OBJECTIVES

Cost-effective patient flow is essential in a cost-contained environment facing increased acute care demands. This study assessed budget impact of software implementation to improve patient flow at a large acute care NHS Trust. The model was extended to estimate budget impact for other NHS Trusts using the software, lost opportunity saving for NHS Trusts not using the software, and projected opportunity saving for Trusts implementing the software from 2019/20.

METHODS

A top-down approach was taken to assess cost implications of patient flow changes from baseline (start of software implementation for implementation sites). Publicly available datasets were used to estimate bed efficiency from baseline date, allowing annual operating costs and incomes received to be calculated under two scenarios: 1. Actual, and 2. Simulated for Trusts continuing to operate at baseline efficiency (requiring beds to be opened). Other budget impacts included were CQUIN monies attributable to the software and reduction in paper-based materials. Costs included implementation staff, hardware and software costs. Differences between actual and simulated costs and income provided lost opportunity saving from baseline for currently non-implementing Trusts. Scaled saving at implementation site generated indicative project cost-saving potential for Trusts implementing from 2019/20.

RESULTS

Patient flow improvements at implementation site enabled the Trust to increase annual admissions by 8.1%, increase ratio of elective versus non-elective admissions by 2.3%, all while reducing number of beds by 2.5%. This was primarily achieved through reducing average elective length of stay by 16%. 207 more beds would have been required by 2018/19 without these efficiency improvements. This all created £61m provider and £19m commissioner cost-savings over 6 years.

CONCLUSIONS

When implemented with sufficient resource and enthusiasm, software for improving accuracy, relevance and timeliness of processes and communications within large acute care NHS Trusts can generate significant positive budget impact for providers and commissioners.