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Posted on Jun 26 2018 by Bobbie Kelly

An article detailing the implementation of value-based healthcare at St Andrew’s Healthcare has been published in the British Journal of Hospital Medicine, in collaboration with Dr Mahek Shah at Harvard Business School.

Part of a symposium entitled: “Value-based healthcare: the strategy that will solve the NHS?”, the article details how St Andrew’s is the only mental health provider to have adopted value-based healthcare holistically, across the whole organisation. This means that across the charity we focus on achieving the very best patient outcomes for every unit of currency spent on patient care.

The value-based healthcare model, based on the work of several international pioneers such as Sir Muir Gray in Oxford, Professor Michael Porter at Harvard Business School, and Professor Elizabeth Teisberg at Dell Medical School in Texas, has been gaining prominence in recent years. Globally, several healthcare organisations have begun to adopt its philosophy, and handful of mental health organisations are beginning to make strides towards it.

At St Andrew’s we constantly measure outcomes to ensure we are helping the people in our care to lead a meaningful life, with – where possible – discharge from hospital as soon as they are ready. We are now starting to manage and review what the provision of those outcomes costs – so we are able to work out whether we are spending our income on things that give the best value to our patients.

To deliver ongoing improvements, over the last year we have restructured our entire organisation into Integrated Practice Units (IPUs) – these are clusters of wards that care for patients with similar conditions and inter-related needs. It’s an evolution of our previous structure which was based around six ‘pathways’. The IPU structure is allowing us to empower our clinical teams to become even more specialised and outcome led, with each managing their own staffing requirements, budgets and the support they offer to patients. We also consulted with 120 patients, carers and clinicians to develop a co-produced outcomes framework, with 28 patient-centred outcomes around physical health, mental health and personalisation.  

Dr Paul Wallang, Outcomes Lead at St Andrew’s Healthcare and Honorary Senior Research Associate at University College London (UCL), explained: “Moving to a value-based model means that we focus on the most meaningful outcomes for our patients. It allows us to take a holistic patient view and make improvements in their overall quality of life. The value based model emphasises the value of care rather than volume and outputs of care rather than inputs, which is a significant and essential paradigm shift to deliver high quality care at an affordable cost.”

To read the British Journal of Hospital Medicine article, click here. If you have any questions regarding our transformation, contact Dr P Wallang.