Impact
The Value Management Collaborative launched in November 2019 and ended in October 2022. The majority of the Collaborative was delivered in the context of COVID-19 and the programme was temporarily hibernated from March 2020 to September 2020. However despite this and the significant pressures COVID19 continued to place on services, engagement remained high and progress was promising.
Unfortunately, the early cessation of the funding meant the collaborative ended 18 months earlier than planned (Oct 22 rather than the planned March 24). This, combined with the context of COVID-19, significantly impacted on the ability of the programme to achieve its initial aim. However, it has still delivered a range of results which highlight the potential of this approach going forward to deliver improvements in quality alongside reductions in costs.
Capacity and capability
Value Management enables the learning and embedding of quality improvement skills with clinical staff in a way we haven't achieved before." – Service Manager
I think really what we were trying to get to was just developing that capability and capacity to do quality improvement. And I think it is delivering on that… I wanted to get a staff team that had a better grasp of quality improvement and [now] I've got that." - Service Manager
The capacity and capability programme was designed to increase Value Management coaches and team members’ knowledge, skills and confidence. This included using and teaching the Value Management approach, quality improvement, the use of data and Excel, and coaching and team building.
Coaches self-reported gains in knowledge, skills and confidence throughout the collaborative. Further quantitative information on how coach confidence changed throughout the collaborative is in included in the interim impact and learning report.
The capacity and capability programme provided a great opportunity for learning and helped build a network of Value Management improvers across Scotland. I believe that this programme has not just shaped my technical knowledge and skills but has fundamentally improved my leadership skills." - Improvement Coach
Career Development of Coaches
An unintended consequence of participating in the coaching and capability programme was the career progression of coaches within NHS Scotland. Ten of the coaches reported career progression following being part of the collaborative.
Figure 5: Value Management Coaches – Prior and Subsequent Roles
Quality and value improvements
A series of case studies have been produced to spotlight the work of teams involved in Value Management. These demonstrate the benefits delivered and experienced, and capture the learning generated in these contexts.
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To read the case studies for more information, click the links below. |
15% |
NHS Taysides Catering Team improved efficiency in the supply of milk at Ninewells Hospital, resulting in savings of 15% (£10,185) while ensuring that people received enough. They adopted a Value Management Approach to implement a standardised process for milk allocation and delivery across inpatient areas thus reducing waste. |
15% |
NHS Highland Easter Ross Community Mental Health Team reduced referrals returned to GPs from 31% to 15% to ensure patients get the right care, in the right place, more quickly and efficiently. They achieved this through engaging with local GP practices, optimising referral processes and providing appropriate signposting information. |
90% |
NHS Forth Valley Adult Mental Health (Admissions) improved staff Joy in Work and sustained over 90% responding staff feeling supported and feeling safe NHS Forth Valley and NHS Highland chose mental health services as a primary focus for spread of Value Management leading to positive outcomes including prompt care planning and risk assessment upon admission leading to reduced length of stay, and sustained improvements in staff experience |
£69k |
NHS Forth Valley’s Day Medicine Unit helped patients to receive care closer to home, and also reduced the cost of its provision by £69,720. NHS Forth Valley’s Day Medicine Unit provide day-time treatments to patients under the care of a variety of specialties. Their positive experiences with Value Management included switching administration of medicines to patients from in patient to community-based administration of some drugs. This reduced the need for patients to attend hospital, and improved the information given to GPs on discharge. |
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NHS Greater Glasgow and Clyde’s Philipshill Spinal Unit provides rehabilitation following spinal injuries, with patients staying for a considerable length of time (approximately 4-5 months on average). This team focused on Joy at Work during COVID-19 and reported a change in team culture to one of valuing and listening to all, and acting to improve staff and patient experience. |
In addition to the quality and value improvements noted, other public bodies, such as the Mental Welfare Commission have noted the difference that taking a Value Management Approach makes in staff wellbeing.
We saw first-hand the positive influence the introduction of value management has had for staff and indirectly for patients… We were impressed with the ongoing commitment to supporting a learning culture in the ward and [multidisciplinary team] and the commitment to clinical supervision." - Mental Welfare Commission for Scotland, Report on announced visit to Ward 3, Forth Valley Royal Hospital
How it differs from traditional quality improvement approaches: An example
Value Management encourages an extended multidisciplinary approach to quality management by including finance, data, and other non-clinical staff. Exploring capacity and cost alongside performance encourages a whole system lens to be taken.
For example, the work in NHS Forth Valley’s Day Medicine Unit required input from colleagues in finance, community pharmacy, acute and clinical care governance to redesign the pathway to reduce footfall in hospital during COVID-19 and provide care closer to home.
In addition, the board are now encouraging a teams-based approach to quality management across all of their acute sites, and are offering teams-based improvement education to teams.