The West Yorkshire Integrated Care Board in Leeds - Case Study

Access Adam Care Commissioning software is being used by the West Yorkshire Integrated Care Board in Leeds, Continuing Healthcare Department, to improve efficiency within all areas of the Continuing healthcare process.

By streamlining the commissioning process and management of care providers, staff have more time to focus on what matters most: patient care.

The West Yorkshire Integrated Care Board (ICB) was created in 2022 to enable joined-up care between different departments and healthcare providers within West Yorkshire. As part of this, Leeds CCG was combined with Bradford and Craven, Kirklees, Calderdale and Wakefield in to a single ICB with the aim to drive better communication and cooperation between these different areas. This in turn will ensure the quickest possible treatment for patients, all whilst maintaining high care standards. 

Leeds ICB (now part of West Yorkshire ICB) began their journey with Access Adam Care Commissioning in 2018 after a previous merger of departments which saw the Continuing Care team expanding their services to a larger remit and increased care provision. Due to this, the current case management and database processes, created by Head of Continuing Care Services, Andrea Dobson, were no longer fit for purpose, and needed to incorporate a larger range of processes and data. 

What the organisation needed was a reliable database and brokerage tool that could track patient journeys and details, was accessible by staff on the go, easy to learn, easy to use, and made communication simple. 

You don’t want patients waiting, because they’re making life-changing decisions on the outcome of this assessment.

Andrea Dobson, Head of Continuing Care Services 

After an initial consultation period, Leeds CCG chose Access Adam Care Commissioning as the software solution to help. Access Adam is cloud-based data management software that operates within one central location.

The team manages its entire workflow within the platform; brokerage of continuing healthcare services, clinical assessments and referral data, management of provider services, compliance and provider engagement, contracting and auditing, and invoices and payments.

The continuing healthcare department is staffed with clinicians and administrative staff for referrals, finance, and strategic business planning, all of which work together to provide NHS continuing care services to patients.

Patients using this service are often suffering from long term conditions or end of life care, it is therefore incredibly important for the patient and their families to be looked after and receive efficient and quality care with clear communication throughout the process. 

The original system implemented by Leeds, was a Microsoft Access database; functional, zero-cost, but slow, and with limitations in terms of its ability to process and present data for the clinicians and admin staff to evaluate and act on. On top of this, the database was growing too big.

What might have been a sufficient tool for the Leeds CCG before the merger, was quickly being overwhelmed by several departments worth of patient data, and with the Integrated Care Board coming online in the near future – plus requirements from NHS England for a Patient Level Dataset – it was abundantly clear that something had to be done. 

As part of providing the continuing care service, NHS clinicians perform patient assessments – at home or in care – on people with deteriorating health or specific care needs. This is often a two-stage process ensuring a breadth of experience and knowledge is used to make the most accurate assessment of a patient’s condition and their needs for continual healthcare. 

By using the Access Adam system, referrals for continued care can be completed through the electronic checklists and DSTs directly into the system by nurses and clinicians working in the field – no longer are they required to copy up notes after the assessment has taken place, where an error could easily occur.

Clinicians can not only log core patient data, but they can add extra information from their own observations and interactions, as well as details provided from their families. Any missing information can be requested through the system. This then feeds into  the centralised patient records (Case Management) to ensure the most accurate information available, but also to avoid duplication or missing vital intel about a person’s condition and needs. 

From here, the team would then work to provision packages of care with a list of approved providers. At the time this was a largely a manual process and relied on communicating with providers via email and telephone.

It could be difficult to understand the quality of each provider as the team would be focused on placing a patient with a care service who responded first and met the initial criteria of care. Not only could this mean the team were paying more than they should be for a service, but another care provider could have been more suitable and meet other requirements such as location to family.  

By introducing Access Adam, the overall time spent on sourcing packages of care has been reduced by 35% since implementation. By grouping commissioning in one system, the requirements are clear and transparent to all applicant providers, and the system’s criteria notifies eligible organisations that they can put in an offer to provide the package of care.

Upon this process, more data is available than ever before – and presentable to better determine which contract of care should be pursued. Leanne McGee, Business Support Officer for West Yorkshire CCG, said:

It's made it easier for the providers to be able to contact us with regards the requirements, they can see them at an instant notification, and they are then very responsive to that so then we are picking packages of care up probably quicker than we were before so that makes a huge difference. 

It wasn’t just the assessment and referral process that was struggling to keep up with demand. Finance and Business were also experiencing the growing pains of such a merger. A core KPI target for completing assessments from referrals for continuing care is 28 days. Like many NHS services in the current climate, Leeds was also struggling to have oversight and achieve this target in most instances.  

Mutale Bwalya, the Business and Special Project Manager with West Yorkshire ICB, was closely involved in the implementation and impact of Access Adam Care Commissioning. He spoke about the ease of data evaluation and exporting for reporting purposes, especially when tracking KPIs and adjusting these data sets. 

Speaking to Mutale, he told Access:

Our main care KPI as a service is we have to complete our assessment within 28 days. That’s a main KPI that we’re able to monitor effectively throughout the Adam system because it’s readily available at the click of a button. We can review that information and say we’re either meeting this target or we need to do something about it. It helps us develop action plans on how we can move forward as a service and improve.

We can review that information and say we’re either meeting this target or we need to do something about it. It helps us develop action plans on how we can move forward as a service and improve.

