The University of SalfordVisiting Professor Series

10 November 2011

The Changing NHS

Duane Passman Director of 3Ts, Estates & Facilities,

Brighton & Sussex University Hospitals NHS Trust

Visiting Professor, University of Salford

Duane Passman – Major Projects

• The Current NHS;• The Future NHS;• Future Challenges;• The 3Ts Programme.

Overview

The Current NHS (1)Department of Health

•Policy & Direction;•Standards & Resources;•Choice

Strategic Health Authorities

•Performance Management;•Strategic Capital;•Developing local strategies

Primary Care Trusts

•Commissioning Services;•Delivery of Primary and Community Services;•Improving Health

NHS Trusts and FTs

•Delivery of Acute and MH Services

Monitor

•FT Authorisation;

•Independent Regulator

• One DH (sometimes);• 4 SHA Clusters (10 legal bodies);• Circa 50 Primary Care Trust Clusters

(151 legal bodies);• Circa 240 NHS Trusts (inc FTs);

– 140 FTs (41 mental health and 3 Ambulance);

– Still broadly 100 to become FTs;

– Mergers expected.

The Current NHS (2)

• 10 SHAs: – Overall strategy and leadership;– Overview of health system and developing

market;– High quality commissioning of services;– PCT Performance Management;– Developing strategic alliances;– Governance & corporate responsibility;– Capability and capacity building.

The Current NHS (3)

• 151 PCTs: – Guarantee access and choice;– Health promotion and protection (links to

Local Authorities);– Support and reinforce patient-led NHS

• Market information;• Public engagement;• Local target setting;

– Performance management of providers.

The Current NHS (4)

The Future NHS (1)

DH

NHS Commissioning

Board

ClinicalCommissioning

Groups

Monitor

FTsNHS

Trusts

SenatesHealth &

Well-BeingBoards

OtherProviders

• More FTs;• Increased Shared Services:

• Finance;

• Back-office.

• Greater plurality – independent sector, local authorities, third sector;

• Greater role for GPs and Local Authorities.

The Future NHS (2)

• One national framework – accountability for outcomes;

• Five domains – of responsibility:– Preventing people dying prematurely;

– Enhancing quality for life for people with LTCs;

– Recover from ill-health or injury;

– Positive experience;

– Safe environment.

The Future NHS (3)

• Ten overarching indicators;• 31 improvement areas;• 51 indicators to measure improvement

(in development).

The Future NHS (3)

• Cost:– National tariff – to be set by Monitor as

economic regulator;

– Same payment for same procedure to encourage efficiency;

– Local variance.

The Future NHS (4)

• Economic Climate:– More for less – 5% (at least) CIPs;

– Less public capital available;

– Poor liquidity in private markets (for larger schemes);

– Sustainability;

– Continuous improvement.

(same slide as 2009!)

The Future NHS (5)

Royal Sussex County Hospital CampusProposed Redevelopment Area (red boundary)

Barry & Jubilee Buildings

Barry & Jubilee Buildings

• £420m project, 91,000 m2

• Design using integrated BIM;• Examining in-use energy and water

(with Matthew Bacon);• Occupancy analytics;• BIM and Operational Facilities

Management;• Benefits realisation.

3Ts in Brighton