Lincolnshire Academy for Clinical Excellence (LACE)
Based in the Ross Lucas Medical Science Building, also home to Lincoln Medical School. LACE is comprised of a small team of staff with different roles and expertise employed at the various stages of the review process.
LACE is the engine room within the Directorate, it is primarily responsible for facilitating and supporting detailed and complex reviews of care provision and pathways, ensuring that rigour and quality improvement methodology are applied to problem-solving and solution-generation in relation to prioritised areas of care.
To fulfil this role, the academy has developed its own approach to supporting and facilitating such change initiatives aligned to the six functions within the system’s Function Map.
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LACE Pipelines of Activities
Anybody working in Lincolnshire Integrated Care System can identify an area of care for significant improvement. LACE will offer the following:
- Advice about how to scope out the details of the issues and improvement ideas
- Guidance and advice on how to gather the necessary information required to seek approval from the Strategic Board to carry out a detailed care pathway review facilitated by LACE
- Support in preparing a report and presentation for the Strategic Board
The Strategic Board will review the submitted report and presentation and agree one of the following with regards to the proposal:
- Approved
- Disapproved
- Further work required, then resubmit
The academy assesses requests for care pathway reviews and improvement proposals in terms of low, medium, and high complexity which are aligned to three pipelines of activities.
LACE Pipelines Criteria
Pipeline 1
Low Complexity
Pipeline 2
Medium Complexity
Pipeline 3
High Complexity
Crosses organisational boundaries
Crosses organisational boundaries
Crosses organisational boundaries
Single issue
Multiple issues
Multiple issues
No impact on other organisations
The issues under review and the proposed changes impact on more than one organisation
The issues under review and the proposed changes impact on more than one organisation
Has a project and delivery team available
Has a project and delivery team available
Project and delivery team source within the individual strategy delivery providers
Is high priority in terms of urgency of delivery
High priority in terms of time delivery
Low priority in terms of time delivery
Is subject to local, organisational governance and sign-off
Subject to Strategic Board and Programme Board/Local sign-off
Subject to Strategic Board and Programme Board/Local sign-off
The evidence base and best practice guidance is readily available and underpins the change initiative
The evidence base and best practice guidance is readily available and underpins the change initiative
Requires detailed evidence synthesis, problem diagnostics and solution generation
Maybe nationally mandated
Nationally mandated
No national mandate
May lead to business case requirement
High level of co-production
Incorporates prediction and prevention aspects of population health management
May lead to business case requirement and procurement
Proposals of high complexity, more aligned to the criteria for Pipeline 3, which is a detailed care pathway review (subject to agreement by the Strategic Board) will benefit from a series of facilitated activities, face to face with an Expert Reference Group, progressing through the five stage of the pipeline. The stages of the LACE Pipeline 3 are aligned to the System Improvement Framework.
System Improvement Framework
LACE Pipeline Stages
Diagnosing and Prioritising
1
Seeking approval from the Strategic Board
2
Establishing stakeholder and expert engagement
3
Detailing the current position and areas for improvement
Defining and Designing the Future State
4
Mapping the future state and building a high-level strategy and plan
Planning the Change
Managing Implementation
5
System sign-off and ownership of the strategy and plan
- LACE Pipelines Flowchart
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LACE and its long-term aim
The long-term aim is for the academy:
- To be the repository of information regarding change initiatives across the system that directly relate to patient care and clinical outcomes, mapping the interdependencies and overlaps as well sharing of learning and success stories.
- Have more of an advisory role in relation to smaller scale, system service change initiatives and the wider application of quality improvement methodology
- Develop closer links between the directorate, system, and national and local clinical networks
- Have a greater role in promoting and sharing good practice, innovation, learning
- Have a greater role in embedding the quality improvement approach and agreed methodology
As we are in the early stages of developing our service and web information describing what we do, we would really welcome your feedback on the content and layout.
For further information about LACE, please email: licb.laceteam@nhs.net or louise.jeanes@nhs.net.