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The Pressures The Pressures of Sustainability of Sustainability

in the NHSin the NHSPaul Holt Paul Holt Director of Estates Director of Estates

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‘The management of an organisation’s total impact upon both its immediate stakeholders and upon the society within which it operates………..accounting for a wide range of criteria relating to the financial, environmental and social implications of business operations.’

DTI/CRG Report – Changing Manager Mind-sets (2003)

Defining Sustainability Defining Sustainability

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Pressure or PleasurePressure or Pleasure

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Pressure or PleasurePressure or Pleasure

THE DAY JOB

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Provide high quality, accessible and responsive services by putting the patient at the heart of everything we do

The Trust’s values & missionThe Trust’s values & mission

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COMMUNITYFINANCESERVICESTAFF

Corporate ObjectivesCorporate Objectives

Department / team objectives1 year timeframe

Corporate objectives1 year timeframe

Strategic objectives3-5 year timeframe

Individual objectives1 year timeframe

PATIENTS

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Strategic objectivesStrategic objectives

Avoid needless deaths by providing effective, evidence-based care, reducing HSMR to 80 by 2012

Continually improve patient and family experience: achieve top 10% in national patient satisfaction survey

Be in the top 5% of Trusts nationally by April 2013

Ensure financial security: achieve a Monitor risk rating of 4 or better every year in the medium term plan

Develop and sustain a valued, motivated and skilled workforce to deliver excellent patient care

Leaders use lean techniques to inspire, drive and sustain a culture of continuous improvement

Avoid needless harm by providing safe and clean care to all patients

Business Groups and Directorates proactively contribute to corporate social responsibility (CSR)

Ensure national targets are met, achieving NHS Operating Framework requirements each year

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Provide high quality, accessible and responsive services by putting the patient at the heart of everything we doProvide high quality, accessible and responsive services by putting the patient at the heart of everything we do

Trust Business Plan by Strategic ObjectiveTrust Business Plan by Strategic Objective

Improve minimum ward standardsImprove minimum ward standards

Efficient and effective utilisation of beds and theatres

Efficient and effective utilisation of beds and theatres

Improvement embedded in business groups’agendas

Improvement embedded in business groups’agendas

Deliver clinical income targets Deliver clinical income targets

Include CSR objectives in bg business plans

Include CSR objectives in bg business plans

Comprehensive workforce plans created and implemented

Comprehensive workforce plans created and implemented

Reduce MRSA to zeroReduce MRSA to zero

Meet mixed sex accommodation standards

Meet mixed sex accommodation standards

Reduce ALoS for Medical patients from 8.5 to 8.0 days

Reduce ALoS for Medical patients from 8.5 to 8.0 days

First class leaders undertaken by 75% per cent of clinical managers

First class leaders undertaken by 75% per cent of clinical managers

Deliver planned activity and performance within expenditure budget

Deliver planned activity and performance within expenditure budget

Extend VLS to more departments and increase placements

Extend VLS to more departments and increase placements

80% of Trust staff have an annual appraisal

80% of Trust staff have an annual appraisal

Screen 100% of elective patients for MRSA

Screen 100% of elective patients for MRSA

Address reasons for patient complaints reliably

Address reasons for patient complaints reliably

Deliver 4% improvement in efficiency and productivity

Deliver 4% improvement in efficiency and productivity

Deliver 4% improvement in efficiency and productivity

Deliver 4% improvement in efficiency and productivity

Achieve CMIP target reductions Achieve CMIP target reductions

96% of staff demonstrate commitment by reliable attendance

96% of staff demonstrate commitment by reliable attendance

Reduce hospital acquired C.diff.Reduce hospital acquired C.diff.

Reduce MRSA to zeroReduce MRSA to zero

Reduce hospital acquired C.diff.Reduce hospital acquired C.diff.

improve recognition of the acutely unwell patient

improve recognition of the acutely unwell patient

Reduce harm from patient fallsReduce harm from patient falls

Improve efficiency and reliability of patient identification

Improve efficiency and reliability of patient identification

Engage with patients & service users to obtain feedback

Engage with patients & service users to obtain feedback

CQC rates Stockport FT as ‘excellent’ for use of resources

CQC rates Stockport FT as ‘excellent’ for use of resources

Implement and use service line reporting system for bg monitoring

Implement and use service line reporting system for bg monitoring

Reduce staff travel to work in single occupant cars by 0.5%

Reduce staff travel to work in single occupant cars by 0.5%

Deliver minimum standards for all cancer patients

Deliver minimum standards for all cancer patients

Act on all areas for development identified in patient surveys

Act on all areas for development identified in patient surveys

Deliver capital programme within budget

Deliver capital programme within budget

Reduce non-clinical landfill and increase recycling

Reduce non-clinical landfill and increase recycling

Deliver minimum referral to treatment pathway standards (18 wks)

Deliver minimum referral to treatment pathway standards (18 wks)

