#WeAHPs - Thursday 27th July 2017 8pm (GMT Standard Time) Evidencing the quality and productivity of AHPs' care

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Hosted by WeAHPs using #WeAHPs

This chat is guest hosted by @jkfillingham

On Thursday 27th July we'll be discussing how AHPs can and should measure and evidence the demand, capacity and quality of our services. 

Strategic context

Evidencing the quality & productivity of Allied Health Professions' (AHPs) care, is crucial in the current climate of changing need and demand, and financial austerity. The NHS Five Year Forward View outlines the challenges posed to health and healthcare, and makes recommendations to address these. ‘AHPs into Action’ demonstrates that the ambitions for future care models will require a more flexible workforce, one which is responsive to changing demand. 

If the aspirations of the Five Year Forward View are to be realised it is important that a more joined up approach is taken to developing and managing staffing establishments to ensure there is sufficient capacity and appropriate skill mix, including staff with the appropriate competencies, to deliver high quality care. Measuring capacity and capability to demonstrate safe, effective, sustainable care is required to ensure that services have the right number of staff, with the right skills, organised in the right way,within an affordable budget, delivering person-centered care.

NHS Improvement together with national partners are leading the national programme to develop and deliver NHS safe staffing improvement resources which will support and enable NHS providers with making safe and sustainable staffing decisions in specific care settings. National work streams have been established to develop safe staffing improvement resources for the following care settings: mental health, learning disability, community,maternity, acute inpatients, children’s services, urgent and emergency care.

NHS Improvement are also leading on the National Operational Productivity Programme which is the development and implementation of the recommendations from the Lord Carter's review of efficiency in hospitals which show large savings can be made by the NHS. Operational productivity and performance in English NHS acute hospitals: unwarranted variations (2016) has insisted that a single reporting framework must be introduced to the NHS that pulls together the clinical quality and resource performance data and compares it to the ‘best in class’. Take a look at #WeAHPs tweet chat in August 2016 for further information and the result of the discussion here.

Ensuring services continually deliver high quality and productivity, whilst delivering on the expectation of the people we serve, is complex. And, for AHPs, there is sparse resource of tools and consistent data sets to support this process. Schoo et al (2008) carried out an extensive literature review to identify workload capacity measures and methods for profiling allied health workforce requirements.The review identified five different methods for calculating workload capacity or/and workforce requirements. However, it was noted that there was surprisingly significant variation in calculated workload outcome across the five methodological categories, and little empirical evidence to suggest which of the different outcomes are the most accurate.

Our discussion

This tweet chat will explore how currently the following is measured and evidenced, and how it should be measured and evidenced in the future:

  • Demand
  • Capacity
  • Cost
  • Impact

Agreement on a consistent approach for AHPs nationally is both paramount to build consistency of data and to enable benchmarking. 

  • How do AHPs currently measure demand?
  • How do AHPs currently measure capacity – workforce and workload?
  • How do AHPs currently measure cost? 
  • How do AHPs currently measure output/impact?
  • Should/could AHPs agree nationally a consistent data set to measure quality and productivity?
  • What tools/resources should be developed to support evidencing the quality and productivity of AHPs care?





