News

January 6, 2016

The ‘morning huddle’: performance management in managing retrospective claims for continuing healthcare funding

In Stoke, a single team are responsible for managing nearly 1,000 retrospective claims for continuing healthcare funding. The first member of the team, Jody Collier, started work on July 13, 2015, single-handedly taking possession of a mountain of paperwork and ordering cases until others joined the team through August and September.

They face tight deadlines which cannot be missed. In January 2016, just six months after the team’s inception, they must have completed 100 cases. In February, a further 100 must be completed and the same every month until they reach the final deadline of July 2016.

Each day starts with an innovation which Jody brought from her professional background in the banking industry: the ‘morning huddle’. Led by co-ordinator Ros Howard, the team gather around a large whiteboard. No-one sits down as they run through the work targets for the day. The team’s administrators have ten open cases each – their job is to gather all the required evidence from care homes, GP records and other sources such as hospital records. They tell the huddle if they have any files they are likely to complete that day. “It means at the start of each day, everyone in the team is aware of where we are up to; there is a clear sense of working as a team and having a clear purpose,” explains Jody Collier, team leader. In addition to the administrators with their responsibility for compiling files, there is an assistant who travels to care homes across Staffordshire, meeting staff and photocopying records to short-cut possible delays.

The huddle also serves an important role in terms of supporting motivation. “It isn’t an easy job,” explains Ros Howard, who has decades of senior management experience in health and social care and was in the group that developed the national criteria for continuing healthcare. “The huddle serves as an outlet for people to talk about any problems or hurdles they are facing. There can be things which are outside our team’s control which affect their performance. We want individuals to share problems at an early stage so we can come up with solutions or change things so there is no hiatus in the workflow.”

Importantly, small prizes are often given; not for their monetary value but to show appreciation for team members and support motivation. The huddle takes no more than ten or 15 minutes at the start of the day and then individuals quickly proceed to their own daily workload.

Tight deadlines are a constant theme for the team. “We have mapped out the process in great detail and we know claims can be completed eight weeks from the time they are allocated to a medical administrator,” explains Ros. “However, this is wholly dependent upon the performance of the administration function. If, for example, the case manager finds there is a period of assessed care missing and unaccounted for, that case will go back to the square one, producing a significant delay.”

The administrative function of Team Osprey is also critical at the latter part of the claims process, arranging the family meeting to discuss the Care Needs Portrayal, then sending the decision letter out to the claimant family. Jody and her joint team leader colleague James Duff fulfil this function and as the main point of contact for each claimant family, are the communication lynchpins in the process. “It can be challenging – sometimes there are conflicts among family members making a claim and once the decision letter is received, if the answer is negative, that can be difficult to accept,” says Jody. “Our role is not to advise but to explain the process and to be that constant point of contact and source of information for families.”

The Stoke team have a memorable name: Team Osprey, after the rare breed of birds who were recently sighted nearby. Ospreys are characterised by their keen eye for detail and ability to fish and hunt; both qualities required for tracking down retrospective care records and the precision required in completing files and managing cases. It is an apt name and the team are living up to the associated characteristics. Just five months after their inception, they were nominated for the Midlands and Staffordshire Commissioning Support Unit staff awards in the Inspiring Change category.