Providing patients with greater choice through enabling them to choose ‘Any Qualified Provider’ (AQP) has been at the heart of the government’s reforms and vision for the NHS. The concept means that a wide range of new providers can compete in this new market outside of acute and elective care.
Pam Lewis, Information and Regulatory Lead at CancerCare argues that charities have an important and unique role in providing patients with increased choice and an improved quality of service but they can’t do it alone.
While maintaining our charity status, becoming a serious and competitive player in the NHS world is a huge step for our charity CancerCare, which supports more than 1,500 people a year who have been affected by cancer. Not only does the NHS speak a completely different language to us but also the bureaucracy is something completely new to the way we operate. However, we see our move as an extremely valuable one and numerous discussions with local GPs have demonstrated that being able to share information will enable us to work alongside them to remove some of the burden and help provide the correct emotional support to those who have been diagnosed with cancer, which many GPs say they are struggling to do.
Compliant, competent, qualified
When we started our journey to becoming an AQP, we knew it was critical to be seen as ‘fit for purpose’ from both a financial and regulatory standpoint. Like others going through this process, it has been vital that we demonstrate that we are Choose and Book compliant (or the successor system), can meet contractual requirements relating to datasets, securely store patient information using the NHS data centre and share information via N3. It goes without saying that we also need to show that we are fully qualified to provide the care that is right for our patient.
Our vision of becoming an AQP was really part of a bigger opportunity to modernise the way we work. In order to do this we had to start with the very basics and get a system in place that could support our workflows. We realised very quickly that our out-dated IT system was far from up to the job and there was no way that it could underpin our organisation if we wanted to go through this change. The big challenge implementing a new system was that we had an IT-shy workforce, no project manager and of course, limited resources and therefore questioned whether becoming an AQP could really be achieved.
Implementing a completely new IT system to streamline and eliminate paper processes meant huge cultural, behavioural and attitudinal changes but we ensured that this was viewed as a benefit to the staff and our patients rather than as a complex technology project. Rather than dragging staff kicking and screaming, they were involved from the outset and took ownership of the new system.
A helping hand
We looked into ways that we could fund a new system but unlike acute trusts who are receiving funding towards IT, there is virtually nothing available for smaller charities like CancerCare. Fortunately, a supplier who provided patient information systems to the NHS and who had close personal links with CancerCare was able to help with our ambition. Shane Tickell, the CEO of IMS MAXIMS, whose’ father had been a CancerCare patient saw the potential for CancerCare to provide our services to a wider cohort of patients. Of course, we had to do an options appraisal with the staff, but without them even knowing that the system would be given on a complimentary basis, they were impressed that it could be configured to the exact way that we wanted to use it, which was particularly important for those who didn’t have a technical background.
Eight months from appraisal to go-live and we didn’t even need onsite support when the system went into action. Since then we have only needed to make one service call and any minor issues have been resolved straight away.
Becoming ‘fit for purpose’
The system is already enabling us to increase the quality of care by allowing end users to focus on more direct patient care. Managers and therapists alike are increasing their productivity by being able to access and find information at the touch of a button. In seeking to be commissioned by our two local CCGs, we have needed to get on top of our reporting requirements and minimum data sets, which has been a big ask but would have been completely impossible before. Being able to extract so much information from our system means that senior management can report on Patient Reported Outcome Measures as well as Patient Reported Experience Measures. In just a few months time, we’ll be able to access other NHS services, referrals and use NHSmail.
Thanks to the infrastructure we have in place, we are now confident in our conversations with commissioners and are being upfront and saying ‘send that work to us because we can provide the service you need.’ Our ultimate goal is to become an AQP by the end of 2013 and in doing that, start to expand our services to support other long-term conditions.
What does it mean for other charities?
Charities that are able to show they are willing and able to take patients should be considered an obvious option to eliminate the strain on traditional NHS care providers, however, there is both fear and ignorance about how big the challenge is for charities to become AQPs.
Although there are still many challenges that we must now take on ourselves, such as information governance, the learning curve is all part of growing and changing as an organisation. The reality is that these changes would be immensely difficult without the tailored, flexible, IT system that was provided free of charge. If other charities want to achieve the same ambition, they are likely to have to rely on extensive funding and donations, which will be a challenge for most third sector or small organisations. The Department of Health needs to recognise that the third sector provides an untapped resource for patients and assist them financially enabling them to do that.