Care Coordination Centre

Posted on 26th April, 2016


Providing a diverse range of patients with a single point of contact for comprehensive health services, CSC is working with Trafford Clinical Commissioning Group (CCG) in Greater Manchester, England, on a first-of-its-kind care co-ordination centre. The innovative Trafford Care Co-ordination Centre (TCCC) aim to provide patients, families and care providers with significantly improved patient experience and efficiency across Trafford's healthcare system.


A part of the National Health Service (NHS), Trafford CCG is responsible for ensuring that health services for Trafford's 220,000-plus residents are provided at the right place and time, and the services are safe, of high quality and offer value for money. The partnership between Trafford CCG and CSC to develop and manage the TCCC is the first of its type in the United Kingdom.


A contemporary challenge for Trafford CCG, as with healthcare organization globally, is to find new ways to deliver quality healthcare in a coordinated, integrated manner. "Our vision for the health economy in Trafford is to create a healthcare system that's proactive and high-quality, with excellent clinical outcomes and ease of access," says Gina Lawrence, Trafford CCG's chief operating officer. "This will be achieved by designing services that are delivered in an integrated way, so that patients can expect health and social care to work together to offer the best possible holistic advice and support for their needs."As healthcare becomes more focused on the patient, Trafford CCG is taking a more personal, caring approach. Trafford CCG has already begun to build integrated services in the community. However, Lawrence points out, "Unless you have a co-ordination center, people don't access those services very well.Like many regions, Trafford CCG serves a diverse population with a wide range of healthcare needs. The comprehensive NHS care system can be complex to navigate, and TCCC aims to provide a complete offering that sets a new standard for quality in care co-ordination.Trafford CCG engaged CSC to co-create and co-manage the TCCC, with the goal of improving co-ordination and integration across the boundaries of primary, acute, community and mental health sectors to deliver a significantly improved experience for patients and care providers. "The TCCC is designed to make getting services as simple as possible with a single access to t, but it also helps general practitioners and acute trusts navigate through what can be a very complex NHS system," Lawrence says. 


The TCCC is based on a new care model that works like an air traffic control system, tracking patients as they move through the system and guiding them to difference services in an efficient manner. The journey begins with a referral from the patient's general practitioner (doctor) and the care pathway is mapper out using recognized clinical tools and protocols, such as Map of Medicine, a clinical tool that lets physicians plan care according to the best information available.Each patient is assigned a designated care coordinator who has a host of resources and interfaces available to make practical arrangements, such as booking appointments or arranging transportation to and from a hospital. "It is very patient-centric. The system considers the best options and the best care for you," Lawrence says.The continuous tracking of patients allows Trafford CCG to understand what kind of services they access and what kind of services they need to access, "which really helps us manage our budgets and commissioning correctly," Lawrence continues. "We call that 'intelligent commissioning,' and that's the way forward for CCGs in the future."Services range from initial patient communications via a unified communications system, to clinical workflow based on a catalog of services, to back-end analysis of the effectiveness and efficiency of care delivery. CSC also provides innovative business process services and works with partners to deliver clinical services.


Dr. Nigel Guest, chief clinical officer at Trafford CCG, notes that healthcare services are shifting to delivering care at the most efficient location. "We should center services for patients around them, providing the services preferably out in the community, not in the hospital, unless that's absolutely necessary," he says.Part of the innovative TCCC model is that the patients' family situations and transportation needs are taken into consideration when making care decisions. Guest says the service elevate such factors as: "Is there an appropriate time for them, and how will that work with the members of their family? It's very much more about coordination, and not just coordination for the patients, but for the family as well."In the new model, another key is that by steamlining the system, the level of bureaucracy and the amount of paperwork is reduced. Guest says that by making the system more efficient, "We'll derive cost benefits from it, and we can invest further into integrated care."The TCCC approach can evolve into a model for the provision and management of population health, says Philippe Houssiau, CSC's vice president, healthcare & life sciences, UK.The TCCC model, for example, serves as an excellent means for establishing care pathways for diabetes management by "keeping those patients in the preclinical stages of their lives, hence dramatically reducing the burden of the healthcare system and dramatically increasing the quality of their life," Houssiau says.Houssiau adds that he sees the TCCC model expanding well beyond Trafford. "We will be delivering high-quality, value-for-money services, which could lead the way for how care is delivered across England," he says. "This is a really phenomenal opportunity for co-creation, not just at a regional or a country level, but to have a dynamic global activity going, taking place around one common point of view of changing care models globally."

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