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 #WeAHPs transcript

 
@WeAHPs
27 July 2017 20:01
Please don't forget to use the hashtag in all your tweets so we can hear what you have to say #WeAHPs
@HelenOwen3
27 July 2017 20:01
RT @WeAHPs: Only 15 mins until #WeAHPs tweet chat tonight. Demand Capacity Impact #AHPs Are you with us? Grab a cuppa and g…
@WeAHPs
27 July 2017 20:02
Please say hello and where you are tweeting from #WeAHPs
@JanetThomas47
27 July 2017 20:02
Dipping in and out of tonights chat from Edinburgh #WeAHPs
@AireRepRad
27 July 2017 20:02
Good evening fellow AHPs from a Radiographer in sunny West Yorkshire! #WeAHPs
@HindleLinda
27 July 2017 20:03
Hi, I'm here for a while at least #WeAHPs
@PaulChapman09
27 July 2017 20:05
Evening all from on this sunny evening #WeAHPs
@WeAHPs
27 July 2017 20:05
So, for the first question....... #WeAHPs
@NaomiMcVey
27 July 2017 20:05
@WeAHPs Hello from #Manchester #WeAHPs
@Katy_Lyne2
27 July 2017 20:08
Recently started measuring time and input using TUTs. Useful method to show demand and capacity #weahps
@HelenOwen3
27 July 2017 20:08
@WeAHPs Referral numbers, waiting lists, new patient to review numbers #weahps
@AireRepRad
27 July 2017 20:08
Q1: Number of referrals and from which referral sources. #WeAHPs
@jkfillingham
27 July 2017 20:10
From recent regional #AHPs events the most popular is number of referrals. But how do we determine the acuity of them? #WeAHPs
@DonnchaLanePT
27 July 2017 20:10
@WeAHPs Number of referrals, location/speciality of person referring, length of wait for routine/urgent appointments #WeAHPs
@LA_Charlesworth
27 July 2017 20:10
@WeAHPs We also record complexity of the treatment #weahps
@naomi_burden
27 July 2017 20:10
@WeAHPs Referrals overall then split into modalities, always with a trendline to see the building picture plus monthly figures. #weahps
@AireRepRad
27 July 2017 20:11
@WeAHPs Yes, number of referrals and from which referrers. #weAHPs
@HelenOwen3
27 July 2017 20:11
@RozzyCampbell @WeAHPs True, also triaging decisions and new patient slots #weahps
@156hill_hill
27 July 2017 20:11
By referrals to the service but difficult if IT and BI can't produce accurate real time reports #weahps
@HindleLinda
27 July 2017 20:11
There may be a greater 'demand' than we see at the door #weahps https://t.co/YAG0bfhqP3
@PaulChapman09
27 July 2017 20:11
@WeAHPs Paper, electronic systems mainly and with vary depending on acute and community service from my experience #WeAHPs
@wyliedpod
27 July 2017 20:11
@WeAHPs #AHPs #weahps current demand via referrals Future demand via future demographic e.g. Est.??diabetes =??podiatry demand 26% by 2025
@jkfillingham
27 July 2017 20:12
@LA_Charlesworth @WeAHPs How do you measure complexity? #WeAHPs
@NaomiMcVey
27 July 2017 20:13
@WeAHPs Need the be careful with waiting list lengths as indicator - DNAs can be significant factor #WeAHPs
@jkfillingham
27 July 2017 20:13
@wyliedpod @WeAHPs Is it the same demand that you are measuring? Can you compare them? #WeAHPs
@PaulChapman09
27 July 2017 20:13
@jkfillingham Will this be defined by what you say your do and treat? Service Spec? #WeAHPs
@wyliedpod
27 July 2017 20:13
@WeAHPs @weahps #weahps agree re 'false demand' but also opp to identify inappropriate referrals and provide data t… https://t.co/k2nY1Hum8t
@carolinef_90
27 July 2017 20:15
@WeAHPs Hello from Leeds #weahps
@HindleLinda
27 July 2017 20:16
I would say this but how much of our demand is preventable? #WeAHPs
@jkfillingham
27 July 2017 20:16
Does any service have an acuity/dependence tool? #WeAHPs
@fechter_k
27 July 2017 20:17
@NaomiMcVey @WeAHPs #weAHPs waiting lists also more representative of system design issues rather than demand.
@HelenOwen3
27 July 2017 20:17
