Hull and East Yorkshire Hospitals
NHS Trust
Delivering the Productivity & Efficiency Plan
GETTING eQIPPd WITH IM&T
(Energising Quality, Innovation, Productivity, Prevention
& Delivery)
Martyn Smith
Deputy Director of Finance &
MTPEP Programme Manager
9th APRIL, 2010
1
Hull and East Yorkshire Hospitals
NHS Trust
IM&T – THE ART OF THE POSSIBLE
or
(what has IT ever done for me?)
INFORMATICS DEPARTMENT
CUSTOMER SERVICES
Hull and East Yorkshire Hospitals
NHS Trust
QIPP
Why do we need a QIPP Transformation Programme?
•Predicted £15 to £20bn shortfall in NHS Funding from 2011
•Historic income growth trends are not sustainable
•Increased focus on risk, outcomes, location
•Increasing demand: Older people; Drugs; A&E; etc
•We need a combination of:
•21st Century Care Models
IBP
•Clinical Excellence
•Productivity & Efficiency
•Assiduous cost control
•Future (financial) health depends on this:
QIPP
MTFP
Hull and East Yorkshire Hospitals
NHS Trust
QIPP
The Operational Plan
QUALITY
UP
COST
DOWN
 MORE SERVICES CLOSER TO HOME
– Shut down acute capacity
 LESS VARIATION FOR ALL SECTORS
– Defined, mandated, Pathway based Commissioning
 NHS MONEY SPENT WISELY, TO BEST EFFECT, WITH THE BEST
POSSIBLE OUTCOMES
– Drive out waste and duplication, reward excellence, penalise
poor care and poor care models
Hull and East Yorkshire Hospitals
NHS Trust
QIPP
What Does This Mean For Us?
£12m savings in 09/10
£21m savings this year
Circa £20m savings year on year to 14/15
CANCER & CLINICAL SUPPORT
8.14
ESTATES, CORPORATE, BACK-OFFICE
18.03
8.66
MEDICINE
CARDIO & NEURO SCIENCES
9.27
17.39
9.94
WOMEN & CHILDRENS
CRITICAL CARE & THEATRES
SURGERY 1
10.45
12.13
SURGERY 2
Hull and East Yorkshire Hospitals
NHS Trust
QIPP
Making Savings: A Workstream Approach
Clinical
Pathways
STAFFING
PATIENT
CARE
SUPPORTING
PATIENT
CARE
BEST
VALUE
Management
Costs &
Back Office
Workforce
Estates
Outpatients
Theatres
Procurement
Decontamination
Leasing
Transformation
Income
Growth
Energy &
Sustainability
Risk
Management
Corporate / Business Units
DELIVERING
PATIENT
CARE
Hull and East Yorkshire Hospitals
NHS Trust
QIPP
Governing The Transformation Programme
FINANCE COMMITTEE
Exec & Non-Exec representation
MTEP Board
All Exec Directors
Programme Management Team
Martyn Smith
(Programme Manager)
Service
Improvement
Matt Clark
MTPEP Accountant
Peter Tindall
Proj Dir: Pathways
Kevin Downes
Proj Dir: Theatres
Nicky Rowan
Proj Dir: Workforce
Sue Richards
Proj Dir: Outpatients
John Taylor
Information Lead
Planning
Workstreams
Workforce
Clinical
Pathways
Theatres
Outpatients
Leasing
Estates
Clinical
Governance
Transformation
Energy &
Sustainability
Procurement
Management
Costs &
Back Office
Decontamination
& Drugs
Hull and East Yorkshire Hospitals
NHS Trust
QIPP is not a Financial Savings Programme
Clinical & Operational
Governance
Financial
Controls
QIPP
Hull and East Yorkshire Hospitals
NHS Trust
QIPP
Developing Robust Deliverability Plans
Development
Framework
STAGE 1
DROS Development
Stages & Processes
Planning & Scoping
Indicative savings
opportunity added to
MTPEP overview
FINALISED
DROS
GANTT
PLANS
Identified efficiency project
STAGE 4
Delivery & Closure
STAGE 3
Test, Review, Implement
STAGE 2
Detailed Planning
ADDED TO
TRACKER
OUTCOMES
BUDGET
ADJUSTMENT
Projects underway
PROJECT
OVERVIEW
Governance
Live Project is signed
off by BU Triumvirate
or Directors
Formal Sign-off and
Project Closure
BED REDUCTION
THEATRE CLOSURE
OPD RATIONALISATION
STAFF REDUCTION
ETC
MONTHLY STATUS REPORTS
RESOURCE
REMOVED
DRAFT DROS
STATEMENT
EXECUTIVE
REPORTS
BASELINE
BUDGET
REDUCTION
SIGN OFF
Hull and East Yorkshire Hospitals
NHS Trust
QIPP
‘Better Value’ intentions – A Commissioner View
Acute Providers
•Standardisation of tariffs and contracts
•Focus on high volume care –BCBV metrics
•Increase day surgery rates over in patient elective
•Changes in practice –stop procedures with no or limited
clinical benefit/low cost alternatives
•Coding and invoice validation
All providers
•Utilise and embed ‘Productive’ methodologies
•Skill mix changes - increase ratio of non clinical to clinical
•Increase clinician to patient facing time
•Faster diagnostics and tests
•Reduce variation in LOS
Supply Chain/
procurement
•Better medicines management
•Eradicate waste –back room functions
•Improve inventory management
•Collaborative/joint procurement to improve buying power
Care pathway
management
•Admission management for planned and unplanned
•Care planning –changes in location, follow up and patient care
•Increased use of technology to support independence
•Personalisation – empowered user and carers
Hull and East Yorkshire Hospitals
NHS Trust
IT’s the future
‘the widespread use (of computers) in
hospitals and physician’s offices will
instantaneously give a doctor or a nurse a
patient’s entire medical history,
eliminating guesswork and bad
recollection, and sometimes making the
difference between life and death’
Thomas J Watson Jnr – Chairman IBM - 1965
QIPP
Hull and East Yorkshire Hospitals
Has Our Time Finally Arrived?
QIPP
Directors of ICT Group – 2007 Time Out Conference
NHS Trust
Hull and East Yorkshire Hospitals
NHS Trust
What Do Our Organisations Want From IT Systems?
 High Performance:
– Fast; Reliable; Available; Sexy; Easy to Use
 Accessible & Flexible:
– Enough where they are needed; Use it anywhere
 Joined up (but I don’t want to lose sovereignty...)
 Improve what I do:
– Governance / Decision Making / Risk / Security
 Make my job easier not harder ……
 Cheap as Chips: but the highest quality …..
 Solve every problem we’ve got .......
QIPP
Hull and East Yorkshire Hospitals
NHS Trust
Business Cases – A Tribute to Arthur C Clarke

