The “Any Town” Toolkit is a high-level health system modelling toolkit provided by NHS England to assist CCGs in determining which interventions might best improve their local health services (ideally whilst saving money). It is intended to help commissioners in developing optimally effective five-year strategic plans, with a view to achieving financial balance in strategic period to 2018/19. The “Any town” model works with detailed data about local population size and disease prevalence to predict potential changes between 2013/14 and 2018/19 based on hypothetical experiments with different plans.
“It uses extensive research to highlight both interventions that are already proven to have a significant impact (High Impact Interventions) as well interventions that could have benefit but have not yet been widely adopted or fully impact assessed (Early Adopter Interventions) both with a view to helping health economies to deliver better quality care within the available financial resources”.
The Any Town Toolkit comprises five modules:
The Methodology Guide which introduces the Any Town project, explaining the principles and methodology. It explains the relevance of the potential interventions and the methodology behind how the model calculates the results presented.
The Urban Model Module: urban areas tend to involve a younger demographic, involving higher prevalences of COPD, mental health problems and depression.
The Suburban Model Module: suburban areas tend to have a higher level of LTCs; excluding cancer, including heart and endocrine conditions.
The Rural Model Module: rural areas tend have an older demographic with higher prevalences of Coronary Heart Disease (CHD), Heart Failure, Stroke, Chronic Obstructive Pulmonary Disease (COPD), Cancer, Dementia and Lung Disease.
The Further Information Guide: providing background information on the case studies used for modeling the interventions.
Toolkit published to help improve services and close the financial gap in ‘Any town’. London: NHS England, January 24th 2014.
High Impact Interventions
The list of options includes:
- Early Diagnosis: aimed at early detection and diagnosis to improve survival rates and lower treatment costs.
- Reducing Variability in Primary Care: optimising medicines use by reducing unwanted variation in primary care referring and prescribing.
- Self-Management: patient-carer communities for self-management of long-term conditions.
- Telehealth / Telecare: including health apps, telehealth and telecare equipment to help people manage their long term conditions in conjunction with their clinicians.
- Case Management and Coordinated Care: multi-disciplinary case management for frail elderly people and persons with long-term conditions.
- Mental Health: Rapid Assessment Interface and Discharge (RAID), and psychiatric liaison services for people treated for physical health conditions.
- Dementia Pathway: an integrated network model to improve outcomes while achieving efficiencies in dementia care.
- Palliative Care: community-based, consultant-led palliative care services.
Early Adopter Interventions
The list of potential options includes:
Cancer Screening Programmes: for early diagnosis of colorectal, breast and lung cancer to increase survival rates.
GP Tele-Consultation: involving tele-consultation in primary care, to complement practice-based consultations.
Medicines Optimisation: pharmacist-led interventions supporting optimal prescribing and use of medicines.
Safe and Appropriate Use of Medicines: reducing preventable deaths from medication-related incidents (Eclipse Live).
Acute Visiting Service: reducing the demand for emergency care with rapid-access to doctors at home.
Reducing Urgent Care Demand: involving for example acute GP units to triage emergency arrivals and occupational therapists in A&E to reduce low-risk hospital admissions.
24-Hour Asthma Services: for children and young people; again, reducing unnecessary hospital admissions with a 24-hour home nursing services.
Service User Networks: mental health co-designed support services, developed for and by people with emotional / behavioural problems.
Reducing Elective Caesarian Sections: the Campaign for Normal Births.
Acute Stroke Services: hyper-acute stroke units to optimise best-use of acute stroke services and help ensure 24/7 access to specialist care.
Integration of Health and Social Care for Older People: integration of care.
Electronic Palliative Care Coordination Systems (EPaCCS): use of shared electronic records to improve care and allow patients to die in the location of their choice.