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Maintaining high quality care – whilst delivering
efficiencies
Mr David Evans , Chief Executive
About us…..
•  Provide hospital, community and
social care (latter Northumberland
only)
•  Covering One of the largest
geographical areas
•  10 Hospital sites
•  3 DGH
•  7 Community (2 outpatient
facilities)
•  Specialist Emergency Care Hospital –
opened in 2015
•  Contrasting demography
•  affluence –v- poverty
•  Despite this one of the best Trusts in
England – strong brand and excellent
reputation but still with more to do.
Our scale……..
£471m
Staff
circa
9.5k
BEDS
11
SITES
A&E
167k
Budget
Providing care for
over 71,000
inpatients on 57
wards every year
Treat Adult Social
CARE
78k
Appointments
& home visits
5 Clinical
Business
Units
•  36k operations
•  47k day cases
•  1.4m appointments
with patients
outside of hospital
1290	
  
How do we do it…..
•  Tight	
  grip	
  on	
  the	
  money	
  
–  Board	
  through	
  to	
  ward	
  level	
  
•  One	
  of	
  the	
  few	
  Trusts	
  with	
  a	
  surplus	
  
•  Efficient	
  –	
  devolved	
  budget	
  responsibility	
  to	
  Business	
  Units	
  
–  Take	
  ownership	
  of	
  the	
  £	
  
–  Drives	
  innovaAon	
  within	
  teams	
  
•  Buy	
  back	
  PFI	
  –	
  yield	
  £3.5m	
  per	
  year	
  	
  
•  Healthy	
  commercial	
  business	
  –	
  invests	
  in	
  new	
  innovaAons	
  across	
  
the	
  organisaAon	
  and	
  workforce	
  
•  Recognise	
  that	
  quality	
  service	
  supports	
  efficient	
  prac5ce	
  –	
  ge7ng	
  
it	
  right	
  first	
  5me	
  is	
  cheaper	
  
Managing the money..
Priori5sing	
  safety	
  
• 95%	
  mrsa	
  reducAon	
  over	
  6	
  years	
  and	
  81%	
  reducAon	
  in	
  trust	
  
apporAoned	
  c-­‐difficile	
  rates	
  over	
  5	
  years	
  
• 80+%	
  reducAon	
  in	
  orthopaedic	
  surgical	
  site	
  infecAon	
  within	
  4	
  
years	
  
• 40+%	
  reducAon	
  in	
  hip	
  fracture	
  mortality	
  since	
  2010	
  
• Trust	
  wide	
  bundle	
  compliance	
  for	
  all	
  paAents	
  with	
  sepsis	
  	
  
improving	
  from	
  10%	
  in	
  Aug	
  2014	
  to	
  55%	
  by	
  September	
  2015	
  	
  
	
  
A	
  culture	
  	
  
focused	
  on	
  
listening	
  
and	
  
improving	
  
•  CQC	
  Band	
  6	
  (	
  low	
  risk	
  )	
  raAng	
  in	
  intelligence	
  
monitoring	
  	
  reports	
  	
  
•  Safety	
  walk	
  arounds,	
  15	
  steps,	
  quality	
  panels,	
  safety	
  
films	
  relaAng	
  to	
  SUI’s,	
  external	
  	
  and	
  peer	
  reviews	
  
•  High	
  reporter	
  of	
  safety	
  incidents	
  –	
  top	
  quarAle	
  
•  Mortality	
  review	
  and	
  focus	
  on	
  eliminaAng	
  avoidable	
  
harm	
  
	
  
A	
  culture	
  	
  
focused	
  on	
  
listening	
  
and	
  
improving	
  
Priori5sing	
  safety	
  
A	
  culture	
  	
  
focused	
  on	
  
listening	
  
and	
  
improving	
  
The Times 25/7/2015
Seven-day work is no big deal . Our staff have done it for
years
A hospital boss says his colleagues and patients are happy blazing a trail for
Jeremy Hunt’s plans.
‘ Everyone ’ says David Evans , “ sees us as weird…we’ve been quietly doing
seven-day working since 2004” says Mr Evans , the Medical Director of
Northumbria NHS Trust. “ It just so happens that we find we now align
with the things coming from the minister.”
Continuous improvement
•  50k patients independently surveyed
every year
•  Multi-award winning program
•  Leading the way nationally
•  Making a real difference at a ward level
•  Making a real difference to the
experiences for our patients
Open	
  reporAng…..	
  
