Central and North West London NHS Foundation Trust (CNWL) sought support to move to a care closer to home model across its Acute pathway. The Trust recognised this was an organisational development and culture change challenge that needed robust, trusted insights from data; so clinical leaders could redesign inpatient and community pathways.

Our Mental Health Flow Tool (now part of V-Suite) provided visibility over how every service user was passing through Trust services. From visualising the whole trust ‘flow system’ down to a single unique service user journey. This immediately highlighted the extent of planned ‘step up/step down’ care versus unplanned emergency care interventions. It was easy to target and track high-impact flow improvement interventions.

Rapid clinical consensus was built across the organisation when armed with this visibility, while infographics helped communicate pathway changes. A raft of operating model changes was implemented, supported by a weekly cross-locality trend review meeting. Leads from different services received an automated flow pack via the Flow Tool, and all admissions and long stayers were scrutinised. Localities shared learnings from both pathway redesign & operating rigour improvements that helped them stay within local bed allocations.

The result was the closure of old Victorian wards a c.70 bed reduction in total – equivalent to £5.5m in annualised savings – while minimal out of area bed usage was maintained. Occupied bed days continued to fall on a population weighted basis, and similar rigours were extended across both Rehab and CYP pathways.