How Synergy revitalised Dorset HealthCare’s costing team

How Synergy revitalised Dorset HealthCare’s costing team

Background:   

Dorset HealthCare University NHS Foundation Trust offers a range of mental health and physical health services to people of all ages from children to elderly. These services are delivered in both hospital and community-based settings.

The costing team at Dorset HealthCare has long used CACI’s patient-level costing solution, Synergy, to reach various goals due to its high-quality outputs and proven abilities in easing the National Cost Collection submission process. According to Chris Badminton, Head of Income & Costing at Dorset HealthCare University NHS Foundation Trust, “I couldn’t see how another provider could compare with its capabilities.” 

Challenge:   

As long-time Synergy users, Dorset HealthCare’s costing team knew that CACI’s patient level costing solution would help them navigate their most pressing challenges, such as: 

  • Acquiring the necessary patient level costing information that would inform decision-making about clinical care at Dorset HealthCare, which had been exceedingly difficult. 
  • The team was previously equipped with indecipherable data. It was input manually into spreadsheets and could not supply the necessary intelligence to overcome hurdles. “Without Synergy4, we’d never be able to generate outputs to support the challenges that we faced,” Chris explained. 
  • They struggled to get results out to stakeholders or present the results in a dashboard format that could be shared internally. 
  • Limited engagement from the necessary stakeholders became a blocker when trying to make the most of data and tools available to the costing team.  

Solution:  

Through Synergy, Dorset HealthCare has been overcoming challenges and revitalising their costing teams’ capabilities in several impactful ways. For example, consultancy and support from CACI in the form of a help desk has helped keep the costing team up-to-date and running smoothly.

“I access the helpdesk quite a bit. [The help desk] is always incredibly helpful and we always get the solutions and the answers that we desire,” Chris explained. “I also have regular customer care meetings and they’re really useful as well.” 

CACI’s Synergy User Group has also helped inform Dorset HealthCare’s clinical care planning and patient engagement strategisation through knowledge sharing opportunities with other NHS organisations.

“The Synergy User Group is also a great space for sharing and understanding how other [NHS Foundation Trusts’] challenges are being dealt with and for idea sharing,” Chris continued. “This has been really useful not only for the use of the product, but for understanding what the outputs need to be in order to get that engagement internally to support how we deliver clinical care at Dorset HealthCare.”

Synergy has also bolstered the costing team’s management abilities ahead of annual National Cost Collection (NCC) submissions.

“With regards to the National Cost Collection of the mandatory element of the functionality, that has far exceeded my expectations,” Chris continued. “The piece of work that’s been developed by [CACI] makes our management process on an annual basis incredibly easy.” 

Results / Benefits:   

Overall, the costing team’s evolution as a result of Synergy has been, as Chris stated, “over and above”.

“The speed of [Synergy] and the way that you can calculate and produce results is phenomenal… including its usability and how intuitive it is,” Chris continued. “It’s above what we would’ve expected.”  

Equipped with Synergy data, Dorset HealthCare’s costing team is now developing analysis to support decision making for their improved access to psychological therapies (IAPT) service. Currently, the data that Chris has presented back to the organisation through Synergy is being deciphered, and the costing team is finding ways to reiterate the analyses for other areas of the Trust.

“I think [this service] is going to become something that is rolled out across all services within our mental health function to enhance the care that an individual could receive,” Chris explained. “It’s on the cusp of becoming something big for good evidence that has been supported by Synergy.” 

Outcomes/Future:    

Going forward, Dorset HealthCare hope to receive a regular analysis that can be used across the organisation to guide the way that clinical care at Dorset Healthcare should be delivered and further improve patient outcomes. Not only would a regular analysis enhance patient experiences, but it would also encourage the costing team’s conscious, intelligent allocation and spending of funds. 

In the meantime, the costing team will continue focusing their efforts on health inequalities. They are currently looking into deprivation data, a process that involves manually exporting data from government and other websites to generate data that can be compared against or linked to existing patient level activity data used for Dorset HealthCare’s costing submissions and costing reports. The goal is that the costing team will eventually be able to use or link the data to compare results to other NHS organisations. This would help them better understand what a patient’s pathway looks like, the costs associated with specific types of care and how Dorset HealthCare can learn from other organisations to apply best practices to their own. 

 

How InView enhanced Stockport’s data collection & processing capabilities

How InView enhanced Stockport’s data collection & processing capabilities

Background:  

When Stockport NHS Foundation Trust first looked to procure a data warehouse, they were adamant about choosing a provider with a proven track record and experience of delivering products and services to the NHS. Following recommendations and success stories from other users of CACI’s NHS data warehouse solution, InView, it was clear that a partnership with CACI would guarantee Stockport a smooth process with a mature and established provider. 