@HindleLinda Is that then creating a demand for preventative allied health work? #weahps
@carolinef_90
27 July 2017 20:17
A1: I think this is something #AHPs need to do more of, difficult when working within MDT and separating demand and outcomes #weahps
@wyliedpod
27 July 2017 20:18
@jkfillingham @LA_Charlesworth @WeAHPs #weAHPs @weahps challenge to make sure that each tier is delivering at top o… https://t.co/zJwYCf3yU8
@WeAHPs
27 July 2017 20:18
Q2 How do #AHPs currently measure the capacity required to deliver – workforce & workload? #WeAHPs
@hoopge
27 July 2017 20:19
Hello from Cardiff #weAHPS
@wyliedpod
27 July 2017 20:20
@jkfillingham @WeAHPs #weahps Demand for Diabetic Foot Ulcer provision based on % prevalence which is pretty consta… https://t.co/Eycll8vXRs
@DrJulietHarvey
27 July 2017 20:20
RT @WeAHPs: Q2 How do #AHPs currently measure the capacity required to deliver – workforce & workload? #WeAHPs
@LA_Charlesworth
27 July 2017 20:20
RT @HindleLinda: I would say this but how much of our demand is preventable? #WeAHPs
@HindleLinda
27 July 2017 20:20
@HelenOwen3 Yes, however, it doesn't necessarily need to be directly delivered by AHPs #WeAHPs
@Katy_Lyne2
27 July 2017 20:21
@WeAHPs Just developing TUTs to show units of time and compare to treatments. Has been handy to show team capacity #weAHPs
@LeedsChatter
27 July 2017 20:21
RT @carolinef_90: @WeAHPs Hello from Leeds #weahps
@jkfillingham
27 July 2017 20:22
Q2 Capacity. WTE, Head count? Activity? Direct contact/non direct contact, other activities. #WeAHPs
@naomi_burden
27 July 2017 20:22
@WeAHPs This is very difficult because of lack of real-time data #weahps
@RozzyCampbell
27 July 2017 20:23
@Katy_Lyne2 @WeAHPs Sound interesting! Do you agree units of time for different treatments? #weAHPs
@PaulChapman09
27 July 2017 20:23
@WeAHPs In most cases service look at head count, banding and WTE #WeAHPs
@hoopge
27 July 2017 20:24
Job plans with clinical/supporting activities. Then work out avg Rx session from current stats.then use WTE to work out capacity. #WeAHPs
@jkfillingham
27 July 2017 20:24
@AnnaKEvans @TheAPCP Oh, this sounds interesting. So you have agreement on complexity and time for assessment and treatment? #WeAHPs
@JiveCardiff
27 July 2017 20:25
RT @hoopge: Hello from Cardiff #weAHPS
@Katy_Lyne2
27 July 2017 20:25
@RozzyCampbell @WeAHPs Appears to work well to demonstrate our capacity across teams. Have tried with acute and community #ahps #WeAHPs
@RozzyCampbell
27 July 2017 20:25
@PaulChapman09 @WeAHPs Difficult to discern the available clinical time from WTE alone though #weAHPs
@PaulChapman09
27 July 2017 20:25
@WeAHPs Try to factor in the usual equation A/L, S/L #WeAHPs
@LA_Charlesworth
27 July 2017 20:26
@WeAHPs 2/2 body and in departments to my knowledge shift patterns will alter to cover periods of very high activity #weahps
@jkfillingham
27 July 2017 20:26
How do #AHPs services determine competency and therefore banding to know what is required to meet the demand? #WeAHPs
@JoFallsPhysio
27 July 2017 20:27
@WeAHPs Hi from Solihull #WeAHPs
@JanetThomas47
27 July 2017 20:27
Whoops - #weahps At least i didnt default to #physiotalk! https://twitter.com/JanetThomas47/status/890654679239057408
@WeAHPs
27 July 2017 20:27
Q3 How do AHPs services currently measure and track the cost of their sevrices? #WeAHPs
@wyliedpod
27 July 2017 20:28
@aeahps #WeAHPs @nhsggcpodiatry service model & tier descriptors/resource allocation https://t.co/JDGWSTEemV
@RozzyCampbell
27 July 2017 20:28
@Katy_Lyne2 @WeAHPs Great! I could see from this that you could build expected therapy time for each pathway....#weAHPs
@Leigh_Porter1
27 July 2017 20:29
@WeAHPs And it's Hello from Aberdeen ???? #weAHPs
@naomi_burden
