Briefing / Report on the value challenge pilot

This report describes how clinical and finance staff in three acute trusts in England, with support from the HFMA Healthcare Costing for Value Institute, set about translating the theory of value into practice. The aim was to test how easy it is in practice to link costs and outcomes at a patient level, and explore whether there is any correlation between them. The focus was on two areas: fractured neck of femur and inpatients with diabetes.

From the outset this project was seen as a pragmatic proof of concept. This was an ambitious pilot with only a short timescale allocated, and the project team recognised the clear limitations from the start. Nevertheless, considerable progress was made over a period of seven months, and the project has demonstrated that it is possible to link costs and outcomes at a patient level, and identify relationships between them.

Significant challenges were encountered on the way, particularly around data sharing and access to data. If greater value is to be unlocked in the NHS, changes need to be made at a national level to support future value projects, and our project has also highlighted learning for local organisations wanting to start their own value projects.

Recognising this value challenge pilot as ‘work-in-progress’, we are proud with the progress made in such a short time. As well as demonstrating that it is possible to link costs to outcome data in a clinically meaningful way, we have explored the linkages between cost and outcomes in the two chosen specialties across the three trusts. We are able to describe the challenges and obstacles from both clinical and financial perspectives, and have increased the costing team’s access to clinical data. The trusts involved have indicated that they plan to use the initial project outputs to further such work in their organisations.

We hope that this report will provide support and interest to organisations undertaking their own value challenges.  The Healthcare Costing for Value Institute will continue to facilitate learning on how to translate the theory of value into practice by working with members and other stakeholders, and sharing examples from both the UK and abroad.