Creating efficiencies by optimising patient pathways: North Staffordshire Combined NHS Trust

Summary

Engagement Value Outcome (EVO) promotes collaborative working between clinical and finance teams to enhance their collective understanding of patient level costing. It provides the NHS with a framework to ensure resources are used in the most effective way possible to provide high-quality care to patients.

This clinical transformation case study focuses on the North Staffordshire Combined NHS Trust EVO project. The lead consultant for the service was concerned that the clinical pathways were not optimised and bottlenecks were delaying access, assessment and diagnosis of patients. As a result there were  delays to initiating treatment. In addition to potential harm to patients this was resulting in inefficient and wasteful use of resources

Content

Impact on value and efficiency

While the EVO pilot framework ended after the fourth session, the trust was keen close the loop and measure the benefit of the changes made. Following pathway changes the service could see the  positive impact on patient experience but needed to work with the costing team to understand the  impact on activity and cost, and therefore demonstrate if there had been any realisable efficiency and  productivity gains.

• Because head CT scans are provided by a neighbouring acute trust, reducing the number of  patients referred had a direct impact on service cost as well as releasing capacity in the wider system. Comparing baseline activity with the review period showed a 30% reduction in CT  scan referrals and a £7,800 direct cost saving.
•  The number of patients not attending appointments reduced from 572 in the baseline period  to 379 after implementing pathway changes. While not a cash releasing saving this improved  overall efficiency and productivity for the service and contributed to a reduction in overall unit  price per attendance.
• At the start of the project, the average unit price for patients attending the memory service  was £280.93. Through a combination of direct cost savings and efficiency and productivity  gains arising from the revised pathway, this figure had reduced to £205.12 in the review  period.

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