Service Transformation Sue Thomas Florence Nightingale Scholar - - PowerPoint PPT Presentation

Service Transformation

Sue Thomas Florence Nightingale Scholar Winston Churchill Fellow CEO Wilmington Healthcare Commissioning

Aims

• To give an overview of the current NHS and drivers that

impact on MS services

• To put MS services into the context of the NHS today
• To highlight how service transformation can improve care
• To provide thoughts on which areas of your own services

might be useful to explore

The Long Term Plan for England

National Action Plan on Neuro Conditions (Scotland)

General Standards for neurological care and support

• 1. Leadership and governance
• 2. Partnership working
• 3. Staff education, training and information
• 4. Diagnosis
• 5. Assessment of needs
• 6. Treatment and management
• 7. Person- centred care

National Action Plan on Neuro Conditions (Scotland)

Patient Care – as we know it multiple organisations, with multiple contracts

Source MS Trust

Transforming and integrating care

In a traditional patient pathway care is provided by multiple organisations, with multiple contracts

Traditional patient pathway for MS

GP Hospital Trust Independent imaging providers Community Trust Mental Health Social services Ambulance Trust

The NHS is now implementing the Long Term Plan for health and social care, where all providers will need to work together as a partnership under one contract, providing care more effectively and more efficiently.

https://www.england.nhs.uk/long-term-plan/

Main influencers on care

Integration Money Workforce Technology

GIRFT "Not everything that counts can be counted; and not everything that can be counted counts."

“Getting it right first time” www.gettingitrightfirsttime.co.uk

• Using data to improve clinical practice
• Identifying cross cutting themes and facilitating people working together. Implementation teams operating across 7 regional

hubs provide a management structure to facilitate changes and support clinicians to working together in teams. There are currently 46 clinical leads across the workstreams driving forward changes.

• By tackling variations in service delivery across and by sharing best practice between trusts, GIRFT identifies changes that

will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings

• Clinical leads: Geraint Fuller and Adrian Williams
• National development of data
• Local visits to present audit

What types of services do you work in?

• Neuroscience centres
• Neurology centres with in-

patients

• DGH Neurology centres

without in-patients

• DGH with visiting neurologist

Understanding services

Source Binleys database 2018

Greater Manchester Neurosciences Centre @ Salford Royal

Wigan, Wrightington and Leigh Bolton Royal

Pennine Acute Trust Rochdale Infirmary

Royal Oldham Fairfield General North Manchester

Central Manchester &Trafford East Cheshire (Macclesfield) University Hospitals South Manchester

Greater Manchester Hub and Spoke Services

Stockport Tameside

Is the MS pathway the same across the area?

Richmond MS Pathway

Integrated Care Systems

• ICS is an evolved version of the

STP

• Are these also a potential for MS

improvement?

STP ‘s – plan on a page

Moving from organisaiton to place based care by 2021

Workforce

The workforce challenges in the NHS in England now present a greater threat to health services than the funding challenges – Kingsfund report Nov 181

– NHS Trusts face 100,000 staff shortage1 – 40,000 shortfall in nurses2 – 20,000 shortfall in mental Health Staff2 – 10% paramedic vacancy2 – 700 less GPs PA1 – 50% district Nursing Posts 2 – Brexit -

• 12.5 per cent of which is non-British and 5.6 per cent of which is from the EU.
• Brexit has created additional risks in both the short and medium term. Already, a net inflow of nurses from the

EU into the NHS has turned into a net outflow: between July 2017 and July 2018, 1,584 more EU nurses and health visitors left their roles in the NHS than joined.

• Since we cannot instantly train the extra staff that we need, which is to import the staff we need from overseas

1 https://nhsproviders.org/media/3431/workforce-project-initial-analysis-of-issues-facing-the-provider-sector.pdf 2 https://www.kingsfund.org.uk/sites/default/files/2018-11/The%20health%20care%20workforce%20in%20England.pdf

GP Contract 2019 and Directed Enhanced Services (DES)

Information technology empowering patients

Creating efficiency

£0 £1,000 £2,000 £3,000

Average Cost CCG

[Average Cost for a Non-Elective Admission, by CCG]

Highest average CCG cost £2,809 Lowest £991

Gathering intelligence

Wessex MS admissions

Kipps C, Thomas S, Matthews D (2016) Wessex Strategic Clinical Network Intelligence Report

Sue’s Summary - 10 point plan for transforming your service:

• 1. Understand the data national and local
• 2. Understand costs
• 3. Check on variation
• 4. Understand their local strategic plans
• 5. What is the patient pathway, what outcomes are

needed in your area?

• 6. DMD delivery how can you support the wider agenda
• n variation?
• 7. Promote the self-care agenda
• 8. Workforce – understand capacity
• 9. Engage the voluntary sector
• 10. Use the MS Academy for support

Thank you

Sue.Thomas@wilmingtonhealthcare.com 07801 143122