What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?

A fragmented system
The entire support system for citizens is highly fragmented and often behave in silos which creates additional barriers for residents to seek and receive all the support they need.  Our work with Public Health England supports evidence that clients who are unable to access holistic support in the community are more likely to go into crisis requiring long term specialist NHS support e.g. keeping warm at home to prevent COPD patients from deteriorating in winter

‘No wrong door’ approach

1. Empower citizens – Enabling citizens to include additional personal information on the NHSApp to share relevant and critical information about their social issues with community organisations
2. Digital referral platform – An end-to-end citizens referral platform that helps community organisations to manage citizen referral(s) across the local network of support.  This will enable citizens to access the full suite of support regardless of the organisation they begin their journey with.

What does your project aim to achieve?

Aims: To provide the Hastings and Rother community the opportunity to improve lives sustainably, in particular the most vulnerable in our society, during this challenging cost of living, health and public services crisis.

Beneficiaries:

1. Residents

• No wrong door access for help (early evidence of direct impact on reducing inequalities e.g. access for those currently digitally excluded)
• Social needs captured once (helps reduce anxiety and build confidence)
• Ability to track personal progress (for sustained behavioural change)

2.  Service Providers

• Referral management / Active Feedback (prevent missed opportunities to intervene before crisis)
• Optimise use of system resource to reduce wait times (better use of the NHSApp, existing warm home service, debt and money advice services)
• Ability to co-ordinate service user needs across organisations (prevent crisis presentations)

3. Research and Public Sector Bodies

• Drive effective social needs provision in the community
• Assess impact of unmet needs on public services including the NHS and social care

How will the project be delivered?

Agile pilots
A series of 2-4 weeks pilots to test and implement elements of a final delivery model.  Build on an initial series of desktop pilots we conducted with the Hastings Community Network in 2022

Active engagement
Continued engagement across Hastings and Rother partners & residents to support

1. the Primary Care Network test a new front door in the VSC for the management of health and care in the community or at home
2. management of relevant shared clients journeys across partners

Technology
Use existing off-the-shelf healthcare specific command centre software to test referral management across partners. Work with NHSApp and Patients Know Best team to test additional features in NHSApp

Information Governance
Work with healthcare data IG experts to establish data sharing protocol and protection requirements

Programme delivery
Set up programme board to manage progress and risks. Appoint programme manager and technical project manager to manage programme delivery and co-ordination

How is your project going to share learning?

Public sharing
NHSEI Evaluation Team and members of the AnalystX teams have volunteered to conduct evaluation and analysis of impact of the project.  A report will be published to share learning applicable to the wider system across UK and Ireland and specific learning across Hastings and Rother.

Local empowerment
Hastings and Rother communities will have access to the project via the well established Hastings & Rother community network, Hasting Voluntary Association and Rother Voluntary Association.  Public Health teams will also be engaged in improving future services commissioned to maximise outcomes for local residents.

Specific workshops will be provided to local partners interested in using the digital referral platform and support provided to residents interested in using the NHSApp.