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Improve Governance
Improve the patient experience
Reduce Risk
Make it easier to ‘manage’
Richer, more accessible information
Eliminate errors, ‘misses’, non-compliance
Reduce costs:
– Staff; Paper; Transport; Stock; Treatment; etc
Increase Income
Minimal Support (after negotiation!)
It’s a Bargain!
You can have it tomorrow
QIPP
Hull and East Yorkshire Hospitals
NHS Trust
We Have The Answer
QIPP
Hull and East Yorkshire Hospitals
NHS Trust
So How Was It For You?






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
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You never told me about the support army!
What do you mean we didn’t buy that functionality?
But the old one did it – and faster!
But Google never crashes ......
Another day, another invoice!
Why can’t I access that?
Benefits – what benefits?
But they’re only £200 at PC World?
Don’t my opinions count?
QIPP
Hull and East Yorkshire Hospitals
NHS Trust
QIPP
Doing Business In A Cold Climate Of Austerity
Review value added & non value added activities
Improve current value added processes
Introduce ‘leaner’ processes: 10% more for 10% less
Stop / Decommission non value added
Manage impact on patients, targets, etc
New ideas – maximum bang for $
Provide evidence of business value contribution &
tangible, cash releasing benefit: if it doesn’t ‘earn’
then we don’t invest
Hull and East Yorkshire Hospitals
NHS Trust
QIPP
The Reality

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50% cut in Capital Spending (as a start)
87 Developments – 10 Approved (Provisionally)
£21m year on year Revenue Savings
Improved VFM (3 E’s) is non-negotiable
QIPP Demands Innovation
IM&T has to be at the heart of this – doesn’t it?
High-Impact Changes for IT
Delivery: converting hypothetical opportunities into
tangible, measurable, sustainable, improvements
 Failure isn’t an option
Hull and East Yorkshire Hospitals
NHS Trust
Critical Questions For IM&T
 Do we bring IMPETUS and DRIVE to the challenge?
 Can we really help the NHS become 20% more efficient?
– What answers do we have?
– Do the figures stack up?
 How can our own services become 20% more efficient?
– What do we need to start doing?
– What can we stop doing?
– What can we do differently: faster; slicker; lower cost
– Where are we not adding value?
 Have we got the resources & capacity for the job?
 What is the VISION
 What are we doing about it?
QIPP
Hull and East Yorkshire Hospitals
NHS Trust
Delivering the Productivity & Efficiency Plan
GETTING eQIPPd WITH IM&T
(Energising Quality, Innovation, Productivity, Prevention
& Delivery)
Martyn Smith
Deputy Director of Finance &
MTPEP Programme Manager
9th APRIL, 2010
20