Addressing unwarranted variation in care | Steve Sparks

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NHS RightCare delivery partner Steve Sparks shares how NHS England's programme is helping local health economies derive the best possible value for their populations.

The funding and demographic pressures on the health and social care system make it essential that we make sure the best possible value is delivered from all our spending. NHS RightCare is now working with all 209 local health economies in England to help them identify and address unwarranted variation in the care provided to their populations.

This focus on unwarranted variation is justified because it leads to two consequences:

  • Not enough use of high-value interventions, especially by people from lower socio-economic backgrounds or ‘poorly served’ groups.
  • Too much use of lower value interventions, which wastes NHS resources, risks treatment where it isn’t essential or of the highest value to the individual. This uses funding that could be better spent on higher value care and/or patients in greater need.
NHS RightCare has developed a wide range of high quality information resources, in particular the series of Commissioning for Value data packs at clinical commissioning group (CCG) and sustainability and transformation plan (STP) footprint level. These are freely available to everyone and include:

  • Where to Look packs, helping identify the headline opportunities for improvement in a local health economy.
  • Focus packs, a series of seven packs that give detailed information on the 11 highest volume programmes of care for a local health economy.
  • STP packs that collate opportunities for improvement for the local health economies that make up each STP area and highlight shared opportunities that can be best realised by working together.
A team of 20 NHS RightCare delivery partners is supporting local health economies, helping them make the most of the RightCare approach and resources. Delivery partners are aligned to STPs to ensure that opportunities that exist in common across an entire health system are identified and addressed. 

We want to make sure that those involved in implementing the RightCare approach also learn from each other by sharing examples of what works well elsewhere and helping health economies use evidence of best practice in redesigning their care pathways.  

There are three stages to the RightCare approach to helping CCGs maximise value:

  • Where to look: highlighting the top priorities and best opportunities to increase value by identifying unwarranted variation
  • What to change: designing optimal care pathways to improve patient experience and outcomes
  • How to change: delivering sustainable change by using systematic change processes
NHS RightCare’s national rollout began just over a year ago with 65 CCGs and their local health economies involved. These first 65 have identified their big opportunities for improvement, and have now developed detailed plans for how to realise the opportunities. 

This means we are now actively involved in over 200 programmes of work across many different pathways, ensuring the RightCare approach is driving positive change and better outcomes.

A reduction in all types of unwarranted variation will increase value for individual patients and for populations, ensuring that the right people are given the right care in the right place at the right time – all while making the best use of available resources across the health service. Supporting local and national delivery of this is the aim of NHS RightCare.

Steve Sparks is an NHS RightCare delivery partner at NHS England. Follow him and the programme on Twitter @SteveSparks @nhsrightcare 

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