Predict.X for Care and Health Summary , Leicestershire and use The issue: a need for change predictive insight to optimise Intensive and the role of the ICS Community Support (ICS) service The ICS service was launched to address the bed capacity crisis, aiming to reduce About Leicester, Leicestershire and Rutland Health and Social Care Leicester, Leicestershire and Rutland (LLR) Health and Social Care’s hospital activity by promoting, Better Care Together (BCT) programme has been developed to supporting and encouraging transform health and care delivery across the region. BCT brings reablement so people can together a number of organisations, including University Hospitals remain at home for as long as of Leicester (UHL), all three Clinical Commissioning Groups, possible. However, there was Leicestershire Partnership NHS Trust (LTP), Rutland County Council, little visibility of the true impact and Leicestershire County Council. of this service.

Partners across LLR also work closely with patient representatives to ensure that services delivered meet the needs of its 1,000,000 The PredictX Difference residents and result in increased independence and improved Following the findings from outcomes. the assessment, the ICS service has been recently extended with the aim to: The challenge Acute hospital activity is higher than ever, yet bed capacity is • Enable patients who still shrinking. The number of over 85s living in LLR is expected to require support and treatment, increase by around 150% between 2014 and 2039. Inevitably, but are well enough, to leave increased life expectancy goes hand in hand with loss of hospital earlier functionality, increased levels of disability, frailty and long term conditions (LTCs) that require regular medical intervention. • Ensure they received appropriate treatment in the The intensive community support (ICS) service provided by LPT most positive environment for provides an intensive rehabilitation service with an aim to them prevent or reduce the need for permanent or long term care. • Improve integration of social, clinical and other care In order to gauge the impact and effectiveness of the ICS service across the local health and care community, an evaluation was required.

Contact us at | [email protected] or visit www.predictx.com to learn more. The PredictX intervention Key Insights An impartial and unbiased assessment of the ICS service could only be achieved if the multiple strands of data generated by all care providers - from UHL to social services - were integrated and analysed.

A specialist public health intelligence team, led by Gabriele Price, Public Health Business Partner at Leicestershire County Council, was “From the start, it was therefore tasked to develop a methodology for capturing data on this vital that analysis of specific group of patients. the service was both independent and The team worked closely with data analytics experts PredictX, who integrate and aggregate data from Ambulance Service, completely objective. This UHL, LPT, Adult Social Care services and NHS 111, creating dynamic is however, a long term dashboards that enables them to monitor the impact of the extended collaborative project, so ICS service on patient outcomes and readmissions on an ongoing results can not be rushed; basis. This data integration also allows them to view these holistic they must be accurate pathways and outcomes across the whole system. and provide a complete picture of the service and The result The dashboards are currently being used to evaluate the impact of its effect on patients and ICS on: all care providers.”

• Length of stay at UHL • Readmission rates • A&E attendance rates Gabriele Price Public Health Business Partner • Before and after activity costs Strategic Business Intelligence Team

For patients referred to ICS following a hospital stay the above outcomes are compared to patients who did not receive ICS and who were matched on age, number of LTCs, and reason and period for the hospital admission to the ICS cohort. Predict.X for Care and Health allows for matching and a parallel monitoring of both groups to be carried out in an easy, accessible and robust way.

Using Predict.X for Care and Health however, the partnership can assess the impact and benefits of ICS on a month-by-month basis, while also monitoring any changes to service costs and/or benefits.

Next steps The dashboards will continue to be used even more extensively, for an in-depth analysis of the impact of ICS on care delivery across the region. This will include the development of a whole system cost evaluation, as well as an analysis of staff costs, to assess the overall value of the service on this set of patients.

The ICS evaluation team are also working with PredictX to develop a predictive modelling dashboard, which will help shape future developments and assess which services are likely to be the most beneficial.

Contact us at | [email protected] or visit www.predictx.com to learn more.