Capacity Tracker takes centre stage (#DoingOurBit)

North of England Commissioning Support (NECS) developed its Capacity Tracker in April 2017 and prior to the COVID-19 pandemic it was already used widely with around 60% of all 15,500+ care homes in England registered. The aim of the service – funded by the NHS – is to help optimise the discharge process and help individuals to make the right choice when discharge to their own home isn’t possible.

It can help minimise the number of avoidable delayed transfers of care. It can help reduce the amount of time discharge teams waste on speculatively ringing round care homes searching for vacancies. And it can mean that patients are not kept in in hospital unnecessarily for longer than they need to be when they’ve been assessed as medically fit for discharge. For care homes, it can also make it easier and faster to fill their vacancies and minimise the disruption in the home answering these speculative phone calls.

However, it can also provide an up-to-date, real-time central view on capacity and current issues facing the care home sector. This would be valuable at any time, but during the Covid-19 pandemic, the benefits are amplified. And as part of guidance issued in March – Covid-19 hospital discharge service requirements – all care homes, hospices and providers of inpatient community rehabilitation were required to start using the Capacity Tracker.

The government’s expectation was for providers to share their vacancies and to record current status (ie open/closed) and the number of Covid-19 residents as well as their workforce and personal protective equipment (PPE) requirements. This was seen as a key support tool to help NHS trusts accelerate safe patient discharge to free-up capacity in the acute sector ahead of the anticipated surge in Covid-19 demand. It also aimed to help social care response teams, including councils and local resilience forums, prioritise and target their support based on the needs of the care home providers.

Matt Clark (pictured), finance manager for commissioning finance at NECS says it was a significant expansion of the use of the tracker. This expansion was not only in terms of covering the rest of the country, but also in leveraging the already widely used application to capture a broader set of information. This led to NECS rescheduling significant parts of its workforce, including the finance team, to support the Covid-19 response.

‘Large elements or our business-as-usual workload have been paused,’ he says. While support work for accounts submission continued, the adoption of block contracts to pay NHS providers meant contracting-related work more or less disappeared. ‘We were a week away from signing contracts, but that is all on hold and our usual daily tasks – for example meeting with providers to talk about data quality – has been stood down,’ he says. ‘However, we were all really keen to do something practical to help the frontline efforts.’

The Department of Health and Social Care’s decision to deploy the Capacity Tracker application across all care homes for consistent data capture provided exactly this opportunity. ‘We previously had a very small team running the Capacity Tracker in NECS pre-Covid, but we rapidly expanded this to 150, pulling staff from across the CSU,’ says Mr Clark.

These staff oversaw the rapid process of supporting care homes to register with the web-based tracker, validating the information drawn down from the Care Quality Commission, confirming the type of services and the number of vacancies they had and then helping them through the onboarding process. Care homes were then asked to update the system every 24 hours, giving a comprehensive and up-to-date picture of capacity and pressures across the system.

‘The original aspiration from the central team was to get everyone using the system from 1 April,’ says Mr Clark. ‘But given numbers involved, there have been two phases. Phase one was getting everyone registered and phase two is about supporting homes so that they all begin using it routinely on a daily basis to shine a light on their vacancies and wider business continuity status.

‘More than 15,000 care homes - 98% of all those in England – are now registered on the system with 60% of them updating every 48 hours.

‘This is a huge leap forward in terms of information about the sector – giving a single view across all providers,’ he says.

While the CSU worked on this programme throughout April, it has also supported the setting up of the Covid-19 testing programme centre in Gateshead and booking people in to get tested – involving around 280 contacts per day. ‘We are about to start a new task working with Ministry of Defence colleagues helping with the national PPE procurement programme,’ says Mr Clark.

‘This will involve contacting suppliers to understand offers they have made and product quantities. We’ll negotiate a price and prepare the contract document to handover for approval by the DHSC.’

All in all, the focus has been on flexibility and providing the skills available across the CSU team to support the frontline response to the Covid-19 pandemic in whatever way it can.