Busting Bureaucracy

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Busting Bureaucracy Working with the NHS to reduce burden and bureaucracy Healthcare Efficiency Through Technology 2014

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Read how the HSCIC are working with the NHS to reduce burden and bureaucracy. Presentation delivered at the Healthcare Efficiency Through Technology (HETT) Expo 2014 - areas covered included: - Tackling bureaucracy in the NHS - Auditing bureaucracy in the NHS - Testing the hypothesis - Report findings and recommendations - Top ten tips - Changes that make an impact - Self-assessment toolkit - What's next?

Transcript of Busting Bureaucracy

Page 1: Busting Bureaucracy

Busting BureaucracyWorking with the NHS to reduce burden and bureaucracy

Healthcare Efficiency Through Technology 2014

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Setting the scene

• 1 Health and Social Care Act 2012• 2 Hard Truths published by the Department of Health published January 2014• 3 NHS Confederation report Challenging Bureaucracy• 4 A Strategy for the Health and Social Care Information Centre 2013 - 2015

A statutory duty of the Health and Social Care Act

2012

“.. seek to minimise the burdens it

imposes on others1”

The response to the Mid Staffordshire

inquiry Hard Truths

“…minimise bureaucracy,

enabling time to care and time to

lead2”

NHS Confederation’s

Challenging Bureaucracy report

“the effects and impact of

unnecessary bureaucracy from national bodies3”

“HSCIC has a statutory duty to ensure that the amount of time and effort involved in administration and bureaucracy is kept to a minimum to allow health and care professionals to devote as much time as possible to providing care to

people who need it 4”

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How do we define burden and bureaucracy?

• Burden - “a duty or misfortune that causes worry, hardship, or distress”

• Bureaucracy - “excessively complicated administrative procedure”

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Tackling bureaucracy in the NHS

• Audit of 16 acute trusts

• Busting Bureaucracy report

published

• Top 10 tips published

• Self assessment toolkit

• Working on a longer term

bureaucracy audit in collaboration

with two trusts: Royal Liverpool &

Broadgreen University Hospitals

NHS Trust Liverpool Women’s NHS

Foundation Trust

• Audits to be continued in Mental

health, Community and CCG’s

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Auditing bureaucracy in the NHS

• 16 acute trusts• Week long

audit• Observation,

interviews and structured surveys

• Shadowing clinical and administrative staff

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Testing the hypotheses

Hypothesis Findings

“Nurses and doctors spend a significant amount of time perweek on bureaucracy”

An average of 66 per cent of a junior clinician’s time is spent accessing or updating patient notes1

“The use of technology and smarter processes reduces burden and bureaucracy”

77 per cent of Trusts type up paper notes retrospectively into anelectronic system2

“The use of technology releases clinical staff time (which could positively contribute to the timeto care)”

The use of Computers on Wheels has reduced ward round times by 45 minutes3

1 Busting Bureaucracy Report, June 2014 - See Table 2, page 202 Busting Bureaucracy Report, June 2014 - See 2e, page 193 Busting Bureaucracy Report, June 2014 - See 3e, page 24

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Testing the hypotheses

Hypothesis Findings

“The better the local systems are, the better the acute provider is able to meet reporting needs”

It has taken some audited Trusts two years to fully implement a solution to delivering a new return;involving interim ad-hoc solutions, requirements definition, supplier quotation, delivery, testing and implementation. Until developed, manual bureaucratic processespervaded.

“A national concordat would have a positive impact on reducingburden”

In the preceding 12 months, an average of 10 external datasets were introduced or changed4

4 Busting Bureaucracy Report, June 2014 – See 1f, page 12

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Report findings and recommendations

Controlling burden and bureaucracy

Implementing processes

Technology adoption to minimise bureaucracy

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Top ten tips

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Changes that make an impact

Review internal governance of data collections and ensure that there is a clear documented process for implementing new data collections and managing existing data collections.

Organisational ownership

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Changes that make an impact

All data collections have a cost to an organisation. Ensure that all new and existing data collections are supported by a business case identifying the resource commitments.

Cost of data collections

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Changes that make an impact

Ensure that investment decisions are assessed against criteria which drive clinical effectiveness, improve processes and reduce burden and bureaucracy.

Value of data collections

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Changes that make an impact

Ensure that all data collections have: an identified owner; a review date and process; explanatory documentation and a support structure.

Management of data collections

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Changes that make an impact

Consider the holistic implementation of data collections supported by efficient processes and appropriate, available and accessible technology.

Data collections, processes and technology

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Changes that make an impact

Use the self-assessment toolkit at least annually to develop a baseline view of the level of burden and bureaucracy and to track improvements.

Understanding the impact

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Changes that make an impact

Review the implementation of existing technology and its effectiveness in supporting efficient processes.

Driving efficiency

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Changes that make an impact

Consider the implementation of new technology and in particular electronic patient records (EPRs) to directly support care pathways, care settings and data collection.

Data collection as part of

delivering care

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Changes that make an impact

Explore innovative approaches to reducing burden and bureaucracy. Consider ergonomics, accessibility and availability of systems.

Embrace innovation

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Changes that make an impact

Staff involved in data collections and the use of systems will have valuable insights and suggestions for improving efficiency and reducing burden and bureaucracy. Set up mechanisms to encourage their input.

User experience

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Self-assessment toolkit

hscic.gov.uk/bb

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What’s next?

Collaborative audit report

Self assessment toolkit

Top tips for trusts

Working with the Burden Advice and

Assessment Service

Two pathfinder trusts …

Further audits – Mental HealthCommunity

CCG’s

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The journey so far…

“High quality data is crucial to transforming care, which is recognised by both health professionals and the public. However we want to work with providers to stamp out unnecessary bureaucratic burden on those who provide care.”

Kingsley Manning, HSCIC Chair

Source: BB press release issued on 6 June 2014