Public Sector Scorecard in Health Social Care Service

Public Sector Scorecard in Health & Social Care Service Transformation Context The Public Sector Scorecard Outcomes The Sheffield Right First Time programme took a whole systems approach to health and social care service transformation for older people’s care pathways with a view to reducing reliance on the urgent care system. This was a forerunner to current Better Care Fund and placebased Sustainability and Transformation Plans. The seven perspectives of the PSS relate the desired strategic outcomes to the effectiveness of service delivery and the capability of organisations to support people and processes to achieve this. Over the three years of the programme the PSS-derived monitoring dashboard tracked a progressive reduction in emergency bed-nights for avoidable hospital admissions (known as ambulatory care sensitive admissions) and associated secondary care spend, which was a primary aim, reflecting reduced utilisation of the acute care system. Our approach The underlying PSS portfolio of system metrics provided a template of related and/or linked measures across health and social care services, that allowed positive and negative process and capability contributions to outcomes to be tracked via a performance dashboard that went monthly to the Programme Board and Operational Management Group. For the city’s leaders to have effective oversight of the change processes across health and social care services and their outcomes, a systems thinking approach was brought to the design of a balanced metrics portfolio, employing the Public Sector Scorecard (PSS) model. Why the PSS approach? The PSS model is amenable to complexity and able to incorporate core characteristics of the programme of citizen involvement, partnership and integration. It enables the construction of a balanced metrics panorama at the system level, from which performance dashboards can be modelled. Overview dashboard excerpt (pre and post commencement): Outputs An intermediate product of the PSS is a strategy map that describes key system components and their interrelationships. providing a framework onto which metrics are mapped. The Right First Time strategy map shows the various aspects required to How was it done? deliver the desired outcomes. The involvement of directors and This involved a collaborative approach based on a series managers from across health and social care in developing the of workshops at director and senior / middle manager level strategy map enabled the programme board to understand the from Sheffield Teaching Hospitals NHSFT, Sheffield various linkages and to monitor the whole picture. Health and Social Care NHSFT, Sheffield City Council “It’s very helpful to be able to see what's happening across the adult social care & public health, and a Citizen’s Reference whole health & social care system, and where the balance of risks Group. lie”. John Mothersole, Chief Executive Sheffield City Council: Within-year monitoring dashboard excerpt: Public Sector Scorecard – Three Phases John Soady Sheffield City Council & School of Health & Related Research, University of Sheffield John. soady@nhs. net Max Moullin Public Sector Scorecard Research Centre, Sheffield & Visiting Fellow, Sheffield Business School maxmoullin 2@gmail. com | www. publicsectorscorecard. co. uk