Case Study

Complete Continuing Healthcare, Funded Nursing Care and Complex Care Service for Wandsworth CCG.

Service scope

Contract start date: January 2016. Full service start date: 1st April 2016 to the present day.

We had a relationship with Wandsworth as a provider of hospital discharge services for the CCG at St George’s Hospital. When it became clear that their provider of continuing healthcare services was falling significantly short of the required standards, we began discussions about taking over the service. The contract to provide full CHC, FNC and complex care services was signed in December 2015.

Data migration and data cleansing

We began the task of migrating and cleansing data in January 2016. The original contract was split into two parts: business as usual (BAU) and the review backlog. There was a backlog of reviews, around 500 in total (350 CHC and 150 FNC). Almost no reviews were completed by the previous provider in 2015 and many clients had not been reviewed since being found CHC eligible two or more years previously.

Work Streams

During the first year of delivery, we split the contract into two parts covered by two distinct teams. The BAU team based in Wandsworth were tasked with the following:

  • Coordinate and complete all new CHC assessments
  • Coordinate and complete three month reviews for newly eligible CHC clients
  • Ad hoc safeguarding reviews
  • On-going administration, data and finance management of entire Wandsworth case load

Controlling the CHC process

The BAU team implemented much tighter controls throughout the CHC eligibility process. Combining this with tight data and finance management resulted in a reduction in CHC spend as 2016 continued.

The review back log team were tasked with the following:

  • Coordinate and complete all annual reviews for FNC, CHC and joint funded clients
  • Working with the BAU and local authority teams in the reconsideration of eligibility, including the safe handover of service users to their respective social services where necessary.

The review back log project was deemed a complete success.

In March 2017, we commenced a new contract, combining all the work under a single team. We were also requested to extend our service by providing a brokerage, data and finance management service for their children’s continuing care service.

Disseminating expertise

We are now one of the only CHC teams in London to have a clinical nursing team completely made up of permanent members of staff. In September 2017, we moved our office base from a commercial property in Wandsworth town centre to the Royal Hospital Neuro Disability (RHND) in Putney. From this highly regarded specialist hospital, we provide free training to NHS, charity and social work professionals with our two-day module in continuing healthcare.

Full assurance status within 18 months of commencing our service

Since being responsible for Wandsworth CCG’s CHC service, the service has been audited twice: in September 2016 and in October 2017. The audit completed in September 2016 had an outcome of partial assurance, which was considered a reasonable result, considering we had only been responsible for the service for six months. In the second audit during October 2017, we were given ‘full assurance’ status, the highest accreditation possible.

Commissioner evaluation
The Wandsworth CCG commissioning lead commented:
“We have gone from no assurance when you took over the service, to partial assurance last year to full assurance – all within 18 months.”