Learning health system

A learning health system (LHS) is a ‘team, provider or group of providers that, working with a community of stakeholders, has developed the ability to learn from the routine care it delivers and improve as a result’ (Hardie et al., 2022). This is a systematic approach to iterative, data-driven improvement embedded in standard healthcare delivery (Hardie et al., 2022). Providing teams with the opportunity to become LHSs can help to improve the quality and effectiveness of health and care services (Hardie et al., 2022).

There are 8 priority areas that have been identified needing action to support the development of LHSs:

Table 7: Eight priority areas for action for learning health systems. Source: Developing learning health systems in the UK: Priorities for action

Areas for action		Recommendations
For policymakers	Clear narrative	Build on this report to set out a clear vision and set of principles for developing LHSs Build the evidence base – on both the impact of LHSs and overcoming barriers to adopting LHS approaches Align related policy areas to support LHS approaches Support the sharing of expertise and learning across LHSs
	Digital maturity	Provide longer term funding to help the least mature organisations and systems Spread best practice for procuring and implementing digital tools Embed digital skills and knowledge in maturity assessments Support the development of new analytics and data tools
	Data analytical expertise	Support the professionalisation of the data analytics workforce Promote open-source data tools for all analysts to use Develop digital skills across the wider health care workforce
	System interoperability	Further develop interoperability standards and support services to meet them Provide guidance on where interoperability can add most value Make sure that lessons from previous efforts to achieve interoperability are learned
	Implementation and improvement capacity	Develop a system-readiness framework for applying LHS approaches Provide funding to help organisations build their improvement capability Consider implementation support within centrally led transformation initiatives Develop training for implementing and using LHSs Collate and promote helpful tools, such as the LHS Toolkit
For system leaders	Learning culture	Create responsibility for LHSs at board level Embed improvement in organisational strategy Develop wider organisational leadership
	Frontline implementation capacity	Protect staff time for LHS work Provide access to training and coaching
	Organisational improvement capacity	Develop in-house expertise  Support the convening of learning communities

 

Getting It Right First Time

Getting It Right First Time (GIRFT) is a national programme designed to improve NHS care by reducing unwanted variations in the way services are delivered. The national GIRFT report for adult crisis and acute care has 17 recommendations to improve services and ensure people receive the right treatment at the time, which should reduce number of people reaching crisis point (Getting It Right First Time, 2022). The key recommendations are structured around four domains, with an overarching focus on data reporting and use.

Figure 24: Key elements of Getting It Right First Time (GIRFT)

This mental health needs assessment supports the first recommendation of GIRFT, which states that Trusts should ‘review local population needs assessments such as JSNA and to take into account factors known to increase mental health needs and demand, including but not limited to the vulnerable groups highlighted in the report to help drive their strategic plans between 2022-2025’ and to ‘ensure data is segmented to take account of variation in local area needs’.

Adult Crisis GIRFT looks at what can be done to improve access before people reached crisis point, as well as what could be done for people in crisis. The key messages are:

• Trusts need to be routinely analysing and reporting data especially outcome data
• Trusts need to ‘get it right first time’ by ensuring equitable access to timely and effective core mental health community care and treatment before people reach emergency need level
• Trusts need to routinely use proven flow tools, in both community and inpatients, to maximise effective use of capacity; creating ‘easy in, easy out’ services to prevent people getting stranded in the wrong part of the pathway

Additional resources

• Improving mental health services in systems of integrated and accountable care: emerging lessons and priorities
• Learning Healthcare Systems – The Learning Healthcare Project
• Realising the potential of learning health systems
• Overview: GIRFT national report for mental health crisis and acute care focuses on reducing barriers to access
• Mental Health – Adult Crisis and Acute Care GIRFT Programme National Specialty Report
• Getting the most out of GIRFT: A practical toolkit for embedding GIRFT within a trust
• Human Learning Systems: A practical guide for the curious

References

Full list of references is included at the end of this chapter.

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