Mutale Bwalya – Business and Special Project Manager

Additionally, teams were spending high resources on admin work such as payment processing. For instance, in the Finance team’s own words, “Prior to moving to the Adam system, we were averaging over 50,000 invoices a year.” Processing this volume of invoices was taking up huge amounts of time and resource, as well as budget because it required multiple members of a team to handle these payments and post individual invoices to providers.  

Surveys showed a positive response to the implementation of Adam Care Commissioning, with staff describing it as “accessible and intuitive”. Our software solution allows all departments within the ICB to perform their tasks more efficiently or to a greater capacity. Staff can communicate queries or concerns within Access Adam, and can react more quickly and efficiently to care requests thanks to this streamlining and accountability. Fewer phone calls and emails chasing up requests or details mean more time for patients and better care as a result.  

On top of this, the patient experience is further enhanced. The option of multiple care providers to choose from means a patient-centric approach, which provides reassurance and control over what is a very personal care experience. Things like freedom of information requests also benefit, with much quicker compiling of personal data to relay to individuals. 

Those in the Business or Strategy teams can see clear graphics of the patient journey and the ICBs performance re: KPIs and other targets. There’s also more reassurance in the contract process, ensuring no grey areas about what care was intended and what care is being provided. Any breaches can be met with invoices being rejected due to contractual breach, thus enforcing terms and ensuring responsibility.

All of this operational behaviour and updates can be automatically reported in the background from the ICB to NHSE. This is a requirement, but the automated approach shows efficient compliance, and the reliability and regularity of reporting builds up a good relationship with NHS England that care is being properly commissioned and monitored. 

As a result, the referral process for patients has sped up by 30% now that Access Adam is streamlining the administrative process in establishing contracts and the assignment of care services. 

Adam is critical to our service. This is the system that we use for every part of our working day, from the clinicians to our Head of Service to our administration staff… it is important that we are able access this system on a daily basis to do our jobs effectively.

Leanne McGee – Business Support Officer 

This has given staff confidence that patients are receiving the correct care and are able to spend the time communicating with patients and their families, addressing their worries and alleviating an concerns. It also means the team can react quickly when something does go wrong or is queried and have full visibility of the patient’s journey and the care they have received.  

The feedback for us here at Access has been overwhelmingly positive. Staff using Access Adam Care Commissioning at West Yorkshire ICB have spoken candidly about their initial trepidations when using a new software but how they quickly warmed to it, particularly to it being web-based but also how the graphical interface is easy to read and stay updated with – especially for the nurses and the referrals administrators.

This has a positive knock-on effect for patients and their loved ones, as a quicker referral process means less stress for the families worried about care provision and getting the support they need. 

Andrea Dobson, the CCG’s Head of Service, spoke to us about the risk of moving from a zero-cost system to Access Adam, and the justification of spending, but with the time savings on invoices and referrals, improvements to assessments, targets now being met, and even cost savings on staff as finance members moved on and the workload was absorbed by the software... Adam Care Commissioning has proven itself invaluable to the West Yorkshire CCG and ICB. 

This invaluable status has been backed up by other departments, with the business team citing support from The Access Group with Adam from Day 1 and how Adam is critical to their operations, and other staff praising the security involved with Adam; managed access to records, data backups, regular software updates and maintenance, password reminders, monthly forced changes, and even being logged out after idling for a short period of time. 

Some of the benefits of Access Adam Care Commissioning have been touched on already, but it’s in the aftermath that The Access Group and West Yorkshire ICB can assess the real impact of implementing our software solution.  

• Time taken for fast-track referrals reduced by 30%. 
• Time taken for commissioning of care reduced by 35%. 

• KPI target of 28 days or less between referral and assessment now being met. 
• Greater availability of data to inform commissioning decisions. 
• Digital commissioning to source and manage care  
• Finance workload reduced from over 10,000 CHC invoices a year to 52. 
• Incorrect invoices reduced from 15 to 0 (zero). 
• Cost of Adam Care Commissioning offset by savings elsewhere in the organisation. 
• Reporting improvements from FOI ease to automatic PLDS  
• Formalising contracts with providers using the system and manage all contracts  

From a business perspective, the efficiencies and interface come back as a big positive yet again. 

• No longer are suppliers experiencing delays to payment and then complaining to the CCG. They have access to payment information and the CCG gets fewer queries taking up time. 
• West Yorkshire CCG is coding just ONE invoice per week now, not hundreds 
• Different teams can all use the system at the same time and can even all work on one patient but doing different things. 
• Better decision making via better data presentation, which enables market analysis and long-term action plans for improvement. 

What about the future of the partnership? Well, that’s being driven by Andrea Dobson and her team. Andrea’s goal is to get the local authority on board with Access Adam for greater collaboration, but she has a big plan in mind for onboarding local nursing homes too.  

Because it's [Access Adam] got a brokerage function, if a person needs a care home our team can put it on and it’ll go straight to the care homes, the care homes can see what work’s available and whether they can pick it up” Andrea told us. “If we can take even a couple of days out of how long it takes to place somebody, we’re making it better for everyone. It’s better for the care homes because they’re getting funds, it’s better for the patient because they’re not sat in a hospital bed or out in communities with family worried about where they’re going – it'll make it a slicker system.

At The Access Group we are proud to be supporting West Yorkshire ICB with their patient focused goals and look forward to continuing working together on future projects.