Snow White is the fairest of them all

4th December 2014

Cheshire health leaders have developed a system that is the fairest of them all when it comes to managing demand for health and social care services when winter bites – Snow White.

The Snow White urgent care dashboard was invented by NHS Eastern Cheshire CCG to provide a real-time view of the local health system and enable patients to receive excellent, timely care.

Local GP practices were involved in its development and have sung its praises for the difference it has made.

Information such as availability of GP appointments, available beds in hospitals and care homes, and ambulance turnaround times is fed into a special spread sheet by organisations including East Cheshire NHS TrustCheshire and Wirral Partnership NHS Foundation TrustCheshire East Council and North West Ambulance Service.

The spread sheet even includes a daily weather forecast.

The information enables decision makers to see at a glance which parts of the system are under pressure and which have spare capacity.

Early information allows health professionals and managers to predict numbers of patients moving through the health and social care system at different times, exemplifying the joined-up approach that Caring Together is encouraging.

Launched last winter, Snow White has been praised by NHS England. The CCG has presented the system at NHS conferences in London, Leeds and Bolton where other health organisations have expressed interest in using it.

Named after the seven categories of information it holds, Snow White is the brainchild of Jacki Wilkes, the CCG’s associate director of commissioning.

Former nurse Jacki said: “I wanted to have the local health system on a page, using real-time information that would enable colleagues to see which parts of the system are under pressure.

“I asked our quality team to design a reporting system using red, amber and green traffic lights that would be easy to understand at a glance and that wouldn’t contain lots of unhelpful graphs.

“Snow White gives us early warning of changes in demand. For example, if the weather forecast is for a big drop in temperature in five days’ time, we can ensure staffing levels are adjusted accordingly. We can also put out warning messages to our population with advice on self-care and prevention.

“Similarly, if we’re expecting an increase in hospital admissions, we can take steps to make sure enough intermediate care beds are available in community hospitals following patient discharge. We can also gear up the integrated care teams working out of our 23 GP practices.”

Last winter, Snow White ensured that health partners taking part in a daily conference call did not have to waste time trying to understand where the system was under strain.

Instead, they were able to identify the pinch points in seconds and then spend the rest of the meeting making sensible decisions.

Angela Wales, practice manager at Priorslegh Medical Centre, Poynton was involved in developing Snow White:

“The urgent care dashboard is a really innovative idea enabling health organisations to have a true understanding for the first time of the winter pressures facing healthcare providers including GP practices.

“For example, I doubt that anyone outside our practice would have known before last winter that we can take up to 500 telephone calls on a Monday between 8am and 12 noon.

“That sort of detailed information is vital because it allows managers to predict what will happen in the system.

“For example, if the GP practices are busy, we know that some patients will take themselves to A&E even if it’s not the right place for them.

“This understanding enables the various parts of the health system to plan ahead.

“Equally importantly, it gives our communications teams the information to fine tune the timings of campaigns encouraging people to choose the right service, to self-medicate where appropriate and to take the steps needed to stay well during the winter.”

The reporting system was developed by Anita Mottershead and Andy Wilson. They named the system Snow White because it held seven categories of data when first unveiled – as in the number of dwarves who looked after the famous Disney character.

“The fact that Snow White is also a fitting name for a winter pressures system was just a happy coincidence,” confessed Anita.

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