Challenge:  

Stockport needed one platform that would contain all data in one place to simplify the collection process and help the team regain control of their data. Over the years, numerous reporting database tables evolved to the point that multiple individual servers were created. This resulted in many duplications with multiple databases across multiple tables, data not being consolidated or structured, analysts having to work across servers and inconsistent information being produced. Having one unified platform would ensure that everyone would pull data from the same source and would avoid analysts working in silos and creating their own new sources of data. A consolidated data platform would provide much needed resilience and structure. 

Stockport also wanted to take control of their statutory data processing and reporting. They needed flexibility and control over their own data developments, including more automated data submissions and reporting. 

Solution:

CACI’s InView equipped Stockport with a mature data platform that has defined all statutory returns and commissioning datasets. It supports the team’s existing grouping and pricing processes and significantly reduces their month end manual processing, freeing up their time to dedicate their efforts to additional data analysis instead.

Through InView, the team also gained access to a unique support desk headed by a team of CACI’s technical experts, ensuring that any issues arising at Stockport could be mitigated precisely and timely.

“You don’t normally get someone that could just as easily have developed the product on a support line. [Our CACI support lead] knows InView inside out… not only does he know the products, but he also knows NHS data quite well,” Rory MacDonald, Lead Analyst at Stockport, explained. 

“We have a lot of confidence in the fact that CACI’s [team of customer care individuals] understand NHS data and keep up to date on policy decisions to be able to respond quickly to changes,” Debbie Hope, Chief Data Officer at Stockport, continued.

Stockport was also able to identify gaps in the recording of patient observations, with a customised InView module specially developed by another one of CACI’s delivery support leads to enhance Stockport’s reporting capabilities. Through InView, the team could rest assured that all statutory elements would be addressed and that building any added functionalities within the platform would be done quickly and easily.  

The latest enhancement that CACI’s delivery support lead is developing for Stockport is for their audiology data extraction and collection, whereby data is extracted from their system and data quality reports are being created to find any issues. This helps Stockport streamline some of their diagnostic waiting times reporting.  

Results / Benefits:  

  • According to Rory, CACI’s consultancy and support has far exceeded the organisation’s expectations. “The consultants were all really good in terms of both their technical expertise and dynamic advice,” he commented. 
  • A noticeable reduction in the overall time spent processing overnight. After setting up a delta load, Stockport realised that every piece of information in their system dating back from the 1980s was being copied over. This process took progressively longer each day because the amount of data being copied over was continuously increasing. They worked with CACI on setting up a delta load where they could identify using interface messages, pull any necessary information and load it into the data warehouse, which significantly sped up the processing time.  
  • The availability of data. “It’s available to be reported on from early in the morning,” Rory explained. 
  • The enhanced data warehouse solution allowed Stockport to produce their own national CDS extracts. “We were reliant on and restricted to the pace of our PAS supplier previously for the development of those extracts when there were national changes,” Debbie explained. “We’ve removed that reliance and taken full control of those national extracts.” 
  • Moving away from manually processing commissioner assignment within the PAS system. “It was a very manual process for using the contracting functionality within our patient administration system to assign the Commissioner for who pays for a particular piece of activity,” Rory explained. “Now that we’ve got all the national commissioner assignment method (CAM) rules written in the data warehouse, we’ve been able to switch off the functionality on the PAS system and transform the work of our data quality team.”  

Outcomes/Future:   

Stockport’s future ambitions include completely switching off all of the old servers with the legacy reporting databases so that the organisation can have only one development server and one production server for the data warehouse. They are also keen to increase the provision of real-time reporting. CACI will continue to support Stockport by analysing patient flow and frequently refreshing in-patient data to help Stockport understand exactly who is in the hospital at that time, what service they may be waiting for and how waiting times can be reduced, and overall support with the maintenance of their data warehouse. 

How can local authorities monitor elective home education pupils?

How can local authorities monitor elective home education pupils?

Elective home education (EHE) has been on the rise since the COVID-19 pandemic and its aftermath. A recent report by Schools Week suggests that elective home education has risen by 60% since the pandemic. Up to 125,000 children now educated in this way. There are obvious safeguarding issues for local authorities to follow up on, from children missing education to ensuring that those children who are being home educated are in a safe environment and receiving an appropriate education. There are significant barriers to this for local authorities, however, not least in the form of there being no legal requirement for parents to inform local authorities that they are educating their child(ren) at home. So how can the challenge of monitoring these children be met?

This challenge is particularly acute for children who simply never enter full time education. Where a child was previously attending a school prior to receiving elective home education, schools have a duty to inform local authorities of their deletion from the school roll. A joined-up data approach is essential in order that correct and robust oversight is available.

As the Schools Week report highlights, however, growing numbers of elective home education pupils will inevitably result in a greater strain on local authorities in relation to monitoring and safeguarding. With more children to keep tabs on not being met with a similar increase in the number of available resources, it is vital that authorities find the most effective and efficient route to fulfilling their obligations.

