Mid and South Essex Integrated Care System (MSE) has implemented a stewardship programme to support its delivery of the Triple Aim duty of improving population health and wellbeing, improving service quality, making efficient and sustainable use of resources, while addressing health inequalities in each of these areas.
Arden & GEM worked with MSE services to develop value frameworks and outcomes measures for six key areas of care in which stewardships groups were established.
By bringing together a support team with business intelligence, finance and performance expertise, a series of dashboards was developed to enable each care group to better understand delivery against their outcomes and analyse resource usage across the system.
MSE Health and Care Partnership had previously commissioned Arden & GEM’s Health and Care Transformation team to deliver a development programme to help establish stewardship groups within six key service areas:
- Ageing well
- Cardiac care
- Stroke care
- Urgent and emergency care
- Respiratory care
- Cancer care.
These stewardship groups hold responsibility for driving Triple Aim delivery across the whole MSE system. Delivering tailored, timely management information to stewardship decision makers is a vital component in achieving optimal outcomes.
As part of a bespoke stewardship development programme, Arden & GEM helped the six care groups to put in place a value framework which focused on:
- outcomes measures which demonstrate performance against the Triple Aim duty
- metrics to be used to measure the outcomes of the group.
In order to track and measure agreed outcomes, each stewardship group would need a monthly outcomes and performance dashboard.
Bringing stakeholders together
To develop the dashboard series, Arden & GEM brought together a multidisciplinary development team comprising in-house expertise in business intelligence, finance and performance to work alongside frontline clinicians and service managers from the whole MSE economy. Overall system coordination was provided by the MSE Assistant Medical Director.
The whole stewardship programme is founded upon the collaborative relationship now being fostered by the introduction of the ICS model within the NHS.
Meeting the needs of users
Agreeing a specification for the dashboards was an iterative process which began with the outputs from the original development programme. This was then correlated with existing and potential BI streams to understand what was available and what was possible. Regular working group sessions took place with key stakeholders within individual care groups to test out visual presentation of the information, supported by a lead BI analyst, with progress regularly fed back to the monthly stewardship steering group meetings.
Following a nine-month iterative development process, stewardship teams now have reporting in place to improve their understanding of service performance and delivery.
This suite of dashboards has enhanced the flow of information across the system enabling both clinicians and managers to better understand resource usage. This has given resource users access to new information e.g. costing data, in a format that is easy to access and interpret, which improves decision-making within the ICS.
The dashboard series sits within the system’s strategic data and analytics platform, Athena, which is accessible to organisations across the ICS. This enables all members of the stewardship group to view outcomes measures information, as well as providing an access request process for other users who would find the intelligence useful.
"Within MSE, we see stewardship as bringing together resource users (both frontline and back office staff) within care areas to act as stewards – delivering the greatest value for residents from pooled resources.
"Having the ability to track and monitor our progress in achieving this aim, across each stewardship group, is crucial. And from using the dashboards developed with Arden & GEM, we can now take a much more informed, holistic approach, with data from across pathways reflecting the reality of patients’ experiences and outcomes in our health and care services. This has led to measurable improvements in a number of care areas, for example including improved cancer diagnosis waiting times and identification and targeted support for frail patients."
Dr Peter Scolding, Assistant Medical Director, Mid and South Essex ICB
Building on the testing and learning from the first two years of the stewardship programme, MSE is now training and inducting a second cohort of stewardship groups for:
- Children and young people
- Adult mental health
- Eye care
- Musculoskeletal care.
This will result in 12 of the ICS’s 25 care areas adopting a Stewardship approach. Performance dashboards are in development to support the second cohort of care areas and are due to be in place by April 2024.