Future Configuration of Hospital Services Full Business Case Trust - - PowerPoint PPT Presentation
Future Configuration of Hospital Services Full Business Case Trust Board 16 April 2012 Encouraging Taking Pride Putting Honesty Being a Working and Individual in our Work Patients And Clinically-Led Collaborating Ability and and
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Putting Patients First Honesty And Integrity Being a Clinically-Led Organisation Working and Collaborating Together Encouraging Individual Ability and Creativity Taking Pride in our Work and our Organisation
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Putting Patients First Honesty And Integrity Being a Clinically-Led Organisation Working and Collaborating Together Encouraging Individual Ability and Creativity Taking Pride in our Work and our Organisation
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Putting Patients First Honesty And Integrity Being a Clinically-Led Organisation Working and Collaborating Together Encouraging Individual Ability and Creativity Taking Pride in our Work and our Organisation
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Putting Patients First Honesty And Integrity Being a Clinically-Led Organisation Working and Collaborating Together Encouraging Individual Ability and Creativity Taking Pride in our Work and our Organisation
All of these changes actively improve the Trust’s preferred option; and have all been incorporated into the proposed solution set out within the FBC.
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Putting Patients First Honesty And Integrity Being a Clinically-Led Organisation Working and Collaborating Together Encouraging Individual Ability and Creativity Taking Pride in our Work and our Organisation
£968,000 Capital charge £55,000 Dividend £2,252,000 Impact on I&E £1,229,000 Interest £35,000,000 Loan at OBC £968,000 Capital charge £1,118,000 Dividend £2,086,000 Impact on I&E
£35,000,000 Investment at FBC
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Putting Patients First Honesty And Integrity Being a Clinically-Led Organisation Working and Collaborating Together Encouraging Individual Ability and Creativity Taking Pride in our Work and our Organisation
The Trust has continued to seek all appropriate assurances for the proposed reconfiguration in the development of this FBC. This has included four key elements. These were:
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Putting Patients First Honesty And Integrity Being a Clinically-Led Organisation Working and Collaborating Together Encouraging Individual Ability and Creativity Taking Pride in our Work and our Organisation
Proposal for an additional isolation cot on neonatal unit Joint working with Wolverhampton neonatologists – training & development and potential for shared posts Neonatology services ‘Skills Drills’ broadened to include transfers from MLUs Working with Powys Teaching Health Board to review policies and processes in place to assess levels of risk in pregnancy Maternity services Working hard with parents and families on the design and feel of the new unit, which will be third bigger and will have dedicated outside space Day treatment facilities, access to high dependency beds and ability to separate
Inviting everyone who took part in fundraising to be part of task group to decide on legacy Paediatric Oncology PAU at RSH adjacent to A&E Process and guidelines for triage and safe transfer of patients Clinical staff heavily involved in design and development Paediatric services
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Putting Patients First Honesty And Integrity Being a Clinically-Led Organisation Working and Collaborating Together Encouraging Individual Ability and Creativity Taking Pride in our Work and our Organisation
Patient and public focus groups set up for women’s, children’s, children’s
Regular newsletters, articles and adverts Updates provided at town councils, LJCs and community meetings Staff focus groups feeding into Clinical Working Groups Public & staff engagement AAA screening programme Planning and discussion for consolidation of Surgery at RSH and transfer of inpatient Head and Neck services to PRH in 2012 Acute surgery Cross-border agreement – WMAS and WAS Transport and Travel Plan due summer 2012 - Patient and public survey underway Focus groups for staff and patients on travel and transport to feed into plan Travel and Transport
Single site provision is more attractive than split site services for training, working and development Medical staff recruitment challenges and the implications of EWTD are exacerbated through difficult working environments, on-call commitments and numbers of patients to be managed Medical staff recruitment The consolidation of services onto a single site will enable single speciality rotas and enhanced senior clinician cover Changing training programme for doctors resulting in earlier specialisation, a lack of skills in techniques doctors have not been trained to deliver and a disappearing middle grade workforce Changing training programme for doctors A new, fit for purpose Women and Children’s Unit is created which includes two
