Supporting Clinical Strategy and Redesign

4th January 2023
Hayley Michell

Hayley Michell, Managing Consultant – Clinical Redesign Lead

How we are supporting Clinical Strategy and Redesign for Health and Care

What is Clinical Strategy and Redesign?

Clinical strategy & redesign relates to the transformation of services, utilising the perspectives of health and care professionals, patients and carers to consider the best ways to achieve quality care. This includes identifying delays, unnecessary steps, and potential for error so that we can then remove them and redesign the process to significantly improve quality of care. The development of a supporting strategy promotes the positive changes that have already been made, building upon these to make our healthcare system more sustainable for the future.

How can we support?

We use our full range of skills and experience to deliver clinical redesign:​

  • We are skilled at working with health and care professionals; engaging them through a variety of techniques, ranging from smaller working groups to larger workshops. Clinical standards and service co-dependencies are also used to underpin the improvement process​.
  • Our team are trained in mainstream programme and project management techniques​, such as MSP® (Managing Successful Programmes) and PRINCE2®. We are experienced in working with senior stakeholders from across all sectors and supporting clients to foster those relationships​.
  • We have in-house economic and financial expertise to facilitate options appraisals alongside a wealth of experience in producing the full range of high-quality business cases ​including HM Treasury Green Book compliant business cases for enabling investment.
  • We have in-house workforce expertise to support workforce analysis and planning to ensure clients have the capabilities required to deliver new models of care.​
  • To inform the design we develop deep understanding of the population or patient needs through analysis of healthcare datasets. ​
  • We involve patients and the public throughout the process.

Our Experience

Clinical redesign can range in scale from single specialty or provider service redesign to whole system transformation across multiple specialties and sectors.

We support end-to-end clinical pathway redesign that enables integrated care delivery and embeds digital innovation to provide a user-centric approach.

Our robust, standardised redesign methodology can be scaled according to programme needs and ensures that the process is evidence-led, transparent and driven by local health and care professionals. Our team are trained and highly skilled in deploying this methodology.

Our approach has been proven to stand up to scrutiny and satisfy NHS England assurance for more significant change proposals.

Examples of how we have applied this support across a range of programmes include:

  • Cheshire & Merseyside Gynaecological Cancer Services ReviewCheshire & Merseyside Cancer Alliance commissioned the NHS Transformation Unit to undertake an end-to-end pathway review across all gynaecological cancer services. The aims were to help providers achieve challenging cancer standards, and to support delivery of the NHS Long-Term Plan including the Faster Diagnosis Programme (FDP) by 2024.
    More than 100 stakeholders participated via visits to cancer, diagnostic and tertiary units, 1:1 meetings, surveys and workshops across 15 organisations. This culminated in a full day event where findings were shared for feedback/approval, before the report was finalised and recommendations shared. This review initiated a large-scale transformation programme across all gynaecological cancer services.
  • Lancashire & South Cumbria ICS (Acute and Specialised)In early 2020, the Lancashire and South Cumbria (L&SC) Integrated Care System (ICS) reviewed its governance arrangements and committed to enhanced work between providers. The NHS Transformation Unit were asked to support trusts across L&SC to develop new arrangements for collaboration and support collective decision making between organisations, through creation of the Provider Collaboration Board (PCB). Whilst operating in shadow ICS form, we also supported L&SC to produce a 10-year L&SC Health & Care Partnership Clinical Strategy.  We continue to implement the strategy, working specifically on priority programmes of work including dermatology, ophthalmology, clinical haematology, trauma, orthopaedics (T&O), musculoskeletal (MSK) network, stroke, urology and mental health.
  • Manchester University NHS Foundation Trust Rapid Diagnostic CentreThe purpose of the Rapid Diagnostic Centre (RDC) programme (led by NHS England) is to increase the proportion of patients diagnosed with cancer at an earlier stage of disease by providing streamlined and personalised diagnostic pathways, improving outcomes and survival rates.  We worked closely with clinical teams to redesign diagnostic pathways that embed the RDC principles. We then supported the approval of these new pathways through appropriate Trust governance and then via the regional Cancer Alliance Board. Following approval, we then provided support for implementation of the new pathways including for recruitment to new team and roles, procurement of CT and development and agreement of same-day reporting and governance arrangements.This programme of work saw the successful and timely implementation of the non-site specific (NSS) pathways with clinics at Wythenshawe, North Manchester and at Withington. Within 3 months 200+ patients were seen by NSS service with a cancer diagnosis rate of 8%. The programme also saw pathway redesign on multiple Two Week Wait pathways; Gynaecology cancer, Oesophago-gastric cancer, Hepato-Pancreato-Biliary cancer, Head and Neck cancer, Haematology and Sarcoma Cancer. This resulted in three new pathways going live (OG, Gynae & Haematology) across three sites.

How we can help you

If you have a transformation programme and you’d like to discuss how we can help, please get in contact. As part of Midlands & Lancashire Commissioning Support Unit we have access to great range of expertise whether that be strategic planning, business cases, clinical redesign or complex programme management.