"By combining human ingenuity with data on a massive scale, it's possible to identify what's working well; where there are areas of inconsistency within and across ICSs; and where the greatest improvement opportunities lie."
is from an NHE article entitled 'data and benchmarking – how ICSs can transform the NHS back office' written by Sharon Warne, Head of Client Performance for NHS Shared Business Services. Whilst this piece is focused on the need to align back office processes and systems to provide core data to position the new Integrated Care Systems (ICS) Boards and Partnerships for success, the same principles can be applied to data related to the health and care estate.
Montagu Evans recently sponsored the Public Policy Project's (PPP) ICS Futures Roundtable Series and Webinar exploring the importance of the health and care estate as an enabler for integrated services delivery and transformation. The challenges surrounding access to comprehensive and robust estate data sets were abundantly clear, not only from our own experiences as advisors to the sector but also from the frustrations expressed by the delegates themselves.
Without a clear estate baseline, new approaches to health and care estate provision cannot be appraised and informed, and holistic decisions about what to retain and where to invest cannot be made. It really is as simple as that.
Data is key to the new ICSs being able to meet the healthcare needs across an area – coordinating services and planning the health and care estate in a way that improves population health and reduces inequalities.
The Warne piece also states, "With multiple different corporate systems across multiple health and care organisations comes a lack of integration and common standards. Even NHS organisations have different corporate systems. When you add in local authorities, Community Interest Companies and the voluntary sector, the lack of consistency becomes serious – even existential." Again, the same applies to the different approaches taken to capturing, analysing, and interpreting data related to the health and care estate.
NHS England and NHS Improvement (NHSEI) are, quite rightly, promoting consolidation and collaboration to improve processes to drive efficiency benefits. Guidance will be provided to ICSs to support their development of infrastructure plans to include future estate needs. However, without a robust understanding of the current estate and its long-term liability to the system, the strength of these plans will be questionable.
For years, we have worked with organisations and partnerships to develop firm estate baselines. In the absence of comprehensive partnership property databases, we quite often start from scratch building up a picture of the estate using different data sources, categorisations and quality. It can be an arduous exercise, but the benefits of creating a record of all land and buildings owned or occupied by the partners are invaluable.
A single account of the estate enables meaningful analysis of assets by the organisation, location (macro and micro), status, type, use, capacity, condition, cost, alternative use potential, value, and many other bespoke analytical measures. It allows full reporting back to partnerships and the identification of 'bottom-up' opportunities to align to the 'top-down' strategic need – both of which are fundamental to the formulation of place-based health and care strategies – which is the topic of our next thought piece coming soon.