What Does A Model Hospital Look Like?

By Kiri Elliott, BDA Policy Officer.

At the end of 2016, a prototype of an online portal that allowed comparison of metrics between acute NHS hospital trusts in England was launched. The Model Hospital Portal was born out of a recommendation from The Review of Operational Productivity and Performance in English NHS Acute Hospitals, known more commonly as ‘The Carter review’.

The Model Hospital Portal is an excellent opportunity for dietetic and other AHP services to demonstrate the critical impact they make, not only to the patient experience, but to trust objectives in productivity and efficiency too

In 2014, Lord Carter was asked by the Secretary of State to look at what could be done to improve efficiency in the NHS in England. Over 18 months he worked with 136 non-specialist hospital trusts in England where he identified significant unwarranted variation across NHS services. For example, when the costs of operations across different NHS providers was compared, it was found that a hip replacement in one trust might only cost £800 pounds whereas in another it would cost over £1500! Lord Carter made recommendations to address these findings and to promote efficiency.

Becoming ‘Information Rich'

With the aim of realising these recommendations, NHS Improvement (NHSI) has established an online Model Hospital Portal. The NHS has long been condemned as being ‘data rich but information poor’ and allied health professional (AHP) services are no exception to this. The Model Hospital has an AHP-specific compartment under the ‘people’ tab which seeks to address this by helping NHS providers identify ‘what good looks like’ by using a series of standardised metrics that evidence quality outcomes, good use of resources, and efficient processes.

Current AHP metrics in the Model Hospital:

  • W.T.E dietitians and dietetic assistants by band
  • AHP cost per 1000 occupied bed days
  • AHP cost per 1000 outpatient attendances
  • Dietetic staff as a % of all AHPs
  • AHP sickness absence
  • AHP retention rate

The data that currently populates the AHP section of the Model Hospital is data that NHS trusts submit through existing returns, whether it is allocation of staff to the national Electronic Staff Register (ESR) or compilation of reference costs. Given this, it is strongly recommended that NHS trust’s record and report data accurately. Dietetic and AHP leads are urged to engage in this process within their own trusts, particularly as going forward, this data will be used for a more open and integrated approach to performance management across the NHS

A Portal for Better Communication

The portal is live now but is still in development. Anyone employed by an NHS provider in England can have access to the portal. The BDA encourages clinical and operational AHP service leads to register via the following link model.nhs.uk. Once logged in, it is possible to compare your data with that of other ‘peer trusts’. A peer trust may cover a similar demographic, provide similar specialist services or be a similar size. Where variances are found, it is anticipated that trusts can talk to each other, to understand why variances occur and take appropriate action where necessary.

As well as ensuring AHP productivity is represented appropriately via the Model Hospital Portal, it will also be including new tools and best practice guidance to support trusts to consistently measure AHP productivity.

The Model Hospital Portal is an excellent opportunity for dietetic and other AHP services to demonstrate the critical impact they make, not only to the patient experience, but to trust objectives in productivity and efficiency too. The challenge is to find consistent and accurate data that comprehensively describes the components of AHP services in a way that enables productivity to be measured.

Recently, the NHSI published AHP Job Planning Guidance, see bit.ly/2IK5HNH. This is intended to standardise the framework by which trusts identify the clinical capacity of their AHP workforce. It is anticipated that in the future, all AHPs will have a job plan and that clinical capacity will be reported via the Model Hospital in due course. The guidance provides a generic AHP job plan template. A group of dietetic leads who are engaged with the Model Hospital work stream along with BDA office staff have created a more densely populated job plan template for dietetic roles. Any manager who is engaged or keen to engage with this work stream please email edpd@bda.uk.com.

Call For Action

NHSI would like to know of any AHP services that are already measuring productivity alongside quality outcomes and are keen to receive case studies that demonstrate where productivity has improved as a result of a service change or innovation. If you would like to know more about the programme and to discuss how you can get involved in shaping the Model Hospital compartment, please contact Rosalind Campbell, AHP Productivity Lead – NHS Improvement nhsi.ahp-productivity@nhs.net. You can also follow the conversation on Twitter using #supportingclinicalproductivity

With thanks to Rosalind Campbell, AHP Professional Lead for Workforce Productivity at NHS Improvement


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