Post on 20-Mar-2016
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Have you found your Valentine?Have you found your Valentine?Ask at the registration desk!
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DVD 1: Introduction
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Right First Time 24/7Staff workshop 14 February 2014
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Sue JacquesChief Executive
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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!
Share your questions, thoughts and ideas…
Have you found your Valentine?Have you found your Valentine?
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Right first time 24/7Our evolving clinical and quality strategy
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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”
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The case for change
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“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.”
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“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.”
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“Patients are regularly boarded onto surgical wards.
Patients are waiting in A&E for beds to become available for them to be admitted.”
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“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.”
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“Recent surveys of medical trainees show that the Trust is not a placement of choice for junior doctors.”
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“We are experiencing difficulties in recruiting to nursing vacancies, where we want to make ward managers and team leaders supernumerary and strengthen teams.”
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“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.”
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In addition, there are issues from :
•HSMR data•Incidents•Coroner reports
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National financial context
£30bn gap
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Local context: Better Care Fund 2015/16
D/ton DDES N Durham Total
Total Fund Contribution
£7.2m £22m £17.2m £46.4m
Supporting Existing Health Services
£3.9m £11.9m £9.2m £25.1m
Impact on acute services at CDDFT
£3.1m £6.2m £6.3m £15.6m£15.6m
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Local context: Better Care Fund 2015/16
D/ton DDES N Durham Total
Total Fund Contribution
£7.2m £22m £17.2m £46.4m
Supporting Existing Health Services
£3.9m £11.9m £9.2m £25.1m
Impact on acute services at CDDFT
£3.1m £6.2m £6.3m £15.6m£15.6m
We are also seeing the impact of new commissioning arrangements, especially on Health
and Wellbeing services.
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“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.”
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“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.”
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Right first time 24/7How do we respond?
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Our vision Right personRight placeRight timeFirst time 24/7
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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
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“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:
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“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:
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“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:
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“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.”
A cultural shift is required:
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Getting involvedToday’s event!One hour roadshowsMeetings with the project teamService transformationClinical reference group…
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Proposed Workstreams
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Proposed Workstreams
Interested? Why not sign up over coffee?
What do our stakeholders say?
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
acute services
We need credible alternatives to hospital admission
Everybody up!
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The15%challenge
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Working with your Valentine:What skills will our workforce need with 15% of work shifting out of an acute setting?
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Coffee
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DVD2: Front of house
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Doing things differently:
Unscheduled care – Derek and StuartIntermediate care – Debbie and LindaSurgery and diagnostics – Janet and Ian
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DVD3: Surgical CDU
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Discussions questionsCare 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?
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DVD4: Care co-ordination centre
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DVD5: CREST
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ALTC: unscheduled care
The action plan
Work being done in ED
ECIST
Discussion
How can we support the action plan for unscheduled care within our services
How can this contribute to 15% challenge
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Surgery and diagnostics
Focus on surgical specialties and what they are doing to support unscheduled care
CDU and the no pyjamas pathway
CT pilot – removing unnecessary waits
Reference to business case as route in to centres of excellence
Discussion
Are there other area where we could be removing unnecessary waits
Are there other areas where we could assess before we admit
How can this help the 15% challenge
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Feedback by ACOOs
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Lunch
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Friends andFamily Test
“How likely are you to recommend us to your friends and family if they needed similar care or treatment?”
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Friends and family test…
Would you recommend your friends and family to be treated in your service?
Ask not…Ask not…what your country what your country can do for you…can do for you…
Ask…Ask…what you can do for what you can do for your country.your country.
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Getting better all the time…What can I do to improve my service?What could my team do to improve our service?
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Getting better all the time…
What can I do to improve my service? – personal pledge for the pledge boardWhat could my team do to improve my service? – take to your team meeting
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Introducing the senior team…Questions and answer forum
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DVD6: Prevention first
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Taking Action in 2014/15Care groups have been working on their plans
We have to submit 2 and 5 year plans over the next few months
We need a robust “winter” surge plan
2014/15 is a big year in terms of activity, big year in terms of change
15% challenge
What are our breakthroughs for 2014/15?
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Tea
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Care group “huddles”
What are our breakthroughs?
What are the priorities for 2 and 5 years
What are our priorities for the “winter” surge plan?
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Feedback
Breakthrough areas from each care group
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Next steps
Staff workshops and roadshows
Working with partners on Better Care Fund proposals
Submitting 2 year and 5 year plans
Developing a robust winter plan for 2014/15
Meeting required national and local standards (SeQuIHS)