Our analysis and work to track progress in transforming Dudley’s care model helped the system to identify and focus on areas for improvement, bolstering the case for change and informing development of the clinical model.

Background
Dudley Clinical Commissioning Group (CCG) obtained Vanguard status to develop and test the Multispecialty Community Provider (MCP) model within the New Care Models programme. The CCG established a partnership with our Strategy Unit, which was to provide the specialist skills required (instigating innovations and bringing investment as well as providing specific services).

Action
Our wide-ranging support acted at the strategic/system level and the operational/service level, covering both ‘technical’ and ‘social’ elements of change. It included:

• research, evaluation and learning to track progress in transforming Dudley’s care model
• support to primary care in entering the procurement of the MCP. We organised primary care to define needs, select partners and pass the first stage of this large-scale procurement. We advised on organisational form, governance, leadership development, clinical modelling and pathway optimisation
• technical support on contract and payment reform: including advice on outcome measures and assumptions on activity growth for the multi-billion MCP contract, payment models and the construction of contractual risk-gain share arrangements within Dudley’s system
• complex analytics linking pseudonymised health and social care data, showing scope for efficiency through integration and pathway optimisation
• scenario planning to engage stakeholders from across the Dudley system. We also supported public communications and engagement, improving the care model using their insights.
• supporting the Partnership Board
• service improvement and change management in primary care to build an ‘at scale’ offer.

Impact

Our analysis and work to track progress in transforming Dudley’s care model helped the system to identify and focus on areas for improvement, bolstering the case for change and informing development of the clinical model. This work was highly regarded nationally (cited by Sir Bruce Keogh and others). It also added evaluative discipline to the process of innovation: providing evidence for decisions to scale up the most valuable innovations – especially in the use of new roles and skills within the workforce.

Our ‘Enabling Practices to Improve and Change’ programme improved processes, built collaboration between practices and wider services and community assets, released GP time and showed a return on investment of 3:1.

Scenario planning highlighted the importance of changing the relationship with the population helping to increase the focus on this vital element of change.

Feedback was uniformly positive. Projects received top marks in satisfaction surveys; people we worked with valued our support.

Lessons from our work in Dudley have wide applicability and have also informed our transformational change services, ensuring that our support is based on experiences and evidence from a leading Vanguard. We have created a microsite, https://www.strategyunitwm.nhs.uk/dudley-mcp, to disseminate the insights gained.

“I would have genuinely been lost without the clarity and insight that working with the Strategy Unit has given to us. You are remarkable in terms of your ability to connect with the topic and strategically create solutions and options to move us forwards.”
Laura Broster, Director of Communications and Public Insight, Dudley Clinical Commissioning Group