along with antenatal and outpatient clinics. Relocated and improved accommodation for the Women and Children’s services at RSH will be provided. Poor physical environment in the Women and Children’s departments at RSH, as well as the need to provide additional obstetric theatre capacity to support the number of births in the county Poor facilities for Women and Children A single inpatient site for paediatrics will enable a sustainable medical rota to be
high dependency care. The majority of children will continue to be seen in-hours and in the PAUs at both sites (as now). Children requiring inpatient care who attend RSH in the future will be stabilised if required and transferred to the inpatient unit PRH Sustainability of inpatient paediatrics on two sites including: challenge of providing 24-hour senior paediatric input; maintaining accreditation for doctors in training; a reliance on staff/middle grades; and an inability to develop services such as high dependency care Sustainability of inpatient paediatrics A single inpatient site for emergency and elective surgery will enable patients to be managed in the right subspecialty by appropriately trained and experienced medical staff via separate rotas for vascular and general surgery. Training places for junior doctors will be more attractive and locum dependency is reduced Sustainability of acute surgery on two sites including: delays of transfer into appropriate units/beds; delays in access to specialised senior clinical input; a lack of confidence to manage patients out of own surgical expertise Sustainability of acute surgery Expected benefit and impact Current issue
Page 11- Summary document
£34,872,580
£6,625,028 £28,247,552 Total (3rd Quarter 2012)
£1,090,911 £149,717 £941,194 Inflation to start on site 3rd Quarter 2012 £33,781,669 £6,475,311 £27,306,358 Total (at Reporting level BIS Pubsec 173) £4,611,000 £844,606 £3,766,394 VAT £29,170,669 £5,630,705 £23,539,964 Sub - Total £323,864 £110,406 £213,458 Optimism Bias £391,605 £108,241 £283,364 Planning Contingencies £502,592 £0 £502,592 Equipment Costs £374,000 £0 £374,000 Land £716,791 £162,298 £554,493 Non Works Costs (excluding Land) £3,543,069 £724,105 £2,818,964 Fees £23,318,747 £4,525,655 £18,793,092 Works cost (at Reporting level BIS Pubsec 173)
Total Royal Shrewsbury Hospital Princess Royal Hospital
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OBC FBC 2012/13 2013/14 2012/13 2013/14 Reference To WTE £000 WTE £000 WTE £000 WTE £000 Paediatrics Consultants 0.4 45 0.4 59 Junior Doctor Banding Supplement (25) (25) (25) (2.0) (233) Associate Specialist PA requirements (0.6) (45) (45) SHOs (2.0) (88) APNP 4.0 258 4.0 2581 Qualified Nurses 4.19 263 10.1 310 Unqualified Staff 1.8 15 3.87 16 Neonatal Women’s Services Surgery Qualified Nurses (4.12) (160) (10.11) (341) Unqualified Staff (1.14) (24) (3.15) (72) Head and Neck Qualified Nurses (0.88) (36) (3.7) (125) Unqualified Staff 0.5 9 0.32 6 TOTAL 4.0 233 (1.85) (46) 4.0 2331 (4.27) (425)
4 new Advanced Paediatric Nurse Practitioners – 1 in post , 2 in training, 4th being recruited Additional consultant hours 10 additional qualified nurses 3.8 additional unqualified staff
TOTAL COST
Total Capital Charges
PDC
Capital Charges 94 94 94 94 94 94
Total Non Pay
399 399 399 399 399 399
Non Pay 426 426 426 426 426 426 426 Total Pay 120 120 120 120 120 120 120 Head and Neck
Women and Children 413 413 413 413 413 413 413 Surgical Pay 286 286 286 286 286 286 186 186 Total Income 100 100 100 100 100 100
186 186 186 186 186 186 186 186 AAA Screening Income £000 £000 £000 £000 £000 £000 £000 £000 2019/20 £000 2018/19 2017/18 2016/17 2015/16 2014/15 013/14 2012/13
I&E Account impact
2.6 2.7 2.8 2.0 0.2 Surplus after service improvements
Revenue effect of reconfiguration 3.9 4.0 4.1 3.8 0.4 Surplus after CIP 27.3 26.3 25.3 24.3 10.5 PWC Schemes - see section below 29.6 22.0 14.5 7.7 3.1 Trust Schemes – see section below CIP
Result before CIP
Finance Costs
Non Pay
Pay 285.2 286.4 287.6 288.4 302.5 Income £000 £000 £000 £000 £000 2016/17 2015/16 2014/15 2013/14 2012/13
Begin implementation including moving some services, training staff and putting new pathways in place Summer 2012 New women and children’s unit expected to open at PRH. All reconfigured services expected to be in place July 2014 Refurbishment programme starts RSH. September 2012 Start publicity about the changes so people know where they should go for their care and treatment Late 2013
Ongoing Continue to work with patients, carers, the public and staff to develop future services and address issues and concerns 24 May 2012 Decision on the Full Business Case by SHA August 2012 Main construction works start at PRH.