How can authorities monitor elective home education students?

Data sharing is one obvious area in which authorities can help themselves and each other. Having a technology ecosystem in place that facilitates data capture from schools, local authorities, parents and any other professionals involved in a child’s educational journey plays a significant role in creating the transparency required for local authorities to act.

The background context for each elective home education child is another aspect that helps local authorities. If a child is known to local youth justice services, has identified special educational needs and disabilities (SEND) in England – additional learning needs (ALN) in Wales – or has previously been excluded from school, then there are areas around safeguarding and appropriate provision of education to them. This ties into the emerging area of trauma-informed practice when it comes to dealing with children and young people across the education and youth justice sectors. Put simply, context is vital, yet can only be factored in with a joined-up approach is adopted.

Of course, none of that is to say that every elective home education child has safeguarding concerns around them. Many parents and families opt for elective home education for myriad reasons and do a perfectly good job of educating their children. It is still important, however, that is satisfied in the eyes of the local authority.

Fulfilling obligations to elective home education students

So, how can local authorities fulfil their obligations for elective home education children? Making the capture of relevant data as easy as possible is the first step. If a child is taken off the register at the school, the school has an obligation to inform the local authority. How is this data received by the appropriate personnel at the authority? Once visits are scheduled to families, how are the outcomes of such visits recorded within the authority? If a child moves into or out of a local authority, how is that data received or shared with their next authority?

Technology is at the forefront of this. Removing the need to manually trawl through records makes the process far more efficient. If practitioners can easily access full case records, they can pick up and understand a child’s journey quickly. They can then record the outcomes of their own work against a child’s record. This maintains a single thread of information relevant to the child.

Conclusion

Portals can play a significant role, too. For example, IMPULSE Nexus from CACI is a modular system which features school, parent, provider and professional portals. Each touchpoint with the child has the ability to record relevant information which is then stored against a single record. This helps to maintain a holistic view of every child, with relevant data being made available to relevant parties. In the case of elective home education children, local authorities being notified instantly when a child is taken off register or excluded will trigger the appropriate follow up activities for the relevant personnel.

Ultimately, treating each family and child fairly and transparently is paramount. Every child has a right to access education, ensuring that families are appropriately providing this ultimately falls to the local authority. The tools exist to make this process more effective and efficient for everyone. Our data sheet takes a closer look at elective home education, what local authorities need to do inline with the Education Act and how they can best support children and families. You can read it here.

Making the most of Synergy through our User Group

Making the most of Synergy through our User Group

Of the many benefits that Synergy, our PLICS system offers NHS costing teams, did you know that unrestricted access to a user-led group community was one of them?

What is the Synergy User Group?

The Synergy User Group unites NHS organisations from the UK, Ireland and Scotland in an online forum that is entirely driven by Synergy users themselves. This brings a genuine and beneficial collaboration opportunity to Synergy users across the UK. We facilitate monthly User Group virtual sessions (and more frequent clinics closer to the mandated submission time) that are for you, by you and to your benefit. Participants can ask each other questions, learn from shared experiences and gain tips on best practices.

How does the Synergy User Group work?

Step 1: CACI invites users to the Synergy User Group

We invite all Synergy users to join the Synergy User Group with new users always welcome to join the cohort of experienced long term Synergy users. Organisations themselves can determine which of their employees should participate in the group. If you’re a new user from an existing customer of ours, or a brand-new customer all together, we will oversee the invitation process and make sure you have access as soon as possible.

Step 2: Chair of the User Group & CACI align on the agenda

Ahead of each monthly meeting, users will set the agenda collectively with the chair of the meeting. CACI and the User Group chair will then meet to discuss what will be included in the agenda, covering off what participants need or want to get out of the meeting. This helps our experts understand what can be improved – whether that’s new functionality, setting up “how-to’s” for users, scheduling more demos, etc.

Step 3: Monthly User Group meetings take place

During the monthly meetings, CACI’s Synergy lead will help guide the session using their wealth of costing and Synergy knowledge. Anything from how the solution works to how it can support priorities being met can be discussed. While CACI help lead the meeting, the meeting ultimately belongs to the User Group attendees and is their time to share, collaborate and discuss. You can also tell us what you’d like to see or discuss in future meetings, from upcoming requirements to outstanding questions you have about the solution.

In addition to the monthly User Group meetings during the busy critical mandated submission period, CACI offer weekly open-drop-in clinics online for all Synergy users. These clinics are held by the highly experienced CACI team. These sessions are scheduled as soon as the submission guidance and software are released and take place well in advance of submission time.

Why should you join the Synergy User Group?

