Road to Recovery (Fourth Edition)

Journey towards financial sustainability for integrated care systems

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In our previous Road to Recovery publication, published in 2019, we covered how both healthcare providers and commissioners could design, develop, and deliver a sustained financial and operational improvement.

At the time of publication, the NHS Long Term Plan had recently been published, and the drive towards further integration was set to continue with a renewed focus on the ‘triple aim’. This framework had NHS systems, providers, and commissioners prioritise:

  • The health and well-being of their population;
  • The quality of services provided to individuals; and
  • Efficiency and sustainability in relation to the use of resources.

Then, COVID-19 emerged, much of the world went into lockdown, and the health and care system found itself in the most challenging position.

In this publication, ‘Journey towards financial sustainability for integrated care systems’, we detail how the COVID-19 pandemic exacerbated existing challenges (ageing populations with greater demands for health and care services, workforce shortages, financial pressures, etc.) with new ones (staff sickness, burnout, growing waiting lists, and supply shortages).

Addressing this ever-growing list of compounding challenges is a key focus of health and care systems but this can only be achieved together. New and emerging frameworks for partnership working seek to align the health and care sector towards addressing mutual pressures and, underpinned by a future new legislative regime, should provide revitalised focus.

In this report, we tackle an issue we know many systems across the country are facing; how can you balance operational recovery with financial sustainability given the extensive pressures, whilst also capitalising on new opportunities and different ways of working.

We outline the key success factors which we believe are pivotal in working together to begin the journey of recovery as a system.

These include:

  • Understanding the size and key drivers of the challenge - ensuring a system-recognised starting point and alignment on the drivers;
  • Building a financial sustainability programme - developing the appropriate architecture and governance to generate, develop and deliver transformational schemes;
  • Critical enablers - providing teams support needed to progress the programme - ensuring the workforce, data and insights, estate, procurement & supply chain, and engagement support is mobilised; and
  • Leadership and governance - instilling important values and behaviours, including accountability, being driven by data, and working towards shared outcomes.

We ask what the key questions systems should be asking themselves in order to plan for this journey; outlining why these questions are important, and providing some tangible steps systems can take in order to further progress these areas. These actions to consider are aligned to the key success factors, and include:

  • Understanding the size and key drivers of the challenge - actions include undertaking a system financial & supply baseline and drivers of deficit exercise. These would all support preliminary analysis into the areas of opportunity
  • Building a financial sustainability programme - actions include implementing a system Programme Management Office (PMO) to oversee delivery and drive system-wide reporting and assurance. This would provide the necessary architecture to drive a programme of this scale
  • Critical enablers - actions include data sharing agreements, agile data analytics, and alignment in workstream support from corporate colleagues
  • Leadership and governance - actions include centralised communications, channels for addressing risks, and appropriate integration with organisational governance.

And we provide an indicative timeline, covering the short, medium, and long term periods which should aid systems in determining where they are, and where they need to go next.

Fundamentally, this journey will be challenging and will take both trust, transparency, and time to develop. All partners from across the health and care sector must come together and work together in order to achieve the bold ambition of balancing operational recovery with financial sustainability, whilst ensuring high-quality, patient-focussed services is maintained as a top priority.
 

Contact us

David Morris

David Morris

Midlands Regional Market Lead, PwC United Kingdom

Tel: +44 (0)7841 784180

Jacqui Dudley

Jacqui Dudley

Director, Value Creation & Realisation, PwC United Kingdom

Tel: +44 (0)7841 570653

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