Future Plans Becoming a
Foundation Trust
Phil Morley
Chief Executive
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; and
– Provide assurance to our regulators and commissioners that all necessary
standards are being met.
We employ
approx
7500
(WTE) staff
Hull 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.
In 2010/2011 we saw:
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.
• 90,000 Emergency patients
• 87,000 Elective (planned)
patients
• 154,000 New Outpatients
GREAT CARE
Quality and Safety Strategy
The quality priorities for the Trust over the
next five years are:
Safety
To reduce all avoidable deaths.
To reduce all avoidable harm.
Effectiveness
To 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.
Experience
To improve communication through patient and staff engagement.
Friends &
Family
Test
“How
likely are you to
recommend this
ward/department to friends
& family if they needed
similar care or treatment?”
•
•
•
•
Ward Areas
Emergency Department
Outpatient Departments
Maternity Services
Compassion in
Practice
•
•
•
•
•
•
Transparency: Benching local & national
Quality Boards at the entrance to every ward
“you said” “we did”
Intentional Rounding (Dec 2013)
Chief Nurse agreeing appropriate staffing levels
6Cs in appraisals
Setting the
Standard
Ward to Board
Led by the Chief Nurse
Clinical Areas are assessed
against 12 Essential standards
NHS Safety
Thermometer
No
Patients
% Harm
Free
New
Harm
Old Harm
1040
92.1
%
30
52
May
13
1038
June
13
1022
July
13
954
Augu
st 13
962
94.6% 94.1% 94.1% 94.5%
Septemb
er 13
953
93.3%
18
28
30
22
19
38
32
26
30
49
Patients received HARM FREE CARE 95.33%
Harm Free Care is defined as the number/percentage of patients who have not suffered any of the
four harms measured by the safety thermometer before or since admission to hospital.
Hospital
Acquired
Pressure
Ulcer
70% Reduction and the percentage
continues to reduce
•
•
•
Skin Care Bundle Trust wide
Stricter control of interactive
dressing
Expected £50K savings by stopping
inappropriate use of incontinence
products
ED First Phase (Opened May 2013)
ED Children’s Reception
ED Adults Self-Triage
Kiosks
ED Children’s
Waiting
ED Adults Waiting Area
ED Second Phase (Autumn 2014)
ED
‘Majors’
ED ‘Majors’
ED ‘Majors’ Waiting Area
ED Majors Resuscitation
Rooms
Tower Block Encapsulation (May 2014)
Old windows being removed from
inside
Windowsills
and reveals
to be
finished in a
high
performanc
e material
New
windows
being
installed
from outside
Improving our services
•
•
•
•
•
•
•
•
•
Stroke services
Palliative care network
Reconfiguration of Acute Assessment unit
Accreditation as a Major Trauma Centre
Transforming our surgical services
Theatre improvement programme
Pathway redesign
Developing maternity services
59 Clinical Service Strategy
Francis Report
290 recommendations
27 Key Recommendations to take forward by HEY
11 Prioritised
• A Common set of Core Values & Standards
• Assessing Core Values at interview
• Supervisory Status for Ward Managers
• E Observations
• E Prescribing & Administration
• Relative Surgeries on Wards
• Promoting our desire to learn from
comments / complaints
Key R&D Strategic
Objectives
Patient Focus
Partnership Working
R&D Infrastructure
Research Culture & Training
Finance & Risk
•
Microfluidics
‘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.
•
Telehealth
Telehealth 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 elsewhere
•
Nasogastric Tubes
Nasogastric 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.
Great Staff
Communicating and
engaging with our staff
• No surprises! Tell staff before they find out from someone
else
• Be honest even if the message is difficult or unpopular
• Make it easy for staff to find out information
• Use face-to-face conversations
• Invite staff to tell us how we can improve our services
• Involve staff in decisions about changes which affect them
• Help staff to deliver on the things they believe are important
• Communicate the good things we do
• Foster good relationships and partnership working with
unions
Big
Conversations
Over 1000 staff attended.
Key themes identified and
project teams allocated to
deliver on the main issues
Pioneer Teams – staff-led
initiatives, championed by
a Trust Director
20 teams have completed the
programme
•
•
•
•
•
•
•
•
•
•
•
•
•
•
A 70% increase in referrals in to the cancer survivorship service
The creation of an IBD biologic unit in the gastroenterology ward
Access to remote paperless working for all neurology nurses
Hip fracture patients are now 28% less likely to die whilst in hospital
One lift in HRI is now isolated for patient use only to improve privacy and dignity
6 out of 7 anaesthetic rooms in HRI theatres have been remodelled
Patient therapy sessions to be scheduled through the Cayder boards
A standardised Bereavement service has been developed for the relatives of
deceased patients
Freed up almost 20 hours a week for community midwives to spend with their
patients
Implemented significant changes to the catering services being provided to staff
Telephone calls reduced by up to 30% on our pilot wards
Improved recovery for breast care patients
Four beds ring-fenced for neuro patients in ICU, resulting in fewer delays for
patients
Significant progress made towards reducing the amount of paper pathology
results
Great Leaders
programme
240 of our managers to undergo
the programme
Each will learn how to empower
and enable staff
Are you a
transformer?
Each will deliver on their own
personal commitment and
improvement programme through
Big Conversation engagement with
their teams and colleagues
Great Future
Keeping Services Local
Centralisation
Tertiary
services
Specialist
secondary
services
Specialist services will be
concentrated in fewer
centres (to increase
quality of care), with
some patients travelling
for these ‘once in a
lifetime’ events
Unplanned care
Routine secondary services
Ambulatory care
Localisation
More 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.
Partnerships
• Clinical 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.
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 efficiency
• Hugely challenging given the requirement to maintain and in some
areas improve quality – eg: improve privacy and dignity in A&E
• Will need to work increasingly in partnership with others, notably York
FT and NLAG FT to develop stronger clinical networks for patients
• Change is unavoidable given the numbers involved. We would prefer
to be in control of that process rather than have it dictated to us
• What is key is that all change will have to be directed by patient
requirements
Affordable Quality Services:
future in financial terms
The
•
Our aim is to provide the best quality services for the money that is
available
•
It is vitally important that we have a stable financial platform from
which we can deliver quality clinical services
•
Extremely challenging agenda:
Estimated £30bn gap nationally by 2021
Acute Hospitals
The Future
Social Care
Community
Services
‘Technically Enabled’
• £20m investment supporting clinical excellence and
collaborative working
• Making it easy for clinicians and patients to take the right
action, at the right time, with confidence
• Getting rid of paper and joining things up so care
professionals can look at whatever information they need,
wherever they are working
• Making it easier for our patients to access our services and
engage with us using modern, user friendly technology
• Reduce risks, deliver benefits, accelerate the pace of service
transformation
Our FT Application
Become a Governor and be
part of our future