Providing outstanding customer service and support is at the heart of what we do. CACI want to ensure that our Synergy Costing and Finance teams feel supported individually and collectively – with the ease of use and flexibility of Synergy being the driving force to great outcomes. Your self-sufficiency will flourish by joining the User Group and being given the freedom to control the conversation; getting the answers you need to enhance your Synergy experience and carry out your tasks in the most efficient way for you.

The User Group:

  • Promotes self-sufficiency by allowing our users to work together and use the roadmap as their own.
  • Brings more to the table than just a costing solution. The User Group is there for you to utilise as you see fit. You can have as much or as little support or involvement from us during your usage as you want.
  • Allows you to get the most out of Synergy whatever your technical background. Synergy is built with every employee in mind, freeing up your team’s time to dedicate effort and resources to improving your business functions.

What are Synergy User Group participants saying about the group?

Michelle Barnes, Assistant Director of Finance at Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), told us why the Synergy User Group has had such a profound impact on her team’s success.

“The User Group forum feels like it belongs to the Trusts – it’s not a sales update for CACI. It’s a chance to ask each other questions, as well as the CACI consultants. For example, peers might demo what they’re doing with reports – it’s a really good forum because it shows how people use the system in practice. It’s truly collaborative and interactive. Spin-off groups have emerged for different aspects, like the dashboards, and it’s so useful to be able to talk directly to other mental health and community trusts, because our needs can be different from acute trusts,” she explained.

“It’s a strong relationship – we’ve had great support and interaction with everyone from the account manager to the trainers and helpdesk. We had a few IT issues related to our firewall and making connections through it. CACI’s consultants were really responsive and came back to us very quickly to get this sorted. They were always progressing what they needed to and checking that things were satisfactorily resolved. The Synergy User Group is great – it helps us continue to explore and make the most of the solution, to deliver more decision insight and value for our Trust.”

If you’d like to find out more about getting involved in the Synergy User Group, please contact our expert, Susan Brooks, or take a look at Synergy, our PLICS system and what our customers have to say about it.

How Milton Keynes Youth Offending Team uses ChildView to support its work

How Milton Keynes Youth Offending Team uses ChildView to support its work

Milton Keynes Youth Offending Team, is part of the multi agency youth justice partnership involving Milton Keynes Council, Thames Valley Police, Education and Public Health. The team started using Childview, a specialist youth offending information system from CACI, in 2009 following migration from their previous YOIS System. ChildView is used by 31 multi-disciplinary workers at Milton Keynes Council and the team has 160 active youth justice cases at the time of writing.

The administrative problems solved by ChildView

The youth offending team at Milton Keynes Council was using a system of spreadsheets to process and record information. The team realised that ChildView would provide an integrated whole service recording and reporting solution to reduce and enhance oversight across cases and referrals into and out of its services.

“ChildView can hold all the information we need and allow active case management,” says Phil Coles, business support and information manager Milton Keynes Youth Offending Team. “I know some YOTs have issues with aspects of their youth justice work. Generally, I’ve found that these issues are due to not having defined business processes that support (or dictate) the recording practices. Using a system like ChildView helps us to define our processes, whilst maintaining all our data in the same place.

“An example of this is the active management of referrals. By using agreed recording processes, we can instantly see which cases have been referred to another agency and whether they have reviewed the case yet. Then we can see when they accept the case and, finally, when they complete their work for us. This used to be managed in folders, then it became a spreadsheet but – by mapping processes – we’ve now got it to a single ChildView report which has a variety of views for each type of referral and whether it’s active or complete. We are also able to provide all stats that have been requested so far, for example how many referrals have been made (or completed) during a period.”

The benefits of ChildView for Milton Keynes YOT

With the underlying importance of the complex work increasingly undertaken by the team, this enables risks to be captured and tracked in near real time. This facilitates holistic case formulation to ensure vulnerable young people in the area achieve the best possible responses. To this end, being able to report on activities and send and receive data in real time on incidents and cases is vital.

“I have written about 150 reports, many of which contain multiple views, and have found that ChildView facilitates rapid access to information for myself and my team,” says Phil. “We are able to store all necessary documents within the application and are just looking at using the communications module to further integrate letters into the system.”

The built-in reporting functionality with ChildView has also supported Milton Keynes YOT. “It’s sufficient for the majority of requests that we receive,” adds Phil. This helps to meet the needs of the service, with relevant information being captured in locally defined reports. ChildView also uniquely transfers whole case data records between YOTs, which increases accuracy and reduce the effort and risk in tracking young people as they move localities.

Being able to send, receive and view the full case management story, relational history and context swiftly and securely makes it much easier for YOTs to engage and formulate an effective response with incoming cases, crucially being able to understand what has happened to each young person.

Support from CACI’s specialist team

“I’ve always had excellent support from CACI when making queries or raising issues,” says Phil. “There have been times when a resolution has taken time to arrive at, but they are always worked on. Raising queries is very straightforward and the team is always quick to respond.”

