UCLH priorities for 2011/12 Simon Knight Acting director of performance 8 th February 2011 Not for reproduction
Aims of the session • To let you know what our plans / priorities currently are • To hear what you think of them Not for reproduction
Agenda • What’s happening across the NHS • What’s the current state of play at UCLH • Time for questions and observations • Our plans for 2011/12 • Your views on our plans • Next steps Not for reproduction
What’s happening in the NHS and at UCLH • The Health and Social Care Bill 2011 • Funding and finances • What patients say about UCLH • What members say • What GPs say • How we perform against targets Not for reproduction
The Health and Social Care Bill • Patient empowerment: “nothing about me without me” • Commissioning: GPs in the driving seat • Increased competition: “any willing provider” • Continued focus on quality: “outcomes not process”, intolerant on safety Not for reproduction
Financial challenges • Some protection for health: growth of 0.1% • Inflation for health � not as rosy as 0.1% Not for reproduction
Financial challenge Growth in Health Spending since 1999/2000 - UCLH vs. NHS (in England) as a whole 200% % growth since 1999/00 150% 100% 50% 0% 99/00 00/01 01/02 02/03 03/04 04/05 05/06 06/07 07/08 08/09 09/10 10/11 11/12 12/13 Financial Year NHS expenditure in England UCLH Turnover Not for reproduction
Financial challenges • Prices paid to hospitals reduced • We aren’t growing as quickly as in previous years • North central London has a large deficit Not for reproduction
We aren’t growing as quickly Growth in inpatient work (daycases, elective overnights, non-electives) is slowing Not for reproduction
We aren’t growing as quickly Not for reproduction
We aren’t growing as quickly •Our income grew by about 10% in 2010/11 •Currently we think our income will only grow by 2% at most in 2011/12 Which means …. •We can’t rely on growth to deliver productivity •We must start taking out costs from what we do Not for reproduction
North / central London financial problems We have a particular problem in north central London If we do nothing to save money: cumulative commissioner deficit (£) Not for reproduction
North / central London financial problems Money that commissioners want hospitals to save (£m) over next four years Not for reproduction
How do commissioners intend saving money Reducing workload Pushing out wait times Low priority procedures Reducing outpatient follow-ups Moving care to community settings Other threats to activity Total Not for reproduction
How do commissioners intend saving money Paying less for work: Non-payment for readmissions Moving daycase activity to outpatient setting/tariff Pay for repeat first appointments at follow up price Payment for activity beneath maximum price Various other threats to income Total Not for reproduction
Savings targets 2011 - 2014 Efficiency saving requirements: QEP £m Savings as proportion of 4.5% 6.9% 4. 9% 4.9% 2.5% 3.3% x% expenditure 50 45 45 40 35 31.7 31.6 29.1 30 25 21 20 Figures are for illustration only, and have 15.2 15 not been approved by UCLH Board of 10 Directors 5 0 2008/09 2009/10 2010/11 2011/12 (E) 2012/13 (E) 2013/14 (E) * (E)stimated figures that may change; 2010/11 and beyond also includes requirement for locally managed Incremental drift. Source: UCLH Finance; NHS Confederation Dealing with the downturn: using the evidence; UCLH Capital plans; UCLH annual reports 16 Not for reproduction
What patients say • UCLH performs well in patient surveys: – Overall rating of care – Would you recommend the hospital – Questions about doctors and nurses • Key areas for improvement from surveys: – Should have been admitted sooner – Printed information about condition – Some questions relating to nurses • Key lesson from complaints: booking processes Not for reproduction
What members and governors say • Key things we hear from members and governors: – Booking processes – Getting in touch with staff in the hospital – Service culture Not for reproduction
What members and governors say Feedback from survey in UCLH News: Average rankings from responses: • Deliver infection prevention 2.9 • Improve waiting times 3.8 • Meet the cancer waiting times target 3.8 • 4 hour A & E wait 4.3 • Improve response to deteriorating patients 4.4 • Reduce avoidable harm: clots, line infections 4.5 • Make it much easier to contact us 5.3 • Improve admin processes 5.8 • Maintain performance on mortality 6.1 • Show year on year improvement in surveys 6.4 Not for reproduction
