models, and that support was useful in the run-up and afterwards, because we’ve watched how to look after this system as Richard has built it, but when you’re actually live and you’ve got to look after yourself, it’s nice to have that bit of hand-holding as you learn,” he explained.

That brings us to present day, where NBT has moved out of the post-go-live period of constant close monitoring and rapid issue resolution towards a business-as-usual position. Plans for future enhancements to the environment and the data behind it can now be reviewed, along with an assessment of the Trust’s future and the potential of reaching a similar outcome with NBT’s partner, UHBW, enabling both data teams to have the same view of data across Trusts and share it seamlessly. The project’s success also led to Andrew and his team being nominated by NBT’s Operations leadership for their annual staff award, an internal mark of excellence and recognition for a project well-delivered.

“This project has been a lot of hard work, but it’s been a great project and fantastic to work with [CACI],” Andrew concluded. “I really enjoyed it and [CACI] brought a lot of experience and expertise to the vision and ambition that we had, so I really appreciate it.”

How Northern Ireland Trusts successfully adopted Synergy, CACI’s patient level costing solution

Posted on: 15 August 2024

Background

Migrating to and developing a patient level costing solution (PLICS) programme has been a prominent topic of conversation for the costing community in Health and Social for years now, especially following its successful adoption within other jurisdictions. Trusts and the Strategic Planning and Performance Group (SPPG) alike have recognised the value of integrating a PLICS programme to enhance analytical capabilities and the quality and granularity of Health and Social Care (HSC) financial information. By integrating a PLICS programme, providers and commissioners would be able to better understand how resources are used to identify opportunities for cost reduction, improved efficiencies and achieving clinical level ownership.

As an increasing number of Northern Ireland Trusts began reaching the end of their original costing systems’ lifetimes and a drive to deliver PLICS data as quickly as possible, a decision to initiate a tender process was made.

Although the tender process– managed by colleagues in the Business Services Organisation Procurement and Logistics Service (BSO PaLS)– was lengthy, CACI’s patient level costing solution, Synergy, came out on top thanks to its costs and exceptional quality, along with CACI’s project team’s demonstrated understanding of the Northern Ireland landscape through their previous experiences.

Customer lead

Eilis Calvert is a head accountant in financial performance within the Strategic Planning and Performance Group of the Department of Health, responsible for producing guidance, returns submissions, data quality assurance and usage in the most effective capacities possible.

Project mapping & planning

According to Eilis, Synergy’s ability to deliver high-quality PLICS product and data insight with ease and flexibility would address each of the Northern Ireland Trusts’ needs, especially gaining a better understanding of their population. Previous systems costed in aggregate, resulting in a lack of visibility or granularity that Synergy could rectify. In addition, some Trusts previously needed to take additional steps to populate the necessary NI costing template following the completion of the costing process, which Synergy 4 would output directly and significantly reduce time for Trusts.

“Prior to [Synergy], we used higher-level costing data, but the devil is in the details, so getting that level of granularity [was critical] to help us to really understand the whole patient journey, especially as our healthcare system covers social care,” Eilis explained.

Action

The scope of Northern Ireland Trusts differs from NHS in other UK jurisdictions. While the Northern Ireland Trusts lean heavily on the work of NHS England and NHS Wales in developing patient level methodology, Eilis recalls the significant work that had to go into developing methodology and guidance for other elements specific to Northern Ireland, such as social care and adapting datasets to fit the electronic patient data collected in Northern Ireland. Reporting requirements also differed for these Trusts, such as the inclusion of Programmes of Care.

CACI helped the Trusts overcome these differentiation challenges by developing additional guidance aspects and modifying software to process data and report in the necessary capacity that would meet HSCNI’s unique needs. CACI’s project lead provided continuous support and advice through to the final cost submission being made. A constant flow of communication was maintained between CACI and the Trusts, ranging from ad-hoc calls to the creation and delivery of formal reports. CACI’s communicative approach ensured that a collective understanding was met across the Trusts, with Eilis sharing that CACI was “very supportive of everyone’s individual needs while ensuring that the department received the consistency that they required”.

Overcoming challenges

Working with such large data volumes and patient level data was unfamiliar territory for the costing teams, leading to teams having to upskill in these areas. Patient level cost allocation only began (and through a new system) in 2023, changing the pre-existing costing methodology from what the teams had been using for several years prior. With a plethora of data to review and a new system to work with, the cost review challenge was substantially heightened.

The implementation of Synergy began in January 2023, with Trusts trained up on the new system within the year, including working on a pilot model and completing a cost submission. Despite Eilis recalling this time as one of intensity, she is proud of what the HSC costing community have achieved.

“The project team at CACI was great at bringing people along this very challenging journey on a very tight deadline and keeping us all right, so that we were able to achieve what we needed to in that first year,” Eilis shared.

Success

Working with CACI on the PLICS data was helpful, although not without its challenges. The Northern Ireland Trusts are continuing to work with CACI this year to further develop and implement individualised validation and cost review dashboards to ensure Trusts will be equipped to meet their needs and deadlines as they arise.