CACI, as part of its service level agreement, responds to all ChildView support queries received by 5pm on the same day. This helps to give clarity over how issues and queries are dealt with and to provide practical next steps. The support desk is staffed from 9-5:30 Monday to Friday, with 24/7 web support call logging available as well.

“Myself and my team have generally found ChildView to be easy to use,” concludes Phil. “It does what we need it to do and I haven’t been asked for anything that I haven’t been able to get out of the system.”

For more information on ChildView, please visit: www.caci.co.uk/childview

A Voyage of Discovery

A Voyage of Discovery

A month into live operation of your new system and everything could not be running more smoothly. The solution went in on time and within the original budget and quickly delivered benefit, fulfilling the needs and expectations of your business and IT. Everyone was clear from the outset about what needed to be achieved and why.

Panacea, perhaps, but as a solutions supplier, we want this outcome as much as you, our customer. There are many reasons IT projects succeed or fail, some of which are unpredictable, but what practical measures can you take to give us all the best possible chance of a great outcome?

A key measure of success of solution delivery is that the requirements it set out to meet were indeed met. This sounds obvious, but if the requirements laying this foundation were unclear or incomplete, it is unlikely that the solution delivered on them, or that consensus was reached that work was complete. It is no wonder that the Government Digital Service (GDS) stipulates “define user needs” as the first point for consideration in their Technology Code of Practice.

For CACI as a solution supplier, it would be superb if we embarked on a major project where all requirements were fully defined, with clear, testable acceptance criteria and supporting specifications were in place. We could focus our efforts entirely on design, build and testing. But let’s get real: this rarely happens. Eliciting, analysing, validating and documenting a full, detailed baseline of functional and non-functional requirements effectively, is a time-consuming activity. It has dependencies on skilled business analysts and subject matter experts from the business, and technical and security teams who may not be available ahead of procurement or the project mobilising.

CACI’s FUSION delivery methodology recognises this reality by proposing a structured approach through our Shape step. CACI can support these activities as much as you need to build a strong foundation and achieve success together.

To hit the ground running once a supplier is appointed, what practical measures can be taken by you ahead of project mobilisation, when time and specialist skills may be in short supply, to research and define your users’ needs?

Start with the Afters

You should ensure there is a clear definition of the benefits that the solution aspires to deliver. These may reflect pain points the solution is intended to address or additional gains that will be achieved.

There needs to be consensus on these drivers at a business level and with your key stakeholders who will be engaged in delivery.

Having this in place will help provide some shape to the requirements and inform prioritisation. Without it, there may be a lack of clarity on what the solution should be setting out to achieve, which in turn will disrupt delivery both for your organisation and the supplier, once appointed.

Breadth before Depth

It is sensible to appoint a single owner for the business and IT requirements, often called a product owner, and ensure they are fully supported to fulfil that remit. This might involve access to business analysts and subject matter experts (SMEs) on technical aspects and business operations.

They should first establish that the breadth of requirements is complete before the more time-consuming elaboration on the depth (detail). This will help you track where the scope has been defined and where work still needs to be done.

One approach is to take a top-down view, first identifying the major groups of requirements, for example, by breaking it down into epics:

Take each epic a step further by identifying users’ functional needs, such as through defining user stories: “As a [actor], I need to [do something], so that I can [achieve something]”, and adding these to the epics. Just one line per user story is sufficient at this stage.

The system will also need to comply with the organisation’s technical and security standards. Furthermore, there may be other aspects requiring the new solution to “be” something, rather than perform a function. For example, it may need to be available between specific hours, have a certain technical capability or comply with a security standard. These are known as non-functional requirements (NFRs).

If the new “to be” solution is replacing an old “as is” one, you need to ensure that you fully understand all aspects of what the “as is” system achieves and ensure that these are reflected in the “to be” requirements, or that there is agreement as to which elements will not be in scope.

Elicitation of requirements merits an article in its own right, but may involve workshops, interviews, surveys and document reviews. The Chartered Institute for IT (BCS) provides a framework and certification for requirements engineering, which includes such techniques.

Once a working set of requirements has been established, these need to be cross-checked to:

  • Identify and resolve any conflicts
  • Remove duplicates
  • Ensure they are accurate, consistent and understandable

Reviewing that requirements are aligned to the benefits the solution is seeking to achieve, and prioritising accordingly, ensures they will deliver against the business goals.

Now is a great time to agree a baseline for your requirements, since the scope has been fully defined and therefore amendments can be controlled through a change management process. You are also in a strong position to engage with a supplier on detailed implementation plans to deliver the solution.

