Presentation on theme: "Future Plans - Becoming a Foundation Trust"— Presentation transcript:
1 Future Plans - Becoming a Foundation Trust Phil MorleyChief Executive
2 Trust Vision ‘Great Staff, Great Care, Great Future’ Our aims: Deliver excellent quality outcomes and great patient experience;Work in partnerships that add value and in ways that use public money wisely;Have buildings that are fit for purpose; andProvide assurance to our regulators and commissioners that all necessary standards are being met.
3 70% of our £483m annual budget is staffing costs We employ approx 7500 (WTE) staffThe NHS is the world’s5th largest employer with 1.7m staffOur staff include the top 1% and the bottom 1% of intellects in the general population70% of our £483m annual budget is staffing costsWe have 67 different careers to choose from in our hospitals
4 Where are we?We serve a diverse population including areas of extreme deprivation in Hull as well as the more affluent and ageing population in the East Riding of Yorkshire.Health needs range from reducing teenage pregnancy to reducing deaths from Heart Disease and cancer.
5 Two main sites: Inner city vs. suburbs We provide medical and surgical services for approx 600,000 people In Hull and East Yorkshire.We also provide specialist services such as, cancer, neurosciences, cardiology, cardiothoracic surgery, renal medicine and dialysis to a wider geographical area in North Yorkshire and Lincolnshire.Hull Royal InfirmaryHull Royal Infirmary is mainly an emergency site, but also has women’s and children’s services, an Eye Hospital, and extensive Outpatient and Diagnostic services.Castle Hill Hospital is a mostly a site for planned patient care with some emergency cardiology services. There are also more Outpatient and Diagnostic Services based here.Castle Hill Hospital90,000 Emergency patients87,000 Elective (planned) patients154,000 New OutpatientsIn 2010/2011 we saw:
7 Quality and Safety Strategy The quality priorities for the Trust over thenext five years are:SafetyTo reduce all avoidable deaths.To reduce all avoidable harm.EffectivenessTo ensure the Trust always treats the right patient, in the right place,at the right time.To aspire to achieve the best clinical outcomes for all.ExperienceTo improve communication through patient and staff engagement.
8 Friends & Family Test“How likely are you to recommend this ward/department to friends & family if they needed similar care or treatment?”Ward AreasEmergency DepartmentOutpatient DepartmentsMaternity Services
9 Compassion in Practice Transparency: Benching local & nationalQuality Boards at the entrance to every ward“you said” “we did”Intentional Rounding (Dec 2013)Chief Nurse agreeing appropriate staffing levels6Cs in appraisals
10 Setting the Standard Ward to Board Led by the Chief Nurse Clinical Areas are assessed against 12 Essential standards
12 Hospital Acquired Pressure Ulcer 70% Reduction and the percentage continues to reduceSkin Care Bundle Trust wideStricter control of interactive dressingExpected £50K savings by stopping inappropriate use of incontinence products
13 ED First Phase (Opened May 2013) ED Children’s Reception ED Children’s WaitingED Adults Self-Triage KiosksED Adults Waiting Area
14 ED Second Phase (Autumn 2014) ED ‘Majors’ED ‘Majors’ Waiting AreaED ‘Majors’ED Majors Resuscitation Rooms
15 Windowsills and reveals to be finished in a high performance material Tower Block Encapsulation (May 2014)New windows being installed from outsideOld windows being removed from insideWindowsills and reveals to be finished in a high performance material
16 Improving our services Stroke servicesPalliative care networkReconfiguration of Acute Assessment unitAccreditation as a Major Trauma CentreTransforming our surgical servicesTheatre improvement programmePathway redesignDeveloping maternity services59 Clinical Service Strategy
17 Francis Report 290 recommendations 27 Key Recommendations to take forward by HEY11 PrioritisedA Common set of Core Values & StandardsAssessing Core Values at interviewSupervisory Status for Ward ManagersE ObservationsE Prescribing & AdministrationRelative Surgeries on WardsPromoting our desire to learn fromcomments / complaints
19 Microfluidics Telehealth Nasogastric Tubes ‘Lab-on-a-microchip system’ aims to understand how current treatments (i.e. chemotherapy and radiotherapy) respond to specific tumour types allowing to develop more individualised care to patients. A current project sponsored by HEY and funded by the European Commission looks at the use of the device to detect biomarkers in non-small cell lung cancer. Inflammatory Bowel disease is also being studied for microfluidic use.TelehealthTelehealth is a broad term that refers to the use of technology to enable the remote delivery of healthcare or promotion of well-being. It is just one part of ‘eHealth’ – a term that also encompasses electronic patient records and other areas of health informatics.Working with the University of Hull, the Trust is playing an active role in supporting the bringing together of telehealth expertise from academia, primary and acute care, local authorities, industry and third sector partners that will form the future basis for telehealth service delivery in the NHS and elsewhereNasogastric TubesNasogastric tubes have been in existence since Egyptian times but until now, there has been no safe mechanism to ensure these tubes are inserted into exactly the right place. A team from the University of Hull working with colleagues in the Trust has set out to create a fail-safe detection mechanism for the placement of feeding tubes that is reliable and cheap to manufacture.
