Downloading PDF

Improving outcomes for vulnerable residents in Lancashire and South Cumbria

Improving outcomes for vulnerable residents in Lancashire and South Cumbria

Home » Case studies » Improving outcomes for vulnerable residents in Lancashire and South Cumbria

Our Business Intelligence team’s data-driven approach led to: improved care access, lowered acute service demand, and empowered patients, making a positive difference for vulnerable residents in Lancashire and South Cumbria.

Background

NHS Midlands and Lancashire was approached by Lancashire and South Cumbria Integrated Care Board to improve outcomes for the most vulnerable residents during the winter season. Sixty-eight per cent of the targeted cohort continued to experience unmet needs leading to inadequate support or referrals.

Action

To achieve the project’s goals, we used our established infrastructure, specialised skills, expertise, and vision to produce actionable insights. We focused on the prevalence of respiratory conditions in Central Lancashire by using health inequalities and population health management segmentation tools to create a target cohort. Responding to national direction, Core20PLUS5, the project team collaborated with service leads, analysed local data flows, and employed geographical views of data to benchmark across geographies. 

The Winter Respiratory High-Risk project aimed to reduce the demand for acute services and admissions and identify unmet needs and address them. To identify wider determinants, the Business Intelligence team used Acorn Geo-segmentation tools which helped improve access, experience, and outcomes for the targeted cohort, and led to disease and medication reviews, immunisation offers and social prescribing.

Impact

NHS ML established a dedicated help desk and provided training support for staff, ensuring data quality through data warehouse processes, and linking primary and secondary care data. The team was able to capture additional patient activities, such as flu vaccinations, and update patient records with a long-term condition diagnosis, enabling referrals to support services. 

The Winter Respiratory High-Risk Project identified that fifty-two per cent of the targeted cohort had multiple support needs, emphasising the importance of addressing unmet needs. We also shared best practices from other areas and applied lessons learned to refine the process, leading to an improved experience and better outcomes for the targeted cohort. The client was provided secure access to Information Governance compliant patient data, ensuring data protection and privacy. This initiative played an essential role in reducing the demand for secondary care and lowering morbidity rates, empowering patients to manage their health conditions more effectively.

Simultaneously, the average proficiency of individuals in managing their own health and well-being – measured through a Level 3 status – underwent a remarkable transformation. Starting from an initial low-end Level 2 status, which signifies individuals struggling to understand their role in healthcare, we successfully elevated their perception to an empowered Level 3 status. This designation signifies individuals who recognise their integral role in their care journey and possess the knowledge to proactively engage in self-care.

Feedback

“The NHS ML Business Intelligence Team were an integral part of our respiratory work. The team made time to work with us to fully understand the project requirements and desired outcomes. This allowed the team to make suggestions relating to selection of appropriate cohort criteria, to ensure the project targeted those most vulnerable and most at risk. One project requirement was to enable members of the Primary Care Network to generate patient cohort lists – The BI Team were able to streamline this process by creating pre-set filters and guidance documents, ensuring buy-in from the Primary Care Network.” 

Naomi Coldham,  NHS Lancashire & South Cumbria ​Integrated Care Board

For more information

For more information and to learn how we can help your organisation, please contact us.

View all

News and views

News

Blog: Takeaways from the NHS Providers Conference 2024

Clare Thomason, Director of Delivery, NHS ML This blog was written by Clare Thomason, Director of Delivery at…

News

Investigation and intervention proposal for ICBs

In addition to the work NHS England’s (NHSE’s) Intensive Support Teams are undertaking at both regional and national…

Blog News

A walk through of the Court of Protection Deprivation of Liberty process

Fergus Campbell, Clinical Lead, NHS ML In the final post of our blog mini-series on Court of Protection…

View all

How we can help health systems

Clinical redesign and provider collaboration

Redesigning how health and care works across England - placing people at the centre of their own health and care and utilising…

Learn more about Clinical redesign and provider collaboration
Clinical redesign and provider collaboration

Communications and engagement

Supporting ICSs with approaches to design and deliver effective communication, engagement and behavioural insights as a key enabler for system change and…

Learn more about Communications and engagement
Communications and engagement

Developing health systems

Acting as an independent and trusted partner within the system to facilitate working across stakeholders and integrate elements of the provider system…

Learn more about Developing health systems
Developing health systems

Digitally enabled transformation and IT

Digitising care and partnering with systems for the transformation of digitally enabled service delivery (and other supporting processes) across vision, planning and…

Learn more about Digitally enabled transformation and IT
Digitally enabled transformation and IT

Improving productivity and efficiency

We have a range of impactful solutions both across operational services and transformational programmes to support NHS systems to tackle some of…

Learn more about Improving productivity and efficiency
Improving productivity and efficiency

People solutions

Supporting systems to build a sustainable and integrated workforce, transforming systems, organisations and the workforce experience to improve resilience.

Learn more about People solutions
People solutions

Personalised healthcare commissioning services

Providing end-to-end funded care services, including patients as active partners in identifying their healthcare needs and then commissioning care to meet these.…

Learn more about Personalised healthcare commissioning services
Personalised healthcare commissioning services

PHM analytics and decision support

Applying intelligence-led understanding of the health of the population to support the redesign of care and improve patient and financial outcomes across…

Learn more about PHM analytics and decision support
PHM analytics and decision support

Place and primary care transformation

Supporting providers to work together at a place and neighbourhood level to manage common resources, integrate community teams, improve health and reduce…

Learn more about Place and primary care transformation
Place and primary care transformation
MLCSU