27 July 2017 20:29
@jkfillingham Competency is tricky but there is always a competency aligned to national occupational standard. Banding by responsibility etc #weahps
@PaulChapman09
27 July 2017 20:29
@jkfillingham Think this is an area #AHPs struggle. Agreeing competency is a big challenge for some professions, #RtP is a good example #WeAHPs
@naomi_burden
27 July 2017 20:30
@jkfillingham The level to meet capacity is based on activity type (complexity) or need for senior cover ?? #weahps
@LA_Charlesworth
27 July 2017 20:31
@jkfillingham We have workforce models- here is a short example from SoR #weahps https://t.co/VMMfy7yMTP
@naomi_burden
27 July 2017 20:31
#WeAHPs 140 characters is not enough! ??????
@DrJulietHarvey
27 July 2017 20:31
RT @WeAHPs: Q3 How do AHPs services currently measure and track the cost of their sevrices? #WeAHPs
@Katy_Lyne2
27 July 2017 20:31
@RozzyCampbell @WeAHPs Currently working through PT, OT and dietetics using this approach. Won't fit every patient but good way to get average times #weahps
@WeAHPs
27 July 2017 20:31
Such a great chat getting behind with the questions! Next one is another biggie! Q4 How do AHPs currently measure output/impact? #WeAHPs
@HelenOwen3
27 July 2017 20:32
RT @LA_Charlesworth: @jkfillingham We have workforce models- here is a short example from SoR #weahps https://t.co/VMMfy7yMTP
@PaulChapman09
27 July 2017 20:32
@WeAHPs @JoyceWilliams_ is the guru on this #WeAHPs
@NaomiMcVey
27 July 2017 20:32
@WeAHPs Just cost or cost & resource impact & cost effectiveness? #WeAHPs
@naomi_burden
27 July 2017 20:32
@LA_Charlesworth @jkfillingham So lucky, not the same in #diagnosticradiography or other #weAHPs
@RozzyCampbell
27 July 2017 20:32
@WeAHPs Does anyone look at the cost of their service in relation to the activity it delivers? #weAHPs
@WeAHPs
27 July 2017 20:32
RT @RozzyCampbell: @WeAHPs Does anyone look at the cost of their service in relation to the activity it delivers? #weAHPs
@JanetThomas47
27 July 2017 20:33
@WeAHPs In individuals or service level? #WeAHPs
@HelenOwen3
27 July 2017 20:34
RT @RozzyCampbell: @WeAHPs Does anyone look at the cost of their service in relation to the activity it delivers? #weAHPs
@LA_Charlesworth
27 July 2017 20:35
@naomi_burden @jkfillingham This is an out of date version but gives the idea, I'll source the new version after the chat #weahps
@wyliedpod
27 July 2017 20:36
@AnnaKEvans @WeAHPs #controversial #weahps prob is that imo only 20% of health need requires graduate wf. Currently 100% referrals triaged by graduate wf
@jkfillingham
27 July 2017 20:37
@JanetThomas47 @WeAHPs Both. You have highlighted one of the complexities of this agenda and one of the biggest challenges #WeAHPs
@HindleLinda
27 July 2017 20:37
Great new tool to measure public health impact http://bit.ly/2sUQIf5 @R_S_P_H @AHPs4PH #weahps https://twitter.com/WeAHPs/status/890656024108998657
@raybeaker_ray
27 July 2017 20:38
RT @jkfillingham: Does any service have an acuity/dependence tool? #WeAHPs
@JanetThomas47
27 July 2017 20:38
@WeAHPs Aggregated patient outcomes useful for us - presented at #WCPT2017 #WeAHPs https://t.co/WEgJ1vgsxx
@HindleLinda
27 July 2017 20:39
Absolutely Matt #weahps https://twitter.com/mattfitz1979/status/890656940631740416
@WeAHPs
27 July 2017 20:39
@DavidAmosSE11 You've picked up on a key point #benchmarking #variation #warranted or #unwarranted #weahps https://twitter.com/davidamosse11/status/890657300511203329
@youngphysio
27 July 2017 20:39
RT @jkfillingham: Does any service have an acuity/dependence tool? #WeAHPs
@HelenOwen3
27 July 2017 20:39
RT @HindleLinda: Great new tool to measure public health impact http://bit.ly/2sUQIf5 @R_S_P_H @AHPs4PH #weahps https://twitter.com/WeAHPs/status/890656024108998657
