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Join us on 14 February 2014 for a workshop on our evolving clinical strategy. Discuss the current work being done to drive it forward and explore its potential impact on you, your service, and the Trust. Make new friends and influence people while sharing your thoughts and ideas. Don't forget to ask about finding your Valentine!
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Have you found your Valentine? Ask at the registration desk!
Right First Time 24/7 Staff workshop 14 February 2014 Welcome!
Sue Jacques Chief Executive
Purpose for today Discuss our evolving clinical strategy Share work being done NOW to drive it forward Consider what this could mean for you, your service, and the Trust Discuss with the Executive and Senior Clinical Leadership team Make new friends and influence people!
Right first time 24/7 Our evolving clinical and quality strategy
The story so far… 2011: Integrated hospital and community services 2012/13: Discussions with staff and stakeholders around key services as an integrated provider 2013/14: “Getting care right for the emergency patient, especially the frail elderly, must be the priority”
“there are patients, usually frail elderly, who are admitted to hospital unnecessarily… because services are not organised to respond to their needs at an early stage.”
“There are days when the 95% target for A&E 4 hour wait is not achieved. Multiple ambulances can be waiting outside A&E to hand over patients.”
“Patients are regularly boarded onto surgical wards. Patients are waiting in A&E for beds to become available for them to be admitted.”
“Many of our rotas at both junior and senior level are supported by locum staff, which impacts on continuity of care and consistency of quality.”
“Recent surveys of medical trainees show that the Trust is not a placement of choice for junior doctors.”
“We are experiencing difficulties in recruiting to nursing vacancies, where we want to make ward managers and team leaders supernumerary and strengthen teams.”
“The Francis report revealed a tolerance of poor standards and risks to patients. We cannot take for granted that similar problems could not happen here.”
In addition, there are issues from : HSMR data Incidents Coroner reports
National financial context £30bn gap
Local context: Better Care Fund 2015/16 We are also seeing the impact of new commissioning arrangements, especially on Health and Wellbeing services.
“Our reserves can only be spent once, so it is important that we do so wisely, on investments and capital schemes that will help us achieve our vision.”
“Our reserves can only be spent once, so it is important that we do so wisely, on investments and capital schemes that will help us achieve our vision. “However, pressures on services means reserves for investment are being eroded.”
Right first time 24/7 How do we respond?
Our vision Right person Right place Right time First time 24/7
Our principles Deliver core acute specialties across both acute sites Specialty departments delivering care across two acute sites and beyond Consultant delivered care Patients in homes not hospital, clinicians to patients Care closer to home where safe, effective and efficient Older person at the heart of service delivery, supported in the community
A cultural shift is required: “We need to stop thinking of ourselves as a group of small acute hospitals, merged with community services, and really create a vision of one large progressive integrated provider.”
A cultural shift is required: “Services organised so that consultant review, clinical staff and diagnostic and support services are readily available on a 7-day basis.”
A cultural shift is required: “We need to ensure that steps to keep patients out of hospital and support them in the community are clinically effective and cost efficient at a time when there are pressures on budgets.”
A cultural shift is required: “We need to respond to the challenge to improve service quality and outcome. This will require new models of care that are more efficient than those we currently operate.”
Getting involved Today’s event! One hour roadshows Meetings with the project team Service transformation Clinical reference group…
Proposed Workstreams Interested? Why not sign up over coffee?
Clinical Programme Board priority areas… Elderly/frail elderly Urgent Care Long Term Conditions Mental Health and Dementia
“Ambulances need to become places of treatment” “Voluntary sector will build more provision into community services” “More emphasis on independence and self management” “Effective care closer to home will require excellent case management and more carer support” “Disinvestment: There are some hard decisions we need to take together” “We need to learn lessons quickly!” Right First Time Stakeholder Event, 6 February 2014
“Achieve strategic shift (15%) acute activity to outside of hospital via transformational schemes” Right First Time Stakeholder Event, 6 February 2014
The15% challenge
Working with your Valentine: What skills will our workforce need with 15% of work shifting out of an acute setting?
Doing things differently: Unscheduled care – Derek and Stuart Intermediate care – Debbie and Linda Surgery and diagnostics – Janet and Ian
Discussions questions Care closer to home: intermediate care How do we take advantage of new intermediate care arrangements to keep patients out of hospital and reduce length of stay? What will it mean for our patients and their families? How will it change our acute services? What will it mean for community services? How does this contribute to the 15% challenge?
