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Mark Jennings

Mark Jennings
Chief Solutions and Services Officer, Strasys

Building organisational intelligence

“All [statistical] models are wrong, but some are useful” is a useful adage to live by, especially in Healthcare. The NHS world is full of data and measures but notably lacking in insight.

“How do we know?” is a question we frequently ask ourselves, about topics such as medical professionalism, treatment efficacy, board effectiveness, and Trust efficiency but we can rarely get to a sufficiently clear answer given the complexities of the environment and topics.

Strasys is all about helping Boards achieve Decision Intelligence – i.e. making better decisions. Over time, multiple good decisions cumulatively build into Organisational Intelligence, meaning organisations with successful, positive cultures and outcomes.

To help identify and evaluate Organisational Intelligence, we have developed the Strasys Value Index (SVI).

What Is the Strasys Value Index (SVI)?

Put simply, SVI looks at how much activity of good quality a Trust or ICB delivers relative to its costs to run, adjusted for the context in which it operates.

To break that down a bit further, we look at activity performed in a year (A&E, inpatients and outpatients) and adjust that according to a basket of quality metrics.

Lots of poor quality activity is not the objective, so activity volume is reduced or enhanced relative to the quality of work done.

Measuring quality is notoriously difficult and political with a small ‘p’, so we just use a handful of metrics, all of which fit into the category of “a reasonable person would have to agree that this number being better would be a good thing”.

Mortality is one example – whilst every Trust with high observed mortality relative to expected deaths will say (some with good reason) that they take more complex cases, do more risky work etc, all would hopefully acknowledge that reducing unexpected deaths is a good thing.

All our quality metrics fit in that category of “there may be very valid reasons for why it is what it is, but improving the metric would be a positive development”.

That view of quality-adjusted work is then further adjusted for customer service, which at this point just looks at wait times. These are, in our opinion, the most fundamental determinants of good service (aside from the quality of treatment) that patients really care about. Doing great work after an inexcusable wait is not great work.

As with quality, whilst there may be understandable explanations for why wait times are what they are, we can all agreed that shorter waits would be better.

The next adjustment is to look at the complexity of the environment in which the organisation is operating, specifically levels of disease and depravation within the patient cohort.

A Trust dealing with high levels of disease or depravation needs recognition for achieving quality and cost-adjusted levels of output relative to a Trust not facing such complexity.

Using Quality and Outcomes Framework data we can measure this. We all know that Blackpool faces high levels of economic deprivation, but it is useful to know that also translates to disease prevalence in the served population 38% above the national average (measured across a basket of 19 diseases)

What is this telling us so far?

A few early findings stand out.

The first is that 2023 saw a surge in value across Trusts as recovery from the pandemic really picked up.It may not have felt like it from the media reporting, but per (inflation-adjusted) £1,000 spent in 2023 Acute Trusts were delivering 60% more value than in 2022. The talk of declining productivity is not borne out in the data when you take a holistic view of the landscape.

However, 2024 saw those gains eroded and a significant step backwards. Variation in relative value delivery is huge. Some of this will be data anomalies – even though the index relies on nationally published data we know there are some inexcusable quality issues and gaps – but there is more than a 7x difference in value delivered per £1,000 of funding between the highest and lowest ranked acute trusts on the SVI. Even relative (normalised) quality scores can vary by 2x between Acute Trusts.

Tracking progress over time

By analysing SVI trends over the past seven years, we can identify which organisations are improving and which are struggling. These insights help leaders target areas for intervention and improvement.

Most importantly, for individual organisations we can see the journeys they are on. By tracking SVI by year over the last 7 years, we can start to identify those organisations trending in a positive direction and those who are struggling.

Why the Strasys Value Index matters

The SVI offers a holistic view of performance, combining efficiency, quality, service, and context. It empowers healthcare leaders to:

  • Understand their organisation’s strengths and areas of opportunity.
  • Track progress over time.
  • Make data-driven decisions that drive meaningful change and create value.

Next steps

If you’re curious about how your organization measures up or want to learn more about the Strasys Value Index, reach out to mark@strasys.uk. Learn how decision intelligence can unlock your organisation’s potential.