Diving Deeper

Each requirement needs further elaboration to establish its depth, completing its definition:

  • Supporting assets, such as technical specifications, policies, standards, process maps and business rules definitions, are available and can be referenced from the requirement
  • Clear, testable acceptance criteria define the evidence used to assess that the requirement has been successfully met

A full requirements catalogue can quickly resemble a database rather than a single document. When implementing Cygnum solutions, CACI use Jira and QMetry to model requirements, collaborate, link assets together and manage processes such as approvals, change and traceability through testing.

If you cannot clarify requirements to this extent ahead of engaging with a supplier, the exercise needs to be accounted for in the implementation plan. CACI recognise the value to customers and the delivery team in collaborating on this, as this assures a shared understanding of requirements. The Shape step of CACI’s FUSION delivery methodology explicitly provisions for this activity under the Discover phase.

Once complete, you have a solid foundation for solution design and delivery. It would be prudent to re-baseline to reflect this milestone, such that there is a clear distinction between what was agreed at the time and subsequent change.

Better Outcomes

We believe that defect-free delivery to you is achievable when your requirements are clear, accurate and complete. Before handing a solution over to you for acceptance, we run system test cases against your acceptance criteria and evidence the results, providing full, objective traceability that your requirements have been met.

Your time should be focused on value-add activities, such as user acceptance testing against your business processes.

Celebrating a successful, on-time transition into live service is the outcome we all want to achieve and is distinctly more likely when a structured approach is adopted.

The high socio-economic cost of adverse childhood experiences

The high socio-economic cost of adverse childhood experiences

“There is an urgent need to better understand the cumulative impact of adverse childhood experiences (ACEs) on health outcomes across the life course, integrating epidemiology with fields including epigenetics, immunology and neurology. Equally, there is a critical need for knowledge on how services can become more trauma-informed, what impact trauma-informed service delivery can have, and how services for children and families affected by child maltreatment, substance abuse, domestic violence or incarceration, for instance, can be better integrated to provide a cohesive offer.” The Lancet Research Report, Volume 6, Number 11, November 2021

The annual cost associated with the nine health conditions, including violence and four health risks resulting from ACEs, has been estimated at £2.2 billion per annum in Wales.

In several service areas, notably education and youth offending, there is emerging awareness of the impact of trauma upon populations. However, there is limited evidence of the cost effectiveness of trauma informed service interventions and, therefore, there are difficulties in building and sustaining such services, including prevention. This is in part due to the variation in definitions and understandings of trauma and trauma informed practice. More work remains to be done on this emerging area of practice.

Further, there is a challenge in applying research to real lives. The 10 flat ACE categories fail to account for wider adverse experiences and the cumulative and dynamic effects of adversity and associated trauma, as noted by Dr Alex Chard in his 2021 paper, Punishing Abuse. Similarly, service assessment tools have typically failed to fully captured the age timeline details and context of historical adversity and trauma events. This adds to the difficulty of seeing where needs have not been identified earlier and where unmet needs interact with earlier vulnerabilities such as with universal service environments, decisions and outcomes.

Further, point in time screening and assessment tools do not allow an evaluation of the difference that can be made by applying trauma awareness, skills and approaches in support services as well as specialist interventions such as enhanced case management (ECM).

The findings from the recent public health research, Tackling ACEs: State of the Art and Options for Action, point to further adaptations that can be delivered to allow structured recording of adversity and trauma experiences to be more fully and consistently used to provide feedback to service leaders. Further, these arrangements can overcome the practical and ethical problems associated with ACE screening and enable routine reporting and evaluation of efforts to respond to adversity and trauma, for example in youth justice (and perhaps virtual schools) services. The same arrangements can also facilitate effective and sustained multi agency prevention around universal services in education.

However, it seems that children’s services at this time experience significant challenges in implementing statutory safeguarding and other statutory services for Children Looked After and Special Educational Needs. Many service areas are generating high costs without achieving better care or outcomes. Alongside this are workforce challenges of retention, sufficient stability and consistency of skills. Whilst these issues demand leadership time they can also draw attention away from developing the necessary longer term aligned service solutions.

So, what can be done against this backdrop? At CACI we accept that technology can make a significant contribution to the challenges, however, where and how information management is applied, implemented and supported can make a difference to facilitating and ameliorating outcomes or, in fact, becoming part of the problem, for example being overly focussed on process efficiencies to reduce staff and silo costs versus enabling aligned, coordinated and sustained effective multi professional relational helping capability.

The public health research makes evident the very significant long-term socio-economic costs that include:

  • Avoidable costs of social care and health services
  • Increased costs of special educational needs
  • Harm to individuals and communities from anti-social behaviour, violence and other crime
  • Loss of human capital and educational potential
  • Lost cost from providing services not aligned to reducing adversity or ameliorating harm
  • Lost taxes and productivity through lower economic activity, ill health and early death

Further, the recommendations are clear about the need to capture child development and real life adversity and trauma event data alongside service responses and child journeys. The overarching goal will be to use this data operationally to discover where tailored multi service practice responses to individual, familial and local community issues and contexts deliver a sustainable positive impact.