What GPs say • Key things we hear from GPs, in particular from GP survey: – Booking processes – Getting in touch with staff in the hospital – Discharge communications (following A&E visit, outpatient appointment or inpatient stay) Not for reproduction
How we perform against targets Doing well • A&E 4 hour wait • 18 week waiting times • Clostridium difficile cases • Hospital standardised reported mortality • Patient surveys Not for reproduction
How we perform against targets Room for further improvement • Some of the cancer waiting times targets • MRSA cases Not for reproduction
Questions and thoughts? Not for reproduction
So what does this all mean for our plans? Not for reproduction
UCLH objectives and priorities Not for reproduction
Clinical outcomes Not for reproduction
Clinical outcomes � Maintain our strong performance on hospital mortality � Reduce avoidable emergency readmissions � Improve how we do clinical audit so that it makes a real difference to quality of care Not for reproduction
Maintain our good performance on hospital mortality � Improvements based on learning from adverse outcomes � Action on infection and other safety initiatives UCLH HSMR improvements from 1999/00 to 2010/11 Relative Risk (observed number of deaths as a percentage of 120 100 expected number of deaths) 80 60 40 20 0 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 RR Low High Data year average Not for reproduction
Reduce avoidable emergency readmissions � Hospitals not to be paid for patients who are admitted as an emergency within 30 days of being discharged from hospital � Significant lost income, but will be reinvested in reducing readmissions � More careful discharge arrangements � Working closely with community services Not for reproduction
Patient safety Not for reproduction
Patient safety � Further reduce levels of MRSA, Clostridium difficile and other key infections � Reduce avoidable harm in areas including venous thrombo-embolism, central venous line care and surgical site infections � Further improve how our staff recognise and respond to signs that patients are at risk of deterioration Not for reproduction
Further reduce levels of MRSA MRSA coming down fast …… 120 100 Number of MRSA bacteraemias 80 60 40 20 0 2002-3 2003-4 2004-5 2005-6 2006-7 2007-8 2008-9 2009- 2010- 10 11 Year Not for reproduction
Further reduce levels of MRSA ….. but not fast enough GRAPH ON MRSA HERE: page 18 of BoD pack Not for reproduction
Other key infections Work to be done in 2011/12 on MSSA and e.coli Clostridium difficile: within our targets Not for reproduction
Reduce blood clots 2010/11: focus on doing risk assessments on all patients 2011/12: focus on appropriate action on high risk patients Not for reproduction
Patient experience Not for reproduction
Patient experience � Improve our administrative processes so that patients can manage their appointments easily and with confidence. � Improve the experience of patients at our hospitals, particularly how we look after their personal needs � Make it much easier for patients, GPs and others to get in contact with the staff they need to Not for reproduction
Compared to other London hospitals Peer London Ranking against Score out of 100 teaching hospitals peers 2009 UCLH 1 78.0 Chelsea & Westminster 2 77.4 Guy’s and St Thomas’ 3 76.6 Barts and the London 4 75.4 Imperial 5 74.5 King’s College Hospital 6 74.3 Royal Free 7 73.4 St George’s 8 73.1 Not for reproduction
Improvement areas from 2010 • Should have been admitted sooner • Printed information about condition • Hand gel not available or empty • Noise from other patients and visitors • Food was fair or poor • Trust & confidence in nurses • Nurses not knowing enough about condition • Improving experience for maternity and cancer patients Not for reproduction
Patient pathways and services Not for reproduction
Patient pathways and services � Work with GPs and other partners to develop for patients the best pathways through local health services � Progress plans for phase 4 of our redevelopment, including proton beam therapy and the Mouth, Ear, Nose and Throat centre � Commission the Cancer Centre, redesigning pathways to deliver improved care Not for reproduction
Recommend
More recommend
