HFMA Awards 2019: value and innovation
12 December 2019
This year’s Value and Innovation Award went to a programme that has strong clinical-financial engagement and delivers better services to patients as well as savings.
Cheshire and Merseyside Health and Care Partnership, in partnership with Mersey Internal Audit Agency, took the award for its medicines optimisation programme. The aim is to deliver significant financial benefits – multimillion-pound savings – together with improved safety and patient experience.
The programme is clinically led, with finance support, with its strategic direction ‘shaped and owned on a collective basis by chief pharmacists’ from across the health sector.
The programme is based on integration, with a steering group drawn from providers, finance, commissioners, community pharmacy and primary care. All elements of medicines optimisation have been brought together under a single framework across the system, while all projects are owned by a chief pharmacist or head of medicines management. This ensures delivery at place level, with benefits delivered consistently and at pace across the region. And learning can be spread quickly on which interventions work – and which do not.
There is a clinical and finance evidence base for all projects and, with the heath and care partnership adopting a rigorous funding approval process, together with return on investment and project monitoring, the benefits can be recognised and incorporated into place and organisational plans. The benefits realisation process is continually evolving to capture and evidence clinical outcomes and patient experience.
The programme estimates full-year savings of around £8m from six projects, including a focus on wet age-related macular degeneration; making better use of patients’ own medication; and anticoagulation medicines. A project to promote the use of biosimilar drugs is likely to have avoided costs of more than £1m between October 2018 and July 2019 – in excess of the initial estimated figure.
The judges said all three shortlisted entries were of a very high quality, so once the winner had been selected the other two were highly commended. The winner was a unanimous choice: ‘The panel was particularly impressed with the way the programme spans the whole patient pathway, from primary care to specialist tertiary services,’ they said.
‘And while the programme has delivered significant financial benefits, it was clearly clinically driven and took account of a much wider set of measures of success including patient experience. We were also impressed by the team’s desire to transfer their learning to other parts of the health system.’
MIAA commercial director Chris Harrop praised the team effort across the system. ‘Lots of people gave their time willingly and for free to support this programme and it’s amazing that every one of them has been recognised by us winning this award. Although each project was led by a clinician, we’ve worked together across the system – CCGs, providers, NHS England and NHS Improvement – with finance colleagues supporting clinical colleagues.’
Download our HFMA Awards 2019 supplement here
Leeds Teaching Hospitals NHS Trust aimed to truly add value by not only reducing costs but also improving outcomes. Dispensing with the traditional cost improvement programme approach of concentrating on costs to achieve savings, it shifted the focus to waste reduction. While savings remain important, they are seen as a byproduct of the improvement work. This has increased staff engagement, delivery of its aims and the level of ambitions for the programme. Overall, the shift in focus to identifying and reducing waste – doing the right thing to add value for the patient – has helped deliver an improvement of more than £60m.
St Helens Cares, the partnership of St Helens Clinical Commissioning Group, St Helens and Knowsley Teaching Hospitals NHS Trust and St Helens Council, has put integrated business intelligence (BI) at the heart of the development of the local care system. A BI hub incorporates co-located teams from the acute trust, public health and local authority to promote effective data sharing and activity analysis. This is key to informed financial decision-making and improving efficiency by removing duplication. The intelligence generated allows St Helens Cares organisations to anticipate the population needs and better target their interventions.