System-wide changes that will transform the way we deliver care
On 9 June 2021, health and social care experts and leaders came together with staff and students across King’s Health Partners for its event exploring system-wide change that improves health outcomes for the communities we serve.
Across the UK there is a 10-year gap in life expectancy, contributed to by environment, occupation, lifestyle, and access to healthcare. This stark reality makes it impossible to ignore the need for system-wide change that better addresses the many factors at play in determining a patient’s health outcomes, from the wider determinants of health to individual patient pathways of care.
Our Clinical Academic Innovation Workshop gave us the opportunity to explore innovative new services, resources and approaches that are already making a difference. Below are some of the key takeaways from our workshop that will help us turn discussion into action.
‘Unlearning old ways of thinking’
The ever-changing social, economic, and political landscape in the communities we serve, and the implications of this on the health of our population, highlights the need for an agile health system. The workshop addressed the point that traditional approaches to healthcare are not designed to suit everyone who is part of the local population we serve. To create change, we need to unlearn some of our previous ways of thinking.
This idea of breaking down more traditional boundaries in how we deliver care was explored by Samira Ben Omar, Head of Engagement and Partnerships, North West London Clinical Commissioning Groups. Samira highlighted the need for a shift in the way we connect with patients and local communities, moving from a detached approach to engaging at a more personal level with a patient. Samira’s idea of “bringing your whole self, not just your professional self” can help people engage more with their care, improving health outcomes overall.
It is also now much more widely understood that, to see significant, sustainable change in healthcare, we must go far beyond the hospital walls. During her talk, Dr Jo Bibby, Director of Health at the Health Foundation, shared the view that the NHS should use this understanding and influence to help advocate for action outside of clinical settings.
Engaging our patients and local communities
The Public Health England strategy ‘Healthy Lives, Healthy People’ published in 2010 recommends an innovative and responsive approach that is ‘owned by communities and shaped by their needs’.
Understanding and engaging the communities we serve cannot solely be done through numbers. To deliver care focused on the outcomes that matter to our patients, we need to be tuned into the needs and aspirations of our community through leadership at a grass roots level and the practice of active listening.
Samira Ben Omar shared her experience working with community champions in West London to engage residents. The programme was established to ensure that services are better designed to meet local health and social care needs. Innovative programmes like this ensure that communities are listened to and involved in decisions surrounding the care they receive.
John Norton, Citizen Partner on the Board of Discover-NOW, offered perspective as a member of the community, echoing the importance of active listening in improving health outcomes:
Effective healthcare is about what matters to you as well as what is the matter with you.
Innovating with data
Collecting patient and population data isn’t a new concept, but it can be collected and analysed in innovative ways to transform how we deliver care. During the workshop, we explored how consistent, accurate data collection can inform methods of intervention in healthcare, and prevention.
Dr Jo Bibby shared a key example of quantitative data collection: the ONS index for health and social care. The index collates statistics on life expectancy and the impact of wider determinants of health, including occupation, living conditions, and substance misuse, at a local level. Though this index continues to be developed to capture the most accurate view of our local populations, it is part of an important conversation around how we use data to drive change at a system-wide level.
Prof K Ray Chaudhuri, Professor of Movement Disorders and Neurology at King’s College London, also discussed the importance of effective data collection, with a focus on recording patient outcomes. Prof Chaudhuri stressed the importance of data visualisation in clinical decision making. He presented a ‘scorecard’ produced by King’s Health Partners Neurosciences which provides a visual representation of patient outcome data that acts as a source of intelligence for how and where to prioritise efforts to improve care across the health system.
Using our assets to inform care
Building on the importance of data, developments in informatics and artificial intelligence also play a significant role in driving innovation to join up care.
King’s Health Partners unique informatics platform, CogStack, was discussed during the workshop. CogStack is an application framework that is able to process and harmonise unstructured data so that it can be used effectively to assist in research and clinical decision making. Dr Rob Harland, Consultant in General Adult Psychiatry at South London and Maudsley NHS Foundation Trust, gave an example of how the platform is being used at an individual trust level. His team has created a dashboard collating data from 16,000 patients who have engaged with their services, and their medical history. By presenting patient data in a format that can be stratified, filtered or searched, healthcare providers are able to make more informed decisions around a patient’s pathway of care, based on their own or other’s similar experiences.
Dr Anand Shah also explored how his team are aiming to use CogStack and clinical informatics to improve patient outcomes in the context of fungal disease. The use of big data and the potential of machine learning can enable population surveillance, disease stratification and enable his team to improve fungal diagnosis, carry out survival prediction and enhance the care pathway. Dr Shah’s experience comes from his roles as Consultant Respiratory Physician, Royal Brompton and Harefield Hospitals, Guy’s and St Thomas’ NHS Foundation Trust, and Honorary Senior Clinical Lecturer, MRC Centre of Global Infectious Disease Analysis, School of Public Health, Imperial College London.
Learning from the COVID-19 pandemic
When COVID-19 started spreading rapidly in April 2020, primary care teams had to quickly develop new ways to provide services whilst keeping patients and staff safe. More than one year on, the ongoing pandemic has had a lasting impact on the way we work across healthcare services.
Cancer care, for example, has been significantly impacted by the pandemic. Services across our partnership have had to adapt to continue treating patients, and have done so by building relationships and harnessing collaboration – for example setting up the south east London Cancer Surgery Hub for cancer patients in the area who require time critical surgery. This provided transparency on treatment prioritisation and ensured equity of access for SEL patients.
Restrictions to visiting policy in hospitals across the country also forced an adaptation in how we deliver care, as Prof Louise Rose, Professor of Critical Care Nursing, Head of Division of Applied Technologies for Clinical Care, King's College London and co-founder of Life Lines, explained. The Life Lines project was established early in the pandemic to enable virtual visiting for patients in intensive care. This adjusted approach made clear how important visits from loved ones are, offering psychological support and creating continuity for patients being seen by different doctors on a regular basis, and providing clinical staff with additional patient information. This project has highlighted demand for virtual visiting that will exist beyond the pandemic.
To catch up on this Clinical Academic Innovation Workshop, visit our Learning Hub.