SWBH Transformation Plan
Medical Engagement Event
8 February 2012
The Transformation Plan is key to achieving our strategic
goals
Our medium
term objectives
are …
Safety
Quality
Financial stability
2012/13
Site rationalisation
2013/14
2014/15
Foundation Trust status
2015/16
2016/17
To accomplish
these objectives,
we need to …
£25m saving
To ensure that
we reach the
saving targets,
we combine…
£125m
Target
£25m saving
£25m saving
£25m saving
£125m
cumulative
savings
£25m saving
TOP DOWN saving targets based on extensive
benchmarking with …
£ backed … BOTTOM UP saving plans substantiated by
up by plans detailed activity, financial and workforce plans
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Various work-streams have been established and savings
targets identified (1 of 2)
Workstreams
Saving
target
Selected initiatives (on-going / being explored)
2012-17
Outpatient Efficiency
£37,6M
Reduce DNAs, improve N/FU ratios, improve clinic productivity and reduce
overall cancellations, manage decommissioning plans
Diagnostics
£1.9m
Timeliness of diagnostics to support patient flow
Right test every time
Patient Flow & Bed Utilisation
£22,4m
Appropriate patient management to improve flow
Discharge planning and daily reviews
Reduced variation in practice
Community Service Efficiency
£3,1m
Supporting acute activity and pathway redesign , assisting
decommissioning agenda
Fully developing and utilising alternative care pathways available
Urgent Care
£9,6m
Changes to the way unscheduled care is managed out of hospital
Streamlined front door around ED and routes into hospital
Theatre Productivity
£2,7m
Improve productivity and address incentives
Ensure productivity and efficiency changes are implemented
Workforce
£17,3m
Reduced variation
Team working
Maximising skill mix and capabilities
Medical Workforce
£5,9m
Wider than just job planning, needs to take account of wider impact of
medical activity, team working, not silo’d, reduced variation
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Various work-streams have been established and savings
targets identified (2 of 2)
Workstreams
Saving
target
Selected initiatives (on-going/ being explored)
2012-17
£5.1m
Benchmarks show current performance in top quartile
Systematic approach to areas not covered by contracts and more robust
project management
Corporate Services
£5.3m
Benchmarking shows facilities / corporate services in upper quartile
Plans in subsequent years to evaluate opportunities against revised
footprint
Estates Rationalisation
£7.3m
Agile working with IT enablement
Increased utilisation of space ( e.g. BTC, Rowley)
Closure of peripheral buildings
£5.7m
Better value achieved from IT investments
More efficient service provision (reduced paperwork, duplication..)
More efficient clinical services
Benefits to patients/increased levels of patient satisfaction
Procurement
Strategic IT Enablement
Capacity & Demand
TOTAL
£0
Improved utilisation of Trust capacity – human, equipment and space
Contribution to other workstreams (beds, theatres, diagnostics, workforce)
£124m
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Clinical Workstream Visioning Event Example Outputs
Workstream
Summary Outputs
• Improving utilisation and reduction of clinics
and improvement of flow
• Reduce DNAs and cancellations
• Acute follow ups only for those that need it
Outpatient
Efficiency
• Access to experts via virtual clinics or
advise services
• Triage quality of referrals to make sure that
patients are directed to the appropriate
place of care.
• 7 day services
Patient Flow &
Bed Utilisation
• Patients in hospital beds that don’t need
acute care – require investment in
intermediate and community services.
• Twice daily senior clinician ward rounds and
planned date of discharge on admission.
• Improved access to timely diagnostics
• Align with decommissioning and Right Care
Right Here
• Geriatric specialist input into pathways for
older people
• Integrated MDT assessment for discharge
• Effective communication for discharge
management
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Clinical Workstream Visioning Event Example Outputs
Workstream
Summary Outputs
• Single point of access / pre-assessment –
“Boarding Pass”.
Community
Service Efficiency
• Implementation of virtual wards with
consultants linking via teleconference, home
monitoring and working closely with GPs,
Pharmacy and Community Services.
• Develop integrated pathways: Plans for next
year will include a focus on full integration of
acute and community services in three
areas: End of Life Care, Musculo skeletal
services, Diabetes care.
• Evaluate rehabilitation model across acute
and community .
• New roles across community services
(specialist vs. generic) .
• Urgent care (and chronic conditions) require
more proactive management with access to
specialist teams via virtual clinics.
• Early identification of at risk patients in
primary care and proactive case
management.
• Ambulatory care and hot clinics.
• Support of 7 day service and diagnostics
• Better use of main / DC theatres
• Enhanced recovery pathways
• Referral to treat at appropriate times
• Risk stratification at pre-assessment
• Right test every time
• 7 day service with improved reporting
Urgent Care
Theatre
Productivity
Diagnostics
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Clinical Workstream Visioning Events – Common Themes
 Efficiency and productivity
 Integration / partnership working across health economy including out of hours cover
 7 day service including improved access to timely diagnostics
 Right patient, right service - RCRH
 Single point of access
 Development of the multi professional team across the health economy
 Patient risk stratification - preoperative assessment , discharge
 Technology – as an enabler
 Workforce model
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How can we work together to transform services?
The transformation plan
is complementary to the
RCRH strategy –
implement pathway
redesign.
Identify areas to
pilot and take
Our continuous improvement
forward
program is robust but
delivers
Pathway redesign will
require changes across
the whole system
including intermediate
care and primary care
services.
Utilise our partnership
working across the health
economy.
only nominal savings yearover-year. Board is pushing to
double the improvements –
Where can
I get it from?
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Clinical Workstream Leads Contact Details
Workstream
Workstream Lead Contact Details
Outpatient Efficiency
Mr. Hamish Brown : hamish.brown@nhs.net
Patient Flow & Bed Utilisation
Dr. Matthew Lewis: matthew.lewis@nhs.net
Community Service Efficiency
Susan Lane: susanlane1@nhs.net
Urgent Care
Dr. Peter Ahee : peterahee@nhs.net
Theatre Productivity
Dr. Zoe Huish: zoe.huish@nhs.net
Diagnostics
Dr. Jonathan Benham : j.benham@nhs.net
Rachel Barlow , Chief Operating Officer: rachel.barlow2@nhs.net
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