@PaulaOtter1
27 July 2017 20:39
RT @JanetThomas47: @WeAHPs Aggregated patient outcomes useful for us - presented at #WCPT2017 #WeAHPs https://t.co/WEgJ1vgsxx
@WeAHPs
27 July 2017 20:39
Q5 Should/could AHPs agree nationally a consistent data set to measure quality and productivity? #WeAHPs
@HelenOwen3
27 July 2017 20:40
RT @HindleLinda: Absolutely Matt #weahps https://twitter.com/mattfitz1979/status/890656940631740416
@WeAHPs
27 July 2017 20:40
RT @HindleLinda: Great new tool to measure public health impact http://bit.ly/2sUQIf5 @R_S_P_H @AHPs4PH #weahps https://twitter.com/WeAHPs/status/890656024108998657
@Katy_Lyne2
27 July 2017 20:40
@fechter_k @RozzyCampbell @WeAHPs Yep good advice and will keep in mind. Can see it won't suit every patient #weAHPs
@AliciaRidout
27 July 2017 20:40
RT @WeAHPs: Q5 Should/could AHPs agree nationally a consistent data set to measure quality and productivity? #WeAHPs
@JanetThomas47
27 July 2017 20:40
@WeAHPs You mean like Scotland is planning? :) https://www.isdscotland.org/Products-and-Services/Data-Definitions-and-References/Allied-Health-Professionals-National-Dataset/_docs/2016-12-14-AHPOMs-Phase-2-brief-v1.1.pdf #weahps
@RozzyCampbell
27 July 2017 20:41
@fechter_k @Katy_Lyne2 @WeAHPs I guess it is about understanding the headroom that needs to be added to any pathway average #weAHPs
@HindleLinda
27 July 2017 20:42
@WeAHPs This would be a good step forward for bench marking and measuring variation #weahps
@PaulChapman09
27 July 2017 20:43
@WeAHPs Yes should and Yes could but only if we define the product and we are measuring apples with apples #WeAHPs
@Katy_Lyne2
27 July 2017 20:43
@WeAHPs It would be really helpful. Profession specific or suitable for all #AHPs #weAHPs
@PaulChapman09
27 July 2017 20:43
RT @HindleLinda: @WeAHPs This would be a good step forward for bench marking and measuring variation #weahps
@DrJulietHarvey
27 July 2017 20:43
RT @JanetThomas47: @WeAHPs You mean like Scotland is planning? :) https://www.isdscotland.org/Products-and-Services/Data-Definitions-and-References/Allied-Health-Professionals-National-Dataset/_docs/2016-12-14-AHPOMs-Phase-2-brief-v1.1.pdf #weahps
@naomi_burden
27 July 2017 20:44
@WeAHPs Difficult across all the professions, there is nhs benchmarking for some specialities. #peerreview might be better for quality #weahps
@PaulChapman09
27 July 2017 20:44
RT @HindleLinda: Great new tool to measure public health impact http://bit.ly/2sUQIf5 @R_S_P_H @AHPs4PH #weahps https://twitter.com/WeAHPs/status/890656024108998657
@LA_Charlesworth
27 July 2017 20:44
RT @HindleLinda: Great new tool to measure public health impact http://bit.ly/2sUQIf5 @R_S_P_H @AHPs4PH #weahps https://twitter.com/WeAHPs/status/890656024108998657
@fechter_k
27 July 2017 20:44
@WeAHPs Yes! Look at the impact of GIRFT :) #weAHPs
@jkfillingham
27 July 2017 20:44
@PaulChapman09 @WeAHPs I think that's the biggest challenge with the diversity of professions and pathways #WeAHPs
@wyliedpod
27 July 2017 20:44
@WeAHPs #weAHPs @WeAHPs only if an apple in Glasgow is the same apple in Devon!!! Data CONSISTENCY more important.
@jkfillingham
27 July 2017 20:45
@PaulChapman09 @WeAHPs But it shouldn't be an obstacle! #WeAHPs
@LA_Charlesworth
27 July 2017 20:45
@WeAHPs This would be helpful but is likely to be challenging ?? #WeAHPs
@RozzyCampbell
27 July 2017 20:46
@WeAHPs It is essential! #WeAHPs
@RandomStrawMan
27 July 2017 20:46
Not only that, but wouldn't the surface of a few other things. The charter of rights and multiculturalism are alright though. #WeAHPs
@PaulChapman09
27 July 2017 20:47
@jkfillingham @WeAHPs Then is the answer not yes we should but the could is in the too difficult to do box #WeAHPs
@JanetThomas47
