King's Health Partners defines high value care as:
The equitable, sustainable, and transparent use of available resources to achieve better outcomes and experiences for every person in the population.
This definition was developed to define high value care for the NHS and promotes the importance of considering resource use (not limited to expenditure) and its equitable allocation across the whole pathway of care at a population level.
The NHS definition builds on the 2004 Porter and Teisberg definition where Value is defined as the health outcomes (that matter to patients) achieved per dollar spend.
How is KHP working to deliver high value care for our populations?
To improve outcomes and increase the value that is derived from available resources across varied population groups we are focussing on three priority areas.
Digital Health and Data Science
To deliver high value care, first we need to continue to grow our health data science capabilities. Big data will help us to identify unwarranted variation in access, response to treatment and measure outcomes. This data will better inform treatment decisions and allow us to continuously improve services. We need to continue to grow our data assets to enable population health management and we need to develop intelligent tools that allow real-time evaluation of pathways of care and identification of interventions that deliver the highest value to enable the efficient allocation of finite resources.
Population Health
To deliver high value care we need to take a systems approach and consider the impact of interventions and innovations on population health outcomes, using our data and digital capabilities, to identify underserved populations and prioritise equity. We need to work cohesively across partners to further integrate and improve the value of whole pathways of care to improve population health and equity.
Personalised Health
To deliver high value care we need to focus on outcomes that matter to populations and patients, and those close to them, through personalising the care received. We will do this by harnessing our translational expertise to treat disease more effectively, responding to the needs of individuals. We will also promote the effective monitoring and use of patient reported outcome measures as fundamental to ensuring shared treatment decisions respond to individual need.
Mind and Body
Mental and physical health conditions are often connected which is why integrating mental and physical healthcare has the potential to vastly improve people’s experience of healthcare, and their outcomes. Taking a mind and body approach can improve the efficiency of care pathways and is therefore integral to both improving sustainability of our NHS services and ensuring that individuals, communities, and populations needs are met in a holistic way. King's Health Partners recognises the importance of treating the whole person and is committed to integrating mental and physical health care across everything we do.
Our strategic priorities are further explained in our Impact Report 2022-23. Across all our activities we are committed to measuring outcomes and resource use across the full pathway of care. This will ensure that decisions to spread and scale are based on strong evidence of value. We will continue to learn from local and international exemplars and work collaboratively with our partners to strengthen the evidence base for high value care approaches to healthcare delivery.
Our work on high value care:
The King's Health Partners Digital Health Hub aims to accelerate the development of digital health and data science technologies, including through our leadership of the AI centre for value based healthcare.
Our Vital 5 programme forms part of and aims to tackle five modifiable risk factors through high value interventions that address these major drivers of poor population health and inequity.
Our IMPARTs programme has helped deliver personalised, high value mind and body care to people with chronic conditions by screening for common mental health conditions in physical health outpatient appointments using validated patient reported outcome measures (PROMs).
Through KHP Education, in partnership with Erasmus MC, we host High Value Care courses and seminars which support clinical and non-clinical health care leaders from across our system to understand and implement high value care principles in practice. You can watch our introduction to health economics webinar here.
To support our partner trusts to continually improve services based on excellent clinical outcomes that matter most to patients, we are supporting the standardisation of clinical effectiveness monitoring and are supporting shared governance on how and when outcome measures are embedded in the Electronic Patient Record System used across both our acute Trusts.
Our partners
Through our membership of the European University Hospital Alliance we work alongside Europe's leading hospitals to take part in High Value Care education opportunities including:
- Erasmus MC Value Based Healthcare courses,
- and Early Career network for Health Outcomes Research and Management
- the
- H20 Health Outcomes Observatory
- We work closely with South East London Integrated Care system across a number of high value initiatives including the South East London Cancer Alliance
- HFMA Costing for Value Institute
History of high value care at KHP
Our commitment to high value care was first communicated through our 2014-19 strategy ‘Improving health and wellbeing – locally and globally’. Our programme focussed on improving the recording and sharing of outcomes and developing big data solutions and informatics capabilities. We published a series of outcomes books to help patients, service users, carers, referring clinicians and commissioners to make better-informed decisions, and to continuously improve quality of care. The books reported key outcomes for treatments provided by our Clinical Academic Groups.
Our most recent five-year plan for 2020-25 'Delivering better health for all through high impact innovation' embeds high value care through our thematic focus on transforming system-wide approaches to Quality Improvement and outcomes.
We are now working to accelerate progress in three priority areas within this current strategy: digital health and health data science, population health, and personalised health, whilst integrating mind and body across everything we do. These interdependent priorities are connected through a high value care framework.
References
Hurst L, Mahtani K, Pluddemann A, Lewis S, Harvey K, Briggs A, Boylan A-M, Bajwa R, Haire K, Entwistle A, Handa A and Heneghan C. Defining Value-based Healthcare in the NHS: CEBM report May 2019. https://www.cebm.net/2019/04/defining-value-based-healthcare-in-the-nhs/
Porter ME. What is value in health care? N Engl J Med. 2010 Dec 23;363(26):2477-81. doi: 10.1056/NEJMp1011024. Epub 2010 Dec 8. PMID: 21142528. https://www.nejm.org/doi/10.1056/NEJMp1011024?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub 0pubmed
Porter ME, Teisberg EO. Redefining competition in health care. Harv Bus Rev. 2004 Jun;82(6):64-76, 136. PMID: 15202288. https://hbr.org/2004/06/redefining-competition-in-health-care
