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Making it Happen A Regional Perspective Steve Fairman Director of Improvement & Efficiency South Central SHA King’s Fund, 17 January 2011.

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Presentation on theme: "Making it Happen A Regional Perspective Steve Fairman Director of Improvement & Efficiency South Central SHA King’s Fund, 17 January 2011."— Presentation transcript:

1 Making it Happen A Regional Perspective Steve Fairman Director of Improvement & Efficiency South Central SHA King’s Fund, 17 January 2011

2 Population of 4 million -9 PCTs -7 Foundation Trusts -8 NHS Trusts and 2 potential NHS Trusts GPs -547 Practices

3 South Central overview  High life expectancy  Low deprivation (some pockets)  Population growing and ageing  Complex system / borders  Politically high profile

4 South Central overview (2)  Current spend £6.1bn; population 4.2m  Funding gap is £1.4bn by 2014/15  55% provider efficiency  45% pathway changes

5 South Central context  Funded at £1,416 per head v. England average £1,612;  G&A bed ratio of 2.54 per 1,000 v. England average 3.18  NEL hospital admissions 0% growth and  EL hospital admissions 2.4% reduction

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8 Where are we now?  We understand the size of the challenge and that doing more of the same is not enough – we must do more for the same  We are making good progress – we are already in implementation  We have some good delivery mechanisms in place  We have a good regional focus  We are moving into organisational transition

9 QIPP – how are you going to cut the cake… Hint: A hip replacement costs £7599…

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11 The essential elements of effective Regional leadership of QIPP  Understanding YOU don’t actually make any of the changes that deliver on QIPP savings  A ‘profile’ with local leaders  Very well organised Programme Management and Governance arrangements  Standardisation  Integration with normal processes

12 Key risks and barriers to QIPP delivery at a Regional level 1.Gaining front-line engagement on QIPP 2.Organisations look internally for savings (or growth!) 3.No record of change on the scale required 4.Priorities not always properly aligned with the challenge 5.Management / leadership capability 6.Organisational sustainability

13 2011/12 (year 1) £m % of 4 year total Demand pressure on 2011/12 base (£ millions) – i.e. pressure on commissioners if tariff efficiency fully achieved Pressure of tariff efficiency demand on providers Size of challenge (sum of demand and pay and price pressures) The South Central QIPP Challenge (Draft)

14 Key risks and barriers to QIPP delivery at a Regional level (2) …and a new one – leadership and delivery through, and beyond, organisational transition

15 What have we done at a regional level to mitigate the effects of these?  A relentless focus on quality  Maximise safety  Drive out unwarranted variation  Developing people  Tailored our leadership programmes  Mobilised our Clinical Leadership Network  Working with the new commissioners  Building ownership  Developed a communications strategy  Been open and honest about the scale of change necessary

16 What have we done at a regional level to mitigate the effects of these? (2)  Focused effort and resource around the 5 clinical programme areas that evidence shows us will really make a difference:  Planned Care – e.g. enhanced recovery programme  Acute Care – e.g. improved stroke care pathway  Long Term Conditions – e.g. COPD management  End of Life Care – e.g. choice of place of death  Maternity & Newborn Care – e.g. cut caesarean sections

17 What have we done at a regional level to mitigate the effects of these? (3)  Facilitated joint work between local organisations on other system-wide initiatives  Integrated Supply Chain  Estates rationalisation  Pathology services  Medicines Use and Procurement  The ‘productives’

18 Conclusions 1.Regional leadership of the QIPP agenda is essential – but can easily be ineffective 2.You must build an understanding of the scale and nature of change needed 3.You must build a ‘movement’ for change 4.Clinicians must be at the forefront 5.You must be organised 6.You must be resilient!

19 You can’t solve a problem by using the same thinking that created it Albert Einstein


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