HealthPathways Chief Implementation Advisor, Andy Froggatt spends quite a bit of his time talking to health care influencers around the world about how HealthPathways can help to transform their health systems.

In this latest update, Andy provides an overview of emerging developments within the UK health system and highlights messages from the latest King’s Fund report which focuses on lessons learnt from transforming Canterbury’s health system.

HealthPathways in the United Kingdom

As you know South Tyneside are the first region in the United Kingdom to implement HealthPathways and we’ve been working closely with the local team to ensure that we learn about the UK environment and how HealthPathways fits with this. We are very pleased to say that, as South Tyneside HealthPathways reaches the first anniversary of the launch of their ‘live’ site, it’s been a great success.

Utilisation rates are high and an independent evaluation by Sunderland University is highly positive about the process of engagement and implementation that the South Tyneside team has undertaken. As ever, there are some great learnings as well, which we will share once the report moves from its current draft state.

Streamliners CEO, Ian Anderson, Writing Team Manager, Emma Harding, and I recently had the pleasure of receiving a review from the South Tyneside team about the first year of their HealthPathways journey. It has been fantastic working with the team over the past couple of years and the opening slide of Mark Girvan’s (Project Manager) shows the great esteem in which I am now held in South Tyneside!

We are learning that the United Kingdom is a challenging, yet fascinating environment at the moment. We often think of the NHS as this single, easily defined entity, but it is in fact made up of a myriad of organisations that whilst under the NHS banner, are often not well aligned, either structurally or philosophically. In addition to this, the role of local authorities, particularly in regard to their responsibilities for aged and social care, is significant.

In England, the government has now created 44 larger areas where NHS organisations, (including Clinical Commissioning Groups and Trusts) and Local Authorities, have been tasked with writing and implementing Sustainability and Transformation Plans (STP). These are aimed at developing proposals built around the needs of the whole population in the area, not just those of individual organisations. These STP regions have no separate governance processes but require concordance between parties to progress the local STP.

For those with spare time on their hands, you’ll find further information on the NHS website: Sustainability and transformation partnerships (STPs).

At the same time the NHS has announced eight regions that will become Accountable Care Systems. These are described as “an evolved version of an STP that is working as a locally integrated health system”. In essence, ACSs will have a more formalised structure, accountable agreements with NHS England, and more devolved powers.

Interestingly an ACS can cover a whole STP region, or be a sub-set of an STP. When you ask the question, “How will an ACS as a sub-set of an STP region work?” the answer is not immediately clear!

For more information about on Accountable Care Systems, see the England NHS website: Integrating care locally.

In many ways, our experience in the UK so far is not dissimilar to that in Australia and New Zealand. No matter how the system is structured and governed, HealthPathways can be a great enabler for re-engaging the clinician-to-clinician conversation, improving the effectiveness of the resources we have, and providing a catalyst for and link to system redesign.

There is a significant interest in the UK for HealthPathways and when you consider the challenges of implementing change across an STP footprint, it is ideally suited to assisting that process. In other words, HealthPathways works whatever the structure of the system in which it is deployed.

Our focus is currently to work with South Tyneside and partners to further spread the use of HealthPathways within the South Tyneside region and to develop a partnership with a well-respected NHS organisation to be able to help us further support HealthPathways in England. We hope to be able to make an announcement on this soon.

If you want to know more about the South Tyneside story, feel free to contact Project Lead, Mark Girvan via email mgirvan@nhs.net

Latest King’s Fund Report

For many of us, one of the earliest things we read about HealthPathways was the 2013 King’s Fund report on Canterbury.

More recently, they’ve published a second report about relevant lessons from Canterbury in relation to the development of the Accountable Care Systems, which I mentioned earlier.

Much of the material and messages in “Developing accountable care systems: lessons from Canterbury, New Zealand” will be familiar to members of the HealthPathways Community, but the report is a useful reference when discussing how to improve health care in your region.

There are a couple of points that stand out for me in the report when managing expectations about HealthPathways and the reform process in general:

• The overall transformation has not been the result of one ‘big bang’ change, but an aggregation of many simultaneous changes to the way in which care is organised and delivered.
• The experience in Canterbury clearly demonstrates that transformation of this kind takes time, with progress still under way a decade into the journey.

The Guardian also published an associated piece, “What can the NHS learn from New Zealand?”

More information

If you’d like to discuss anything mentioned in this update, feel free to email me at andy.froggatt@healthpathwayscommunity.org