Aviva’s Mark Sharpe, a physio and CSP member, outlines how commercial pressures are increasingly ensuring services offer the best value for money
As physiotherapists, CSP members understand that physiotherapy has an increasingly important role to play in promoting and restoring the health of the UK workforce and the population as a whole.
However, with the challenging commercial environment in which we are all working, it has never been more important to be able to clearly demonstrate the value of the services we deliver not only to our patients, but also our purchasers – including NHS commissioners.
Whether we work in the public or private sector, the challenges of demonstrating the effectiveness of our services remain very similar.
How Aviva tackled rising costs
Within Aviva we saw that medical costs for musculoskeletal claims were escalating year after year and there was a lack of control and co-ordination in what was being paid for.
As a result, we undertook a thorough clinical review and introduced a new approach that made physiotherapists the gatekeeper and guardian of well researched clinical pathways for MSK conditions.
The results were compelling, not only in achieving better outcomes for patients, but also in terms of a reduction in overall spend.
Needless to say, we still have had to prove the value of this approach and we hope that sharing some of our experience will help fellow professionals when dealing with the challenge of demonstrating the value of their services, both clinically and commercially.
1 Know your purchaser
Get to know the person or the group that is buying your services and be very clear that you know what services they want.
There may also be an opportunity to use your knowledge and expertise to influence and help design the services that they are buying – not all purchasers know exactly what they want and if there is a chance to shape the design, take it.
Establish strong working relationships with the purchaser and agree who will manage the relationship – and how – throughout the year.
2 Understand how success will be measured
Be clear what outcomes will be used to measure the success of your service.
These should ideally be a balance of qualitative and commercial factors, as both customers and purchasers will be interested in the difference you have made.
It is essential that you also agree a baseline at the start of the service to ensure you have something to demonstrate the impact you are making throughout the year.
3 Never compromise on quality
Obviously! No matter what the pressures are to generate savings, maintain quality at all costs.
First and foremost, you are delivering a clinical service to patients and this is the crucial foundation on which discussions should be based.
Ultimately, well structured and delivered clinical pathways deliver stronger outcomes against less efficient, less effective intervention programmes.
Invite purchasers to audit your work – it’s an opportunity to excel while ensuring you are meeting their needs.
4 Recognise the bigger picture
High quality physiotherapy services, delivered early, will almost always have a positive impact on reducing the volume of patients being referred on for specialist opinion or investigations – make sure your purchasers understand this and that this impact is factored in to the benefits associated with your service.
Consider this from both a patient outcome a savings perspective.
There are also other benefits that may be considered as a result of physiotherapy services, including reduced sickness absence for example – so think ‘bigger picture’ and don’t underestimate the impact you are having.
5 Innovate and push the boundaries
It is important to deliver core skills well, but consider the advances that the profession has made in recent years in the scope and style of physiotherapy practice – innovation is key evolving service delivery.
For example, experience and research is showing how successful telephony-based physiotherapy services can be highly effective as part of a solution.
Physios are problem solvers by our very nature – how can we deliver our skills in an innovative and more efficient way from both a clinical and operational perspective?
We don’t just deliver treatment face to face anymore.
6 Sell yourself
Don’t be afraid to shout load and proud about your successes – whether it is directly through well articulated results and meetings with purchasers or patient groups, or through entering awards – you owe it to yourself to reward your hard work - and let people know!
7 Think about year two
How sustainable is your service and the impact it will have?
Undoubtedly, what is likely to happen in future years needs to be considered when negotiating the initial contract.
Whether this means considering operational factors such as ‘how would I cope with increasing volumes of referrals’ or whether its clarity around how you will maintaining or further improve the outcomes you intend to achieve in year one, these must be considered in the initial stages.
8 Case study
Case studies are incredibly powerful, especially if they blend patient experience with the cost-effectiveness of the service and also cover a time period of at least a year.
A testimonial from the purchaser completes a compelling story that proves your service is effective in the real world.
Case studies are effectively like having a glowing reference for a job interview.
9 Service users
We all enter the profession to help people get better and we should always remember that patients should be at the heart of every service design.
Services should be easy (and quick) to access, deliver a professional and slick experience, but most importantly give the patient a high quality outcome – whether this is return to work, improved function or simply just having the tools and support they need to manage a long term condition.
Patients will be your strongest advocates if you get things right and your biggest detractors if you don’t.
10 Horizon scanning
What are colleagues and competitors doing in their service delivery and how are they promoting themselves?
This gives you a sense of what you are going up against. It’s also very useful to explore what other service sector industries are doing in terms of new ideas – inspiration can come from the most unlikely places!
Very few of us will have entered the profession thinking about proving our value, but it is now more important than ever, whether we work in the NHS or independent sector.
The pressure on budgets and competition from other providers and professions means we must all focus on demonstrating that physiotherapy has a essential place in all healthcare services, now and in the future.
Mark Sharpe is a chartered physiotherapist who qualified in 1999 and spent a number of years working in the NHS and then latterly in private practice, specialising in MSK and occupational health.
He is currently rehabilitation clinical lead with Aviva UK Health.
A board member of the UK Rehabilitation Council and member of the Association of British Insurers’ Rehabilitation Working Party, Mark’s role in Aviva is leading the development and delivery of rehabilitation services and solutions across both its Health and General Insurance business.
Aviva has a three-year partnership with the Chartered Society of Physiotherapy (CSP) across the Society’s Fit for Work initiative, which includes a programme of activity and resources designed to improve the wellbeing of the UK workforce and to highlight the importance of physiotherapy in preventing and reducing work related ill-health and sickness absence.
- For details see AVIVA
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