27 July 2017 20:47
@jkfillingham @PaulChapman09 @WeAHPs Yup - interesting discussions at the Scotland data set consultation #AHPOMS #weahps
@fechter_k
27 July 2017 20:47
@WeAHPs Find it interesting we talk about AHP data set but we don't talk about Dr's data set? Need context specific e.g. MSK #weAHPs
@rahrahrimmer
27 July 2017 20:48
@jicurryDSM @WeAHPs We're working on it! But it's the problem of if we choose 1 OM that represents acute dept as whole inc all specialities or not #WeAHPs
@PaulChapman09
27 July 2017 20:48
@jkfillingham @WeAHPs Is the pathway not the product? #WeAHPs
@RozzyCampbell
27 July 2017 20:48
@fechter_k @WeAHPs AHPs currently unrepresentative in the GIRFT dashboards precisely because we do not have the workforce data available :( #weAHPs
@jkfillingham
27 July 2017 20:49
@PaulChapman09 @WeAHPs Need to have a starting point & understanding that the development of one will be iterative. It might not be right first time #WeAHPs
@PaulChapman09
27 July 2017 20:49
@jkfillingham @WeAHPs Agree but we make it! #WeAHPs
@WeAHPs
27 July 2017 20:50
Q6 Are there any tools/resources that should be developed to support evidencing the quality & productivity of AHPs care? #WeAHPs
@Katy_Lyne2
27 July 2017 20:53
@WeAHPs Could a gold standard outcome measure be used? #weahps
@JanetThomas47
27 July 2017 20:53
@WeAHPs This is a work in progress for Scotland of course as well as the AILIP work #WeAHPs
@PaulChapman09
27 July 2017 20:53
@WeAHPs Have we not been their before? Develop a tool and not useit or make it mature enough Community Data Set! #WeAHPs
@jkfillingham
27 July 2017 20:53
Do any services use diary tools/time&motion? Procedure based methods were highlighted as most appropriate for #WeAHPs by Schoo et al 2008
@fechter_k
27 July 2017 20:54
#weAHPs https://twitter.com/fechter_k/status/890658500958867457
@LA_Charlesworth
27 July 2017 20:54
@jkfillingham Up to date example of workforce guidance from professional body #weahps https://t.co/JqKYF8FxKm
@JanetThomas47
27 July 2017 20:55
@jkfillingham Have done in past - Scotland wide 'national' day to measure AHP activity A few years ago now :) #WeAHPs
@jkfillingham
27 July 2017 20:55
@fechter_k We don't. But hopefully the model hospital will start to offer a lens in which we can start to ask these questions #WeAHPs
@PaulChapman09
27 July 2017 20:55
@jkfillingham Time&motion has benefits but needs to be performed by those with clinical background not outside agencies #Meridianscarsstillhealing #weAHPs
@chrismcclean80
27 July 2017 20:55
@WeAHPs Context specific more helpful than profession specific in many cases #weAHPs
@jkfillingham
27 July 2017 20:56
Nearly at the end of the chat... One for reflection.... What is the one action to take away from this tweet chat? #WeAHPs
@D_MARSDEN_OT
27 July 2017 20:56
RT @HindleLinda: Great new tool to measure public health impact http://bit.ly/2sUQIf5 @R_S_P_H @AHPs4PH #weahps https://twitter.com/WeAHPs/status/890656024108998657
@HindleLinda
27 July 2017 20:56
@wyliedpod @carolinef_90 If demand is rising we need to minimise the demand so that those we see are the people who most need us #weahps
@WeAHPs
27 July 2017 20:57
Nearly at the end of that chat... One for reflection..... What is the one action I have taken away from this tweet chat? #WeAHPs
@RozzyCampbell
27 July 2017 20:58
@jkfillingham @fechter_k The important part is understanding the variation.....it could be warranted! #weAHPs
@HindleLinda
27 July 2017 20:59
@wyliedpod @carolinef_90 not necessarily if the preventative action is early enough #weahps
@chrismcclean80
27 July 2017 20:59
@jicurryDSM @WeAHPs Agree, needs to be applicable cross systems/professions beyond AHPs #WeAHPs




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