Model Hospital - five key things NHS trusts need to know
15 May 2019
The importance of good quality data has always been crucial to ensure organisations are able to make informed and well-planned decisions. All too often, a lack of reliable data, or inappropriate use of systems, leads to poor, often costly, decision making.
Following the recommendations made in Lord Carter’s review into hospital efficiency in 2016, NHS Improvement (NHSI) developed and launched the Model Hospital; a digital tool which provides benchmarking information to inform inefficiencies and potential savings opportunities. There is a clear expectation from trust boards and NHS Improvement & NHS England (NHSE&I) that trusts become familiar with the key metrics within it and the opportunities explored and where appropriate, delivered.
In our recent publication Road to Recovery - achieving financial balance and sustainability in healthcare providers we discussed areas of focus and importance for NHS trusts seeking to recover their financial position, and at various levels of financial distress. Trusts have become more efficient and collectively saved many billions of pounds in the last few years but, for many, the “low hanging fruit” has been taken, and trusts are now looking for ways to be even more efficient, as well as increasingly looking to system change.
We have been working with a number of trusts across the country supporting them to make the most of Model Hospital, the quality of its insight, ability to usefully compare to peers, and to improve their financial performance as a consequence. From this experience, here are five things we think a trust needs to consider to make best use of this tool.
- Interpreting the Model Hospital cost metrics can be challenging and requires an understanding of your underlying data
Differences in how trusts record cost data can influence the size of the opportunities from Model Hospital. A review of the underlying data may be required to understand which Model Hospital opportunities are achievable and which opportunities are instead caused by differences in how costs are apportioned.
As we discussed at length in our Road to Recovery document, robust data may not always be available in some trusts. We would actively encourage trusts to understand and cleanse the data they are submitting into Model Hospital, which in turn will help with interpretation down the track.
- Business intelligence needs to be applied to make the opportunities presented in the Model Hospital ‘real’ and relevant
Model Hospital will provide the benchmarking, and its metrics in a common language, to read across organisations. The metrics used are WAU (cost per weighted activity unit) and PPO (potential productivity opportunity) - these metrics allow for comparison between specialties and organisations to enable comparison of opportunities. Each trust needs to interpret and understand what the benchmarking is showing as opportunity for them, deep dive and triangulate this with its own patient cohort, to ascertain what represents a “real” opportunity for them, what does not and why this is the case.
Understanding and exploring potential opportunities thrown up by the tool should be done in conjunction with clinical, finance, BIU and workforce colleagues to help interpret the data and to identify where the opportunities may lie, and how they could be realised.
- Ensure you consider known improvements and deteriorations that an organisation has made since the data was supplied to Model Hospital
While the Model Hospital contains some more recent data, much of the website is powered by Reference Costs and accounts data which can be between 6 and 18 months old. When a trust is considering the data from Model Hospital, it should consider what changes have been made in the organisation in recent months - either for a positive or negative impact - that may make the findings today look different. This will include the sustainable changes and savings made in the intervening period.
- Engage with NHSE&I
Model Hospital is an excellent tool that organisations can put to great use to inform where they have potential for further efficiency. It is important that as you work to understand the benchmarking, you engage with the Regulator to take them on the journey with you as you evaluate the realistic short, medium and longer term opportunities. The Regulator may also be able to provide resource and support in realising opportunities as they have done with a number of trusts across the country.
- Connect Model Hospital with your governance
The most successful trusts that get the most from Model Hospital record the exploration of opportunities and connect these with their governance, demonstrating. Some trusts, don’t record their exploration of opportunities and then can end up duplicating work or finding it hard to respond to boards, sub-committees or NHSE&I on how they’ve performed.
We believe trusts that can demonstrate how they are using Model Hospital are an example of good financial stewardship. To find out more, please get in touch.