Salford Royal NHS Foundation Trust

New insights at Salford

Salford Royal NHS Foundation Trust, with a team of 6000 staff, is an integrated provider of hospital, community and primary care services, including the University Teaching Hospital.

 

Management and staff at Salford Royal are passionate about quality and patient safety and have recognised the need for greater transparency of what is really driving performance and costs across the Trust. To obtain more reliable and credible management information that could provide a better understanding of both the income and cost of patients' treatments, Salford Royal chose the Prodacapo software and appointed Bellis-Jones Hill, Prodacapo's partner in UK, to support their implementation of Service Line Reporting and Patient Level Costing.

 

"The information has helped enormously to inform our discussions across a range of issues as we know which areas are profitable or not and, most importantly, we can start to explain why", says Stephen Kennedy, Deputy Director of Finance, Salford Royal.

Performance and Profitability insights

"The trust is on a journey to be the best hospital and to ensure it provides quality and safe services at the most efficient cost. The use of Service Line Reporting is seen as a vital part of the delivery of that agenda", says Stephen Kennedy, Deputy Director of Finance, Salford.

 

The activity based costing solution of Prodacapo produces information for both management and clinicians to help obtain real insight into performance and profitability and provides an objective basis for identifying opportunities for improvement. It allows Salford Royal to deep-dive into its own performance and provides patient episode level costs that help better understand the factors that influence patient outcomes, performance and profitability to speciality, consultants and point of delivery.  

 

Credible financial management information

"The ability of NHS Trusts to produce enhanced and genuinely credible financial management information at patient episode level has now become a reality and is essential if clinicians and managers are to work closely together in developing their Trusts' successfully", says the Head of Bellis-Jones Hill's Healthcare Solution Practice, Robin Bellis-Jones.

 

 

Performance Measurement

The implementation also included the Prodacapo scorecard that measures performance against targets and plans across the Trust and at all levels from Board level down to ward level.

 

Tony Whitfield comments; "As a key part of our overall quality strategy, we now have a comprehensive system that provides the degree of information accuracy required for our management team and clinicians to take important strategic and operational decisions with real confidence". 

 

Powerful Management Information

"It's an extremely powerful management information and reporting tool and while the results have confirmed some of our existing views, it has also given us some interesting insights. The system has given us the ability to explain those insights and has provided us with the information that has enabled us to benefit from them", says Thony Whitfield.

 

"We chose Prodacapo system because it makes it easy to communicate complex information."

Tony Whitfield, Finance Director and Deputy Chief Executive.

 

 

“Prodacapo is an extremely powerful management information and reporting tool and while the results have confirmed some our existing views, it has also given us some interesting insights."

Tony Whitfield
Finance Director and Deputy Chief Executive,
Salford Royal NHS Foundation Trust

More accurate patient data 

More accurate and more comprehensive patient data is now available to clincians and managers who are engaged in the further development and use of the Prodacapo solution. This encourage more objective analysis, dialogue and debate about the provision of service and the management of the Trust and its individual specialities.

 

Keys to successful performance

For example, good theatre utilisation is one of the keys to successful performance in any Trust. In this instance, Service Line Reporting and Patient Level Costing information highlighted the need to look at the theatre utilisation much more holistically and to recognise the complexity inherent in good theatre performance.

 

Similarly, the cost of radiology scans was previously heavily influenced by Korner weightings that were used in the previous approach to Reference Costing. The same weighting had therefore been used to underpin the early development of Service Line Reporting and Patient Level Costing at Salford Royal.

 

However, the resulting costs of radiology scans seemed to be counter-initiative. Certain scans seemed to be very expensive, while complex scans for in-patients seemed relatively inexpensive. This could have posed a problem to the Trust if the charging for radiology scans was based on such data. However closer examination by clinicians and managers together quickly highlighted the fact that Korner weightings are now insufficient to reflect what is really driving the cost of patient scans and a more sophisticated approach was required.

 

The result is that the simple scans are now charged at a much lower price to reflect the lower work content and more complex scans, often for in-patients, are charged at a higher price so that the real financial cost of providing treatments is reflected more accurately.

 

This is just a small illustration of how Prodacapo can be used to drive a deeper understanding of performance and financial management. 

Improved cost control

The Service Line Reports are updated quarterly to coincide with Board reporting and there are sixty clinicians and managers across the Trust with direct access to this information for analysis and decision making.

 

"Being in more control of our cost information has enabled the Trust to become more commercially aware and has contributed to the improved quality of our business cases", says Stephen Kennedy and continues:

 

"We know which areas are profitable or not, and we can start to explain why. It also helps to set our prices when tendering for new work, ensuring that we remain competetive."

 

With clinicians also able to interrogate information that hasn't always been easily accessible, they are now better able to work with managers to identify problem areas and work together to rectify them.

 

Continued improvement

The managers now understand where cost improvements can be achieved but the Trust doesn't stop trying to identify areas where improvements in performance might take place, for example utilisation rates and patient throughput, waiting list clearance, harm reduction and helping to understand the costs when redesigning new patient care pathways.

 

The trust recognises that if it can continue to focus on doing things "right first time" on a consistent basis across the Trust and with a strong patient care focus, then it can continue to deliver excellence in "Quality of Service" and "Use of Resources" (ratings by Healthcare Commission). It also recognises the critical role of Service Line Reporting and Patient Level Costing in managing these elements on an integrated basis and in facilitating real clinical engagement.

What our customers say

"Implementing Prodacapo was a strategic decision we made to respond to the new market conditions for the healthcare sector in the Netherlands."

 

"At the early phase of the project, some of the departments were quite hesitant in participating, but as soon as we were able to present the first results of our project the doubtfulness was replaced by enthusiasm."

Niek Bossché & Paul Steinbush
Erasmus Medical Centre, The Netherlands

 

 

"Prodacapo provides us with great information and more precise patient costing data."

 

"It's also very important for us to compare and analyze on different levels and in between different departments. Prodacapo gives us better management information of for example resource consumption per patient treatment."

Reidun Martine Rømo

Ekonomichef, Helse Midt-Norge

”Using Prodacapo's TDABC methodology (Time Driven ABC) means we have got a an easy-to-use costing tool, a costing model that is easy to understand and a unified method to track the patient level costs.”

Roland Ylander
Head of patient level costing, County council of Jämtland, Sweden

Erasmus MC
Helse Midt Norge
Jämtlands läns landsting