21 Communicating and engaging with our staff No surprises! Tell staff before they find out from someone elseBe honest even if the message is difficult or unpopularMake it easy for staff to find out informationUse face-to-face conversationsInvite staff to tell us how we can improve our servicesInvolve staff in decisions about changes which affect themHelp staff to deliver on the things they believe are importantCommunicate the good things we doFoster good relationships and partnership working with unions
22 Big Conversations Over 1000 staff attended. Key themes identified and project teams allocated to deliver on the main issues
23 Pioneer Teams – staff-led initiatives, championed by a Trust Director 20 teams have completed the programmeA 70% increase in referrals in to the cancer survivorship serviceThe creation of an IBD biologic unit in the gastroenterology wardAccess to remote paperless working for all neurology nursesHip fracture patients are now 28% less likely to die whilst in hospitalOne lift in HRI is now isolated for patient use only to improve privacy and dignity6 out of 7 anaesthetic rooms in HRI theatres have been remodelledPatient therapy sessions to be scheduled through the Cayder boardsA standardised Bereavement service has been developed for the relatives of deceased patientsFreed up almost 20 hours a week for community midwives to spend with their patientsImplemented significant changes to the catering services being provided to staffTelephone calls reduced by up to 30% on our pilot wardsImproved recovery for breast care patientsFour beds ring-fenced for neuro patients in ICU, resulting in fewer delays for patientsSignificant progress made towards reducing the amount of paper pathology results
24 Great Leaders programme 240 of our managers to undergo the programmeEach will learn how to empower and enable staffEach will deliver on their own personal commitment and improvement programme through Big Conversation engagement with their teams and colleaguesAre you a transformer?
27 Keeping Services Local CentralisationTertiary servicesSpecialist secondary servicesUnplanned careRoutine secondary servicesAmbulatory careSpecialist services will be concentrated in fewer centres (to increase quality of care), with some patients travelling for these ‘once in a lifetime’ eventsMore routine services will be provided locally, with travel time for all patients minimised. These are services that patients may need to access frequently during their care pathway.Localisation
28 PartnershipsClinical Alliance with York Teaching Hospital NHS Foundation Trust (February 2013)‘Working Together for Our Future’ conference 8th November, bringing together clinicians from all specialties, in York and Hull‘Strategic conversations’ with Northern Lincolnshire and Goole Hospitals NHS Foundation Trust.
29 Affordable Quality Service: The future in financial terms What does this mean for us?Planning to deliver a 1% surplus each year requires a minimum of 5% increase in productivity and efficiencyHugely challenging given the requirement to maintain and in some areas improve quality – eg: improve privacy and dignity in A&EWill need to work increasingly in partnership with others, notably York FT and NLAG FT to develop stronger clinical networks for patientsChange is unavoidable given the numbers involved. We would prefer to be in control of that process rather than have it dictated to usWhat is key is that all change will have to be directed by patient requirements
30 Affordable Quality Services: The future in financial terms Our aim is to provide the best quality services for the money that is availableIt is vitally important that we have a stable financial platform from which we can deliver quality clinical servicesExtremely challenging agenda:Estimated £30bn gap nationally by 2021
31 The FutureAcute HospitalsCommunityServicesSocial Care
33 ‘Technically Enabled’ £20m investment supporting clinical excellence and collaborative workingMaking it easy for clinicians and patients to take the right action, at the right time, with confidenceGetting rid of paper and joining things up so care professionals can look at whatever information they need, wherever they are workingMaking it easier for our patients to access our services and engage with us using modern, user friendly technologyReduce risks, deliver benefits, accelerate the pace of service transformation