There are a number of national workstreams designed to support the NHS to achieve the quality and productivity challenge it has been set. Some deal broadly with how we commission care, for example covering long-term conditions, or ensuring patients get the right care at the right time Others deal with how we run, staff and supply our organisations, for example supporting NHS orgnaisations to improve staff productivity, non-clinical procurement, the use and procurement of medicines, and workforce.
Long Term Conditions
This workstream will improve the quality and productivity of services for the 15 million people who currently have a long term condition in England so they can access higher quality, local, comprehensive community and primary care services and reduce their need for unscheduled acute care by helping them manage their condition better and slow its progression.
The workstream aims to increase value and address unwarranted variations in spend, activity and outcomes through:
- using programme budgeting and marginal analysis to improve clinical commissioning
- better value commissioning with knowledge, information and coaching.
- reducing the use of lower value interventions;
- reducing unwarranted variation in referral rates to elective care; and
- improving patient satisfaction and reduce the costs of treatment, by involving patients in shared decision-making
This workstream aims to develop a safer system in which every member understands their role in delivering safer care and works towards achieving that goal every day. It will work towards the shared aim of reducing:
- category III and IV pressure ulcers by 80% in acute care
- community acquired category III and IV pressure ulcers by 30%
- catheter acquired urinary tract infection (CA–UTI), serious injury & death from falls and DVT / PE by 50% in all care settings.
The workstream aims to ensure that patients requiring urgent and emergency care get the right care by the right person at the right place and right time, through designing a simple system that guides patients to where they should go. It aims to achieve a 10% reduction in the number of patients attending A&E with associated reductions in ambulance journeys compared to those expected under a “business-as-usual” scenario.
End of Life Care
For people near the end of life, the workstream aims to reduce the emergency attendances and bed days, the use of inappropriate or unwanted treatment and the number of complaints. This will be achieved through identifying patients nearing the end of life, and putting in place more systematic use of care plans for patients to support care in the most appropriate setting.
Medicines use and procurement
This workstream aims to:
- improve cost-effective prescribing in primary care;
- improve medicines management in secondary care;
- support patients to get maximum benefit from their medicines; and
- improve patient safety.
The workstream aims to improve quality and productivity in provider organisations, in particular to:
- reduce length of stay and readmissions
- reduce sickness absence and overtime
- free up non-productive time for staff
- improve staff morale and wellbeing
- improve patient experience
The workstream will offer to all NHS organisations:
Some immediate guidance on how to procure non-pay items more efficiently using existing infrastructure
A review of overall procurement for the NHS
Guidance and toolkits to spread best practice in procurement
Primary care commissioning and contracting
The workstream will help to improve the way the NHS commissions and contracts for primary medical care services to reduce unwarranted variation, deliver more consistently high quality services and contribute to the efficiency needs of the NHS. The purpose of this work is to deliver real improvements in the here and now, while creating a platform for the future reforms.