To drive better outcomes at the health and care interface, changing behaviour is key
Our recent North-West Learning Collaborative masterclass highlighted the need to look beyond structure and process
Anna Littlewood, Associate
Over the last few years, I have worked for a large consulting firm, and taken a senior operational role within a large university hospital foundation trust, before joining an IMPOWER consulting team delivering Adult Social Care transformation.
Moving from consultant to client and back again, and from Acute Provider into the world of Adult Social Care, has given me a perspective that few others observe. I wanted to share 6 key insights that I hope we can all use in our work across the health and care interface.
The Hospital
As the Deputy Divisional Director for Diagnostics and Therapies across nine hospitals, I had overall responsibility for a number of services as well as being on the on-call rota. Being on-call meant that for a 24 hour period every 30 days, I was the senior manager responsible for the out-of-hours operations of eight hospitals.
Not having an NHS background was a mixed blessing as I navigated the complexities of hospital finances, performance measures, operational protocols and the unique role of medical consultants. I learned a lot and also brought a fresh pair of eyes and an ability to ask simple questions about Delayed Transfers of Care (DTOC), length of stay, A&E targets, discharge dependent activity, and demand and capacity planning.
Adult Social Care
Moving across to Adult Social Care was a marked change of pace and culture. The IMPOWER team was focused on the interface between health and care, working to ensure that the intermediate care offering was fit for purpose and could properly facilitate timely and supported discharge from hospital. We brought system partners together to set up a Home First service, and focussed on transforming the Reablement Service to increase weekly case loads and reduce length of stay.
The local authority that we are working with is investing time, staff and money to transforming their part of the system, recognising that the only solution to reducing high city-wide DTOC numbers and costly long term placements is to do things differently rather than patching up the problem with injections of Better Care Fund cash.
Six Insights
From these experiences, I wanted to share my six main insights from the health and care interface,
I continue to have the privilege of working in this space to facilitate real change, the impact of which I hope will be felt on the wards and corridors of the hospitals I used to work in.
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