Getting the right people, to the right place – at the right time
Capacity and Flow is a Provider Digitisation Programme within the Integrated Care System (ICS). It is about using digital technology to manage how people move through and between services across our sites. Our vision is to be a flexible and efficient system that uses digital infrastructure to get the right people, to the right place, at the right time, to meet the needs of people across Nottingham and Nottinghamshire.
The Capacity and Flow programme is governed by an established programme board with representatives from partner operational, technical and transformation functions across the ICS. The board approves funding requests and offers support to scope or unblock any challenges – leaving capacity for overall delivery of this programme.
The Capacity and Flow programme is governed by an established programme board with representatives from partner operational, technical and transformation functions across the Integrated Care System. The board approves funding requests and offers support to scope or unblock challenges, leaving capacity for overall delivery of this programme.
The Capacity and Flow Roadmap
Programme Initiation
System-wide workshop to take stock and identify opportunities
Launched several tactical projects for winter
Long-term priorities agreed
Operational vision defined
Focus on improved flow management and richer data
Sharing ICS data in new ways
Using techonology to streamline handovers across boundaries
Maximising system-wide benefits across our investments
Digital technology is used to enable integrated working throughout our ICS. Our projects help partners to identify where investment in digital solutions will most benefit their ability to manage capacity and flow. This could be a digitisation project to move partners away from paper and spreadsheets onto more efficient and accessible systems or tools, or a project to access information in one system and share it with others as required, to help improve and automate the sharing of key data items between system partners. Some examples of our work are shown below:
Our two largest acute hospital; Sherwood Forest and Nottingham University Hospitals, have used this project to collaboratively align processes and terminology, particularly around discharge management.
The project has supported Sherwood Forest to implement a ‘live flow’ view in the Nerve Centre, using the successful and well established Nottingham University Hospitals’ model.
This went live in November 2020 and allows those colleagues working on supported discharge to seamlessly receive ward referrals, manage a complex and dynamic workload, and have a clear oversight of which patients to prioritise at any given time.
The ICS has also benefited by the use of consistent technology, terminology and key performance indicators (KPIs) across the two trusts.
Before we had live flow we were very reactive, which was stressful for staff and made the team’s work hard to manage. Now, we’re able to plan proactively and monitor incoming work throughout the day. We can go straight to the patient record from the overview screen and immediately view information from all over the hospital. It’s better for the team and better for our patients.
This project supports all the ICS bedded capacity (acute and community) to achieve at least a basic level of visibility of real-time patient level occupancy and data regarding ‘who is waiting’. This data will primarily drive internal flow but will also be accessible externally for the system-wide objectives of the Capacity and Flow programme.
In May 2021, Nottinghamshire Healthcare Trust delivered a complete digitisation project at Lings Bar Community Hospital, moving teams off paper and into a comprehensive patient and flow management ICT system. This saves time for staff and improves patient experience by reducing waiting and clearly indicating to our ward staff where action is needed to ensure a safe and timely discharge.
For every new admission, we are saving over an hour on administration and staff movement around the hospital.
This priority encompasses a series of ongoing projects to build on exemplary interoperability work completed by Nottinghamshire County Council to automate social care referrals from partner acute and mental health services.
We are currently supporting a project to deliver interoperable discharge referrals and updates from Nottingham University Hospitals to Nottingham City Council, to reduce manual information gathering and the risk of miscommunication. We plan to replicate this approach for our community health partners, so that all hospital discharge referrals within the ICS are sent, received, and updated, automatically without double keying.
Managing and planning these projects collectively facilitates shared learning and standardisation across the ICS, and also gives colleagues working on similar projects for different organisations a useful forum for collaboration and peer support.
This project is an operationally-led initiative to create a meaningful view of those metrics which reflect both capacity and flow for all our key urgent and emergency care and discharge services, at any given moment. It will create a system-wide view which reduces operational barriers and improves transparency and ease of collaboration.
To ensure we deliver the right product for the operational and tactical teams managing resilience and flow across the ICS, we are conducting an extensive business analysis exercise with multiple stakeholders within each partner service, to ensure we deliver a tool that is relevant, future-proof, and supports the ICS to manage patient movement and safety as one integrated system.
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Digital Notts
Nottingham and Nottinghamshire ICS Digital Programme
King’s Mill Hospital
Mansfield Road
Sutton-in-Ashfield
NG17 4JL
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