Ensure all services and policies are impact assessed for E&D

Ensure all services and policies are impact assessed for E&D

Standardise existing and new Service Level Agreements

Standardise existing and new Service Level Agreements

Increase local purchasing Increase local purchasing

Consistently deliver ED waiting times performance standards

Consistently deliver ED waiting times performance standards

Increase membership involvement and activity

Increase membership involvement and activity

Deliver performance standard for thrombolysis

Deliver performance standard for thrombolysis

improve outcomes for patients with #NoF

improve outcomes for patients with #NoF

Improve care through Advancing Quality

Improve care through Advancing Quality

Increase survival through additional, effective evidence-based practices

Increase survival through additional, effective evidence-based practices

Create efficient & effective complaint response and resolution process

Create efficient & effective complaint response and resolution process

StockportNHSFT2011-12

StockportNHSFT2011-12

Patientexperience

Patientexperience

WorkforcedevelopmentWorkforce

developmentImprovement

cultureImprovement

cultureTop 5% of

TrustsTop 5% of

TrustsFinancialsecurity

Financialsecurity CSRCSRNational

targetsNationaltargets

Avoid needless harm

Avoid needless harm

Avoid needless deaths

Avoid needless deaths

Productive ward objectives metProductive ward objectives met

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Medicine W & C D&CS ElectiveServices

Ensure CSR objectives in Business Group by March 2012

Ensure CSR objectives in Business Group by March 2012

Continue to develop relationships with 3rd sector providers

Reduce staff travel costs

Continue to develop links with Children’s Trust and sub-groups to improve links with other orgs

Increase number of volunteers

Business Group DeliveryBusiness Group Delivery

Organise open days for local community

Encourage staff to use public transport, car sharing & cycling

Offer work experience placements

Provide school talks about careers in the NHS

Ensure all new equipment is energy efficient

Encourage staff to use public transport, car sharing & cycling

Identify areas with all depts to extend and increase placement for VLS

Identify key areas and materials for which recycling can be increased by raising awareness

Ensure all new equipment is energy efficient to contribute towards carbon footprint

Reduce amount of paper usage & maximise opportunities within digital dictation

Estates Facilities

Source equipment & materials locally where possible by communications with procurement

Sustainable CapitalProgram

SustainableAgenda

Facilities LiaisonSustainable

Agenda

CMIP Agenda

Deliver CSR

EnergyManagement

WaterManagement

Reduce dependence on

landfill

WaterManagement

Deliver a workable solution

to encourage car share

Continue involvement and

Commitmentto VLS

Extend use of electric vehicles

Deliver recycling plan

Identify local purchasing

opportunities

Improve education for clinical waste

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Progress against the Strategic ObjectiveProgress against the Strategic Objective

Include CSR objectives in bg business plans

Include CSR objectives in bg business plans

Extend VLS to more departments and increase placements

Extend VLS to more departments and increase placements

Achieve CMIP target reductions

Achieve CMIP target reductions

Reduce staff travel to work in single occupant cars by 0.5%

Reduce staff travel to work in single occupant cars by 0.5%

Reduce non-clinical landfill and increase recycling

Reduce non-clinical landfill and increase recycling

Increase local purchas/ing

Increase local purchas/ing

Increase member’sinvolve/ment and activity

Increase member’sinvolve/ment and activity

RAG rating RAG rating

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�Increased our performance by 13%

�Achieved 60 % score of the – Good Corporate Citizenship score card

CSR – Current PerformanceCSR – Current Performance

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• Environment– 1st Impressions � Regular Inspection agenda &

scoring mechanism� Focussed investment in those

areas of most need� Reducing clutter & improving

storage� Brightening up clinical areas � Developing plans to create a

‘Ward charter standard’ that we all aspire to maintain

� Strong/positive PEAT scores

Estates & Facilities - Specific HighlightsEstates & Facilities - Specific Highlights

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Estates - Specific HighlightsEstates - Specific Highlights• Carbon Management

Implementation Plan� Exemplar document – Carbon Trust� Mitie – Energy Partners preparing a

strategic plan� Capital Investment of £ 300k per

annum� Seeking external Salix funding to

complete the ‘Big Bang’� Influencing the development of the

site through advice and guidance� Appointment of energy champions� Helps deliver the CRP

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Facilities - Specific HighlightsFacilities - Specific Highlights• Transport

– Travel Plan

� Ratified by the Board & the Local Authority

� Regular TRICS survey� Roll out of bike facilities� Improved walking access across

the site for people wheelchair users

� Promoted through the Team Brief

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• Waste– Recycling

� Commercial plastic bottles

� Waste Cardboard � Waste paper � Majority of construction

waste� Procurement methods

reduce waste at source� Recycling of computers� Food waste is reduced

to a liquid and put down the drain

Facilities - Specific HighlightsFacilities - Specific Highlights

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Finance Specific HighlightsFinance Specific Highlights• Procurement

– How to guide is allowing greater access to local contractors to tender

– Involved in ‘Meet the Buyer’ events– Probably 80% of companies we

use are Manchester based – Design development considerate of

the BREEAM standard– Southern Sector main supplier –

MTX– Expect P 21+ partners to procure

through the local economy

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Summary Summary

Despite the increasing economic pressure� A good start � Demonstrated through the values being

embedded within the Corporate Objectives� Delivered through Divisional objectives� Evidenced with a growing list of real outcomes� Saving Money & the environment

We can keep our ethical principles whilst facing the economic challenges remembering………….

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The Trust’s values & missionThe Trust’s values & mission

Provide high quality, accessible and responsive services by putting the patient & Sustainability at the heart of everything we do