Improving outcomes, reducing clinical risk and cost and minimising outpatient appointments and diagnostics
Overview of Connect
Connect Health is the largest specialised independent provider of community musculoskeletal (MSK) services (including orthopaedics, pain and rheumatology) in the UK, serving over 250k NHS patients and 75 businesses.
There is an urgent need to increase the efficiency and quality of care of MSK provision in the UK – both NHS and corporate sectors – by optimising care and reducing the inappropriate flow into hospitals. Connect effectively and efficiently delivers care in a lower cost community setting, transforming services around specific quality and financial objectives, dramatically reducing waiting times and improving access to treatment and patient outcomes.
Established in 1989, the organisation has enjoyed phenomenal recent growth, winning 7 out of 10 community MSK tenders. This success is based on a series of proven collaborations with the NHS, which is underpinned by evidenced and improved outcomes for the patient.
“Over the last 5 years Connect has provided MSK services in the community for Camden. I have always found Connect to be responsive, easy to work with and they see patients very quickly. I like their approach which isn’t all about making money – they bring ideas, innovation and are constantly looking at different ways to provide effective service.”
Dr Tom Aslan, GP, Commissioner and MSK Lead, Camden CCG
Clinical Expertise
Problem
Variation in primary care and community physiotherapy clinical skills results in un-necessary diagnostics and un-necessary referrals into out-patients and avoidable surgery.
Connect Benefit
We are able to focus all of our attention on one clinical area built over 30 yrs. Our range of training programmes for the multidisciplinary team are renowned throughout the UK. We’ve created the capability to measure clinical effectiveness at clinician level and as a result we are able to standardise and reduce variation.
Efficiency
Problem
It is common for patients to have 6-12 weeks waiting time for traditional MSK services which are delivered in a disjointed and multi-provider landscape with perverse incentives and variable outcomes
Connect Benefit
Connect’s service model reduces waiting times (to 48 hours for first contact with physio), freeing up GP and patient time, consolidating pathways for MSK, rheumatology and pain, reducing referral route variability, promoting patient choice, empowering patients, and providing a cost effective mechanism for managing patients. New services are consistently mobilised within 3-4 months, using a tried and tested, project-managed implementation programme which achieves KPIs in the first quarter.
Patient Outcomes
Problem
1.8m employees have a long-term sickness absence on ave of 4 weeks or more in a year. If off work with lower back pain for more than 6 months, 50% of employees don’t ever return to work.
There is a need to reduce chronicity with prompt treatment to reduce waiting times.
Connect Benefit
Connect delivers MSK services in over 75 companies in England and can evidence consistent reductions in the incidence and length of absence. We develop services wholly designed to focus on the patient experience and what really makes a difference to them delivering care closer to home. The average patient satisfaction rating across all of our services is 9.3 out of 10. Clinical outcomes (EQ5D) significantly exceed previous best-published results.
Innovative Partnerships
Problem
Transformation to new models of care are difficult to achieve in practice with culture change and fear being key barriers, alongside a political and societal reticence to move from hospital
to community provision.
Connect Benefit
We are able to bring innovative ideas and are constantly looking at different ways to provide effective service delivery, at work or in primary and community care settings. Connect’s ability to mobilise at scale and in full is proven by recent successful mobilisations of Wakefield, North Kirklees and South Tyneside CCG contracts all on-time simultaneously on 1st October 2016, covering a total population of 700,000.
Financial Savings
Problem
MSK accounts for £5-7bn pa* of NHS spend (the 4th highest clinical area) affecting 9.6m** adults. MSK services have historically suffered under-investment and their future viability is
poorly understood.
*Department of health (2012), Programme Budgeting Data 2009-10, June
**Graham Stringer (2011), Hansard col:1342
Connect Benefit
We significantly improve patient flows and deliver savings in both delivery AND downstream costs in terms of reduced unnecessary hospital consultations and diagnostics. We can evidence parity/improvement in outcomes for patients compared with many orthopaedic consultations and subsequent avoidable surgical procedures, had evidence–based conservative measures been more successfully applied at an earlier stage of the development of their problem.
Building the evidence base
In 2016, Connect commissioned the University of Northumbria to carry out a retrospective, multi-centre study of EQ5D outcomes for more than 4,000 NHS patients receiving physiotherapy treatment from Connect.
The results, which are awaiting publication are:
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