Improving Lives Together Programme update – July 2023

The Improving Lives Together Programme, is looking at discharge, transactional HR and elements of digital, such as contracts and IT.

On 12 May 2023, our ICS Executive Management Team (EMT), made up of provider CEOs and directors from across our health and care system, met and considered both HR and digital elements of the programme. A number of cases for change are being developed following this work, which are summarised below.

Many colleagues from across the system have taken part in this work and fed shared their views. Supported by Newton, we have listened and now arrived at some cases for change.

This will support us to become more efficient as a health and care system, helping us to work even closer together.

A summary of what we think you need to know

HR case for change

ICS EMT has agreed two areas of work to implement initially:

  • greater use of automation (both using existing functionality more effectively and potentially purchasing more automated systems), and
  • increasing alignment of HR practice across NHS organisations ensuring there is consistency in ways of working that matches local and national best practice.

Digital case for change

ICS EMT has agreed a programme of work that is focused on reducing duplication through the systems we use. The programme involves:

  • standardising the cost of devices we purchase, standardising our refresh rates and benefitting from increased leverage,
  • consolidating the network redundancy in our system,
  • standardising our policy for when to remove licenses, and
  • freeing up BI capacity through standardising our reporting processes and reducing duplication.

It is recognised that being able to drive this level of change within digital services, whilst simultaneously providing support to the many and significant change programmes underway across the ICS (especially the Electronic Patient Record) will be complex, challenging and involve some risk.

Therefore, the sequencing of all the work resulting from the Improving Lives Together programme will need to take account of other projects being undertaken by the system.

Discharge and Intermediate Care case for change

In addition, 4 in 5 people who end up in long-term bedded care did not achieve their ideal long-term outcome, they could have gone home with support.

Long term home care: 1 in 3 people who ended up in long-term home care did not achieve their ideal long-term outcome, they could have gone home with a more independent package.

The discharge and intermediate care case for change identifies a range of areas where the system could take action, including:

  • making better use of existing capacity in the system and making process improvements
  • pump priming to clear our backlogs and establish a new baseline position in the system, and
  • undertaking a significant redesign of our intermediate care.

ICS EMT have agreed to undertake a significant redesign of our intermediate care offer in line with other programmes in existence across the country, such as Leeds (HomeFirst), Coventry and Gloucestershire. The estimated annual financial benefit to the system resulting from the redesign is in the region of £30m. There will be a three-to-six-month design phase, followed by a 12-to-18-month implementation phase to deliver the full scope of the potential improvements.

The redesign of intermediate care would be in addition to the existing programme of improvements being led by our Discharge Board.

Completing the demand and capacity review will improve our understanding of what is needed for each pathway and how far the current programme of work will get us. Notwithstanding this, it was agreed that a complete re-design of intermediate care is absolutely needed.

The final case for change documents for discharge and intermediate care, HR and digital are now being finalised with partner organisations.

Full business cases for each area will be developed in the weeks ahead.