Can Do Health & Care Thinking Differently - November 2020

Thinking Differently Together | 2 2. What more do we need to consider to embed PHM within our ICS? Learning from Dorset Dr Karen Kirkham, National Clinical Advisor System Development and Population Health Management NHS England and NHS improvement, and ICS Clinical Lead, Dorset Integrated Care System Karen explained that leading the National Population Health Management Programme in Dorset was pivotal to changing focus and direction and seeing significant change within the Dorset system. Karen has also been involved in the national development of Primary Care Networks, and embedding PHM in all that they do. Karen recognised that the PHM programme in Suffolk and North East Essex has been developed organically, taking a ground-up approach, which is a great foundation. It is crucial to now think ‘What next?’ Making PHM as a programme meaningful at system, place and person level PHM needs to be owned by everyone in the system, both in terms of healthcare and the wider determinants such as housing and education. A focus is also needed on inequality. Throughout the Covid-19 pandemic we have seen wider inequality but also fantastic social cohesion, people coming together at place level for people. Building a house of data Data is an essential element of PHM, so we need to use the data we have and build on it, layering on top the rich sources of data that are becoming increasingly available. It is important to own the content of that data together, recognising it as a single source of ‘the truth’, personalise our approach and make it applicable to all so that we can develop and use the insights to build an action plan for the system. In Dorset ICS, there was very little linked data, and with help, including from NHS England, it has managed to create a single combined data set that the whole system can access. The Dorset system built a Covid dashboard in response to the pandemic that is used by every sector. Dorset ICS has also invested in the people to help to drive the increased use cases within the data source as well as in the interpretations that support clinicians and managers. Speaker: Influencing change during the journey This involves using a common language, building on our individual and collective learning, and the powerful transfer of knowledge from teams who have completed the programme to the next cohort of teams. There should also be a focus on clinical leadership. Clinical Directors in Primary Care Networks and the teams around them need to embed PHM into everything they do, and develop partnerships with the voluntary and community sector around bio- psycho-social models in their communities. PHM should also be embedded in acute trust pathways, using data to build insights and identify the gaps and inequalities. It is also important to use PHM to understand the reality of the time we are in, the inequalities arising from Covid-19 that need a different approach. Crisis is both a danger and an opportunity, so we should look hard at where we focus our efforts, avoid duplication, identify the most important work and build on our priorities. Making Population Health Management mainstream By working smarter as a system and making increased use of the collaboration that PHM can bring, we can bring the best possible value to the entire system. What hits home is the value of data in putting a spotlight in inequalities, which can then be a catalyst for integration across our health and wellbeing system. What is Population Health Management? “An approach aimed at improving the health of an entire population. It is about improving the physical and mental health outcomes and wellbeing of people within and across a defined local, regional or national population, while reducing health inequalities. It includes action to reduce the occurrence of ill health, action to deliver appropriate health and care services and action on the wider determinants of health. It requires working with communities and partner agencies. How all these contributions connect and work together defines a population health system.” (The Kings Fund, 2018. To read the full report click here )