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allocative-efficiency

3 April 2023

Smarter Spending in Population Health: A first year of insights

The Smarter Spending in Population Health (SSPH) programme puts healthcare analytics into the hands of the people delivering and receiving treatment and services, empowering them to make impactful changes. After a year of leading these innovative collaborations, the SSPH team reflect on what has already been achieved and what they have learned.

How can you best use your budget to help chronic obstructive pulmonary disease (COPD) patients?

Ask this question to individuals across primary and secondary care, or in public health, and they will often focus on their isolated section of the care pathway – making small budget changes and hoping they have some small impact.

But put those groups in a room, together with patients, and equip them with an insightful and easy-to-use allocative efficiency tool and soon you have everyone considering the whole pathway. By working as one to find big changes, they can uncover significant impacts, and immediately start collaborating to make these happen.

This is exactly what we’ve done in our delivery of the Midlands Decision Support Network’s Smarter Spending in Population Health (SSPH) programme, and already we’re seeing the impacts.

Collaborating on analysis

Over the past year (2022/23) we’ve created decision analytic models and run decision conferences with five ICSs/Places: Coventry Place, Northamptonshire, Nottingham and Nottinghamshire, Gloucestershire and Birmingham and Solihull.

Across 10 decision conferences, we have engaged more than 100 stakeholders directly, including patients, ICS employees, clinicians from primary, secondary and community care, public health professionals, tobacco control leads and more.

On top of this more than 500 patients responded to a patient preference survey, the results of which have been used to inform decision making in the ICSs.

By using the Socio-technical Allocation of Resource (STAR) method, an approach to priority setting using the principle of allocative efficiency, we’ve helped these partners discover new areas for potential focus and maximum impact from their budgets to make a difference to the lives of thousands of COPD patients across their areas. The next step will be for the ICSs and Places to adopt these insights into their COPD pathways.

Partner feedback

Following our collaborative SSPH decision conferences we invited feedback from attendees, who gave their perspectives on the programme and its delivery.

“…I think it was a really helpful discussion and helped to set the scene on how we make plans for next year […]. I think this will be widely celebrated and taken on across the system…”

Komal Goriana, Senior Commissioning Manger, Northamptonshire Integrated Care Board

“I feel the work that we did will make a difference and provide an improved updated COPD pathway with better outcomes and an improvement in quality of life for patients and more importantly lead to a reduction in COPD in the years to come. It may even lead to a very different way of working…”

Patient representative, Asthma and Lung UK

Acting on Insights

Following the programme analysis the SSPH team have collaborated with the partner ICSs and Places to create actionable insights, helping them to focus on the areas for biggest impact on the COPD pathway.

There were some common themes across all five of the ICSs in terms of their priority areas where interventions will save money and generate population health. These included maximising capacity in the virtual ward, implementing a case finding strategy (risk-based screening) to find undiagnosed COPD cases, initiating group consultations and improving patient education. Our analysis showed that all improvements will generate population health whilst either being cost neutral or cost saving.

Health Economics Unit Director Andi Orlowski said: “Too often healthcare analytics can take place behind closed doors, with stakeholders simply informed of the results and what they should do next.

“By bringing stakeholders together in one room and doing the analysis live, we make it easy for them to feed into and understand the results of the STAR approach.

“We have created an environment in which not only can we use the analysis to find helpful insights, we can start to build a plan together as to how to action them.”

For all the latest news and updates from SSPH, check out our programme portal, or get in touch with us directly with any questions or enquiries.

 

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Using allocative efficiency techniques and population health analytics to improve value and deliver the best care possible

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