Optimising Business Performance
This document describes an Innovative approach to helping
NHS organisations develop strategies to support World Class Commissioning through
the Optimisation of Business Performance. Our approach is dynamic and focussed on
continuous improvement at various points across the Commissioning Process.
NHS Transformation
The last ten years has seen massive changes in the NHS. More money than ever before
has been invested, decision making has been devolved to the local level and aspirations
are greater than ever to improve patient care. Initiatives such as 18 week “referral-to-treatment”
(RTT) for all patients and World Class Commissioning (WCC) are driving demand for
improved performance and an enhanced quality of service. WCC in particular, is at
the forefront of this transformation and is viewed as being critical to deliver
the aspirations for improved levels of patient care. WCC moves the debate from a
theoretical ‘nice to have’ capability, to a ‘must do’ that demands a more businesslike
approach to ensuring the effective delivery of services and efficient use of taxpayers’
money.
World Class Commissioning
Commissioning is a complex set of activities and processes involving multiple
organisations and people in providing healthcare services where and when they are
needed to ensure people live healthier and longer lives. World Class Commissioning
(WCC) is defined in the NHS Operating Framework for 2008/9 as THE Standard all organisations
must attain and it seeks to deliver:-
✦ Better health.
✦ Better care.
✦ Best possible value for every health pound invested.
✦ Achieved by minimising
risk and driving for continuous improvement in quality.
The Department of Health defines the skills required to achieve WCC and they
include Knowledge Management, Business Process Management, Data Analysis and Forecasting,
Strategic Planning, Procurement, Contract Management, Financial and Performance
Management. Some of these skills exist, some are bought in and some developed internally
through Training and
Development programmes.
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Managing Complexity
WCC requires effective collaboration with PCTs working through Local Strategic
Partnerships (LSPs), clinicians, patient groups and business to deliver on their
obligations. However, these relationships are complex and represent a continuing
challenge to achieve WCC aspirations. The ability to be able to Visualise, Model
and Manage them to operate efficiently is a key factor in achieving success. The
efficiency of how business processes operate is also an important factor in successful
performance and that is why there is a growing awareness of and interest in Business
Process Management.
Focus on Performance
This devolution of power also brings responsibility and accountability and there
has never before been such an acute focus on performance within the NHS. Every PCTs
performance is rated by many bodies such as the Department of Health, Monitor and
the Healthcare Commission on various measures such as Quality of Services, Use of
Resources and Patient Opinions. Transparency of performance measurement brings issues
into sharp focus and this is why there is such an interest in Performance Management.
Agile Information Systems
To perform at the world class level also requires access to world class information.
It is the lifeblood of any organisation and to make great decisions requires skill,
expertise and an element of intuition. However, it also relies on having access
to the right information, in the right format at the right time. In some PCTs this
is a challenge because existing information systems do not fully support evolving
business models as they can’t be easily or cost effectively changed. This does not
facilitate informed decision making and it has a negative impact on the PCTs ability
to achieve WCC standards. This is another reason there is interest in Business Process
Management as a way of making information systems more agile and responsive to changing
needs.
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What we do
We are a consulting and software development company with extensive knowledge
of the NHS. We have a proven track record of successful Business Performance Optimisation
projects and we bring Fresh Thinking to the whole process of WCC. This includes
looking at WCC as a Supply Chain and by applying proven industry thinking, optimising
business processes and developing supporting software, we can help drive success.
Linking Strategy with Execution
The most successful organisations in the world have a Vision they deliver on. They
are able to align Strategy with Execution and ensure that all resources are used
in the optimal way to achieve that goal. For WCC this means ensuring the right patient
services are available where and when needed. Failure to do this is highly visible
and can put lives at risk. The ability to graphically model different strategies
and look at the impact on patient services is essential. For example, what is the
effect on a community hospital if a new polyclinic is opened in the same area? What
impact would this have on how services are delivered? Previously this was a long,
laborious, sometimes subjective and potentially error prone exercise but now, tools
exist to manage this much more rapidly and effectively. We partner with Metastorm
and use their ProVision® and Metastorm BPM® (Business Process Management) tools
to help optimise performance in WCC. ProVision® is very relevant to managing the
complexity in WCC. It is an Enterprise Modelling tool that enables alternate strategies
to be graphically modelled and the impact on performance monitored. Research firms
Gartner and Forrester describe it as ‘best-in-class’ due to its capabilities and
integration with Metastorm BPM®.
Business Process Management
A traditional software package is developed to contain as much functionality as
possible so it appeals to a wide audience. Custom software on the other hand is
developed for a specific purpose. Both are prone to the same issue - difficult and
expensive to change. BPM is different because it considers business processes first
and then generates supporting software to fit the processes. Once simulations have
been run, they can be fed (‘Round-tripped’) into Metastorm BPM® to automate business
process and develop software. |
This
can be achieved in a fraction of time taken by other methods and rapidly integrated
with existing systems to leverage existing information and protect investment. Metastorm
BPM® specifically improves business processes and drives efficiencies. It enables
collaboration between I.T. and business users to modify or create business processes
and develop supporting software that is integrated with existing systems. This can
either be achieved in Metastorm BPM® or round-tripped from ProVision® as described
above.
Reference Points
Metastorm ProVision® and BPM® are used by some familiar names in the U.K. And
some of the most progressive thinking organisations in the private and public sector
and recognisable brands around the world such as :- BBC, Coca Cola, Home Office,
Shell, HSBC, London Transport, Lloyds of London, Ericsson, Fiat, Saab and the NHS.
Metastorm in the NHS
Although used for
managing referrals rather than Commissioning,
Metastorm is being used in the NHS today at North Staffordshire Health Intelligence
Service. The Stoke Musculoskeletal Appointment Slot Hospital Early Referral System
(SMASHERS) project, uses Metastorm BPM® to manage the terms of a primary care service
for the triage, assessment and treatment of patients with musculoskeletal problems.
Electronic referrals are generated by General Practitioners (GP) offices and forms
are pre-populated with patient demographics for faster entry and then automatically
routed to the appropriate staff member for action. This helps move patients through
the system and allows GPs to deliver timely care to its patients. North Staffordshire
now plans to use Metastorm BPM® in additional areas including its Rapid Access Chest
Pain Clinic referrals - a process comparable to its initial automation project except
with a focus on cardiac patients. By automating this process, patients now receive
care in a matter of hours. Another core process that has been automated is Incident
Reporting - a critical procedure that tracks any incident that occurs on the clinical
or administrative side and routes the incident form to appropriate personnel for
action. The system documents and tracks explanations for risk management and audit
purposes. North Staffordshire has also automated a process known as Establishment
Control, which is used as its electronic recruitment system for job posting authorisations.
Metastorm BPM® is seen as a critical system and will continue to be used to automate,
and control core processes to enable North Staffordshire to achieve its goal of
improving the health and welfare of its local communities. |