“Increasing the methodological consistency of data collection, particularly in children, would help to promote early prevention, inform the provision of support, evidence the impact of prevention, and evaluate progress.” Tackling ACEs: State of the Art and Options for Action

A key challenge is achieving the alignment of universal services, effective multi professional prevention and early help responses.

Population data is increasingly available about the high costs of adversity and trauma accrued over the life course and could be considered in guidance, oversight and regulation of individual service decisions and options. This can be the next challenge for information system designers.

The importance of an exceptional patient level costing solution

The importance of an exceptional patient level costing solution

Costing teams within NHS healthcare organisations can play a vital role in identifying inefficiencies and cost improvements that will enhance services. This means they deserve an exceptional Patient Level Costing Solution (PLICS) that will not just handle the NCC submission, but will also give them the tools to flourish in several other capacities from making meaningful decisions to developing internal reports that will consistently validate these decisions and benefit both healthcare professionals and patients daily.

But what makes an exceptional costing system? And why exactly is it so important? That’s what we’ll discuss in this blog so you can make an informed choice on what you should be getting out of your PLICS solution.

What capabilities should you look for in an exceptional patient level costing solution?

If you want your PLICS system to be considered exceptional, these are the capabilities that you should be looking for:

Accessibility & ease of use that encourages self-sufficiency…

Ease of use is key to assessing how good a costing system is – your costing system should help your team be more efficient not hold them back. Your costing team should be able to run calculations quickly so that they can maximise their time analysing the data rather than exhausting their efforts trying get the data in a comprehensible form.

…no matter what level of technical skill you have in the team

Another sure sign that you have an outstanding costing system is that it is an end-to-end solution that can be easily accessed by any team member with any technical skill level. This helps the process of migration and implementation through to data dissemination be as seamless as possible. A solution that’s customised and flexible in its design will encourage all team members to use it regularly to continuously meet NHS needs and challenges as they arise.

Simple & successful National Cost Collection (NCC) submissions

As well as being compliant to meet your annual costing return and meeting the National Cost Collections and PLICS submission requirements, an optimal costing system will also include the tools and supplier support to make the often-onerous submission process as simple as possible. The value of an experienced supplier supporting you through the process cannot be overstated, as this means you can be confident in your team submitting on time and without errors no matter its size.

Insights & analytics that are accurate & reliable

Another feature of an exceptional costing system is that it is capable of easy integration with your organisation’s wider analytics platform or strategy. Your costing system should act as a reputable source for sharing data widely, both across your organisation and, most importantly, with ICS Partners. The more secure and trustworthy the analytics you can integrate, the easier it will be for your costing team to collaborate with members of the ICS on treatment cost analysis and the impact of recovery plans.

Low cost, high return on investment for your organisation

Do you find your team spending excessively on a solution that causes frustrations or complications? An outstanding costing solution will be of reasonable cost to your organisation and simplify your experience, resulting in a high return on investment and low total cost of ownership (TCO).

Why the quality of your costing system matters

An exceptional costing system creates a reduction in unwarranted variations and will help your team orchestrate strategic service transformation through insightful analysis of the costing data. It will also encourage an information-driven culture and increased data literacy not just within the costing team, but across the organisation. This will help NHS organisations secure healthy financial positions and deliver optimal outcomes.

Adopting and implementing a state-of-the-art costing solution like Synergy is not as challenging as you may think. The long-term benefits of doing so far outweigh the short-term feelings of uncertainty so is something you should consider when thinking about a potential upgrade to your existing system.

If you’d like to find out more about how a new and improved costing system could help your organisation, please contact our expert, Susan Brooks. or take a look at Synergy, our PLICS System and what our customers have to say about it.

The Hillingdon Hospitals NHS Foundation Trust uses synergy as its main costing engine

The Hillingdon Hospitals NHS Foundation Trust uses synergy as its main costing engine

The Hillingdon Hospitals NHS Foundation Trust use synergy, CACI’s NHS patient level information and costing system.

” The Trust now produces regular quarterly SLR/PLICS information. CACI’s synergy has given the Trust a powerful platform to produce and share this information at patient level, incorporating both income received and cost incurred in the delivery of the care at patient level. The Trust also uses this information to produce further productivity measures to show how each service lines are performing pre/post COVID. As we continue to improve the internal data quality of the underlying information there is an immense appetite within the Trust to use the Trust SLR Pack supported by the CACI’s very powerful Dashboards for the day today performance management of the service lines. CACI’s synergy platform and a very expert support team has provided an ideal platform to develop the usage of PLICS/SLR information within the Trust. The Trust continues to be very excited with its partnership with CACI.”

Attiq Ahmad, Service Line Reporting Lead
The Hillingdon Hospitals NHS Foundation Trust

Effective workforce management – training and competency management

Effective workforce management – training and competency management

Ongoing training and competency management efforts are vital for organisations in maintaining effective service delivery. Keeping staff competent, via mandatory ongoing training for their role, is often a regulatory issue. Offering staff opportunities to expand upon their core competencies makes the same process beneficial to the development of your workforce.

Whilst training and competency management are closely linked, there are some differences.Training and competency management

Training management

Certain training courses are mandatory in most professional environments. For example, offices require a number of trained first aiders and fire wardens. Such training needs refreshing every three years, so having staff with those competencies in the office requires them to be trained on an ongoing basis.

In more public facing and safety critical roles, ongoing mandatory training in aspects of health and safety is required. Not fulfilling these training obligations leaves firms at risk of staff carrying out their tasks improperly.

Keeping on top of these courses is vital. A central system helps firms to set reminders and book in mandatory courses for their employees. Such a system can also help to keep track of attendance, ensuring that courses have been attended and completed.

Using the same system, organisations can also make their training courses open to their employees for them to book onto when it suits them. This makes your training management more flexible and opens up training opportunities to employees who may find them interesting. By offering the opportunity to expand on their professional interests, training management can help with staff morale and career development.

If you can train and bolster the competencies of your existing workforce, it makes life easier if you need to move staff around tasks to keep project and service delivery on track during times of strain.

Running training courses also incurs an expense. It makes sense to monitor attendances and interest in certain courses, so that you can offer tailored and more relevant courses to your workforce. Where spaces are likely to be free in arranged courses, having robust oversight of this enables you to open course registration within your organisation, or even sell spaces to other industry firms, the employees of which also need to attend such a course.

Competency management

Competency management is closely, even inextricably, linked to training management. Where it differs in the first instance is in the recruitment of new employees. If an employee says they have the necessary qualifications to fulfil the role for which you are employing them, competency management is the simple act of ensuring that they are indeed appropriately qualified.

For example, if you’re employing someone to do a driving job, it’s prudent to check that they have a driving licence. Where competency management would link with training management in such a scenario would be if you need that employee to further their driving credentials at a point in the future. So, for example, you may need to enhance their competency and send them on an advanced driving course.

Ongoing training plays a crucial role in competency management, too. As mentioned above, in many industries ongoing training is mandatory. This keeps your workforce competent for the tasks that you need it to be competent for.

Where competency management extends this is by linking to performance. If a certain employee is involved in a certain number of similar incidents, it can be a good idea to try and find out why and assign them to an appropriate training course. This means that you are taking reasonable steps to provision for both employee and customer safety, whilst also keeping your services running smoothly.

Assessing staff competencies on an ongoing basis, therefore, is crucial. In the same way that you would schedule an employee, assessors need to be scheduled to staff members and teams to periodically check their work. On the rail network, for example, such assessments take the form of an assessor conducting a ride along with a train driver to check that they are carrying out their job appropriately.

If all is well, this can be logged instantly in a central system. Similarly, if errors are detected, these can be logged instantly, with any follow-up tasks, such as another assessment or the requirement for further training, being actioned straightaway. This helps to ensure that the competencies of your staff are covered, whilst linking directly to your training management for mandatory and remedial courses.

Maintaining a central database of your workforce and its competencies fundamentally helps you to ensure that your have the right people performing the right tasks. A robust competency management framework benefits your scheduling efforts, too, since your administrative teams responsible for scheduling can assign tasks with peace of mind that those employees being rostered are appropriately qualified and/or experienced for the role to which they are being assigned.

Furthermore, a central competency management system feeds into other areas of your organisation. In being able to swiftly and accurately assess the strengths and weaknesses of your workforce, you can make informed decisions in other areas such as recruitment.

Training management and competency management for your entire organisation

The benefits of having robust training and competency management across your organisation are clear. Fulfilling mandatory ongoing training obligations whilst at the same time opening up opportunities across your workforce to expand upon their competencies is hugely beneficial.

Keeping staff competent is one thing but offering career progression boosts morale and helps to keep staff working for your organisation rather than having to seek opportunities elsewhere.

Ultimately, your workforce is your point of project and service delivery. Maintaining and understanding the array of skills and experiences drives effective and efficient delivery. Plugging this into other areas of your business, such as scheduling, enables your organisation to be agile in the face of short-term changes and responsive in remedying medium and longer term issues which are more easily identified with a bird’s eye view of your workforce.

Getting your training and competency management frameworks to dovetail will help drive understanding of your workforce, which in turn will help effective and efficient deployment to projects and services.

CACI has recently published a whitepaper, Effective workforce management to improve outcomes across your business which explores this topic in more detail. You can download your free copy here.