What next…..
Already	
  on	
  our	
  Journey……	
  	
  
•  Accountable	
  Care	
  OrganisaAon	
  will;	
  
–  Deliver	
  a	
  beber	
  service	
  to	
  paAents….at	
  reduced	
  costs	
  
–  Use	
  simple	
  outcome	
  measures	
  that	
  are	
  not	
  burdensome	
  –	
  but	
  
collecAvely	
  owned	
  
–  Develop	
  contacts	
  that	
  incenAvise	
  integraAon	
  and	
  paAent	
  self-­‐	
  
management	
  
–  Develop	
  soluAons	
  to	
  legal	
  and	
  IT	
  barriers	
  that	
  inhibit	
  integraAon	
  
–  Create	
  a	
  culture	
  to	
  assist	
  further	
  integraAon	
  
–  Joining	
  up	
  teams	
  will	
  join	
  up	
  care	
  
–  Greater	
  innovaAons,	
  learning	
  and	
  conAnuous	
  improvement	
  	
  
Evolving	
  our	
  	
  
Health	
  System….	
  
What	
  are	
  we	
  trying	
  	
  
to	
  achieve….	
  
•  Beber	
  paAent	
  experience	
  from	
  hospital	
  
through	
  to	
  community	
  and	
  social	
  care	
  
•  Streamlined	
  discharge	
  
•  New	
  model	
  showing	
  early	
  signs	
  of	
  significantly	
  
reduced	
  length	
  of	
  stay	
  
•  RelaAonships	
  are	
  essenAal	
  to	
  success	
  
•  SupporAng	
  our	
  collecAve	
  sustainability	
  
Learning	
  to	
  date….	
  
Thank you

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Maintaining high quality care - whilst delivering efficiencies

  • 1. Maintaining high quality care – whilst delivering efficiencies Mr David Evans , Chief Executive
  • 2. About us….. •  Provide hospital, community and social care (latter Northumberland only) •  Covering One of the largest geographical areas •  10 Hospital sites •  3 DGH •  7 Community (2 outpatient facilities) •  Specialist Emergency Care Hospital – opened in 2015 •  Contrasting demography •  affluence –v- poverty •  Despite this one of the best Trusts in England – strong brand and excellent reputation but still with more to do.
  • 3. Our scale…….. £471m Staff circa 9.5k BEDS 11 SITES A&E 167k Budget Providing care for over 71,000 inpatients on 57 wards every year Treat Adult Social CARE 78k Appointments & home visits 5 Clinical Business Units •  36k operations •  47k day cases •  1.4m appointments with patients outside of hospital 1290  
  • 4.
  • 5. How do we do it…..
  • 6. •  Tight  grip  on  the  money   –  Board  through  to  ward  level   •  One  of  the  few  Trusts  with  a  surplus   •  Efficient  –  devolved  budget  responsibility  to  Business  Units   –  Take  ownership  of  the  £   –  Drives  innovaAon  within  teams   •  Buy  back  PFI  –  yield  £3.5m  per  year     •  Healthy  commercial  business  –  invests  in  new  innovaAons  across   the  organisaAon  and  workforce   •  Recognise  that  quality  service  supports  efficient  prac5ce  –  ge7ng   it  right  first  5me  is  cheaper   Managing the money..
  • 7. Priori5sing  safety   • 95%  mrsa  reducAon  over  6  years  and  81%  reducAon  in  trust   apporAoned  c-­‐difficile  rates  over  5  years   • 80+%  reducAon  in  orthopaedic  surgical  site  infecAon  within  4   years   • 40+%  reducAon  in  hip  fracture  mortality  since  2010   • Trust  wide  bundle  compliance  for  all  paAents  with  sepsis     improving  from  10%  in  Aug  2014  to  55%  by  September  2015       A  culture     focused  on   listening   and   improving  
  • 8. •  CQC  Band  6  (  low  risk  )  raAng  in  intelligence   monitoring    reports     •  Safety  walk  arounds,  15  steps,  quality  panels,  safety   films  relaAng  to  SUI’s,  external    and  peer  reviews   •  High  reporter  of  safety  incidents  –  top  quarAle   •  Mortality  review  and  focus  on  eliminaAng  avoidable   harm     A  culture     focused  on   listening   and   improving   Priori5sing  safety  
  • 9. A  culture     focused  on   listening   and   improving  
  • 10. The Times 25/7/2015 Seven-day work is no big deal . Our staff have done it for years A hospital boss says his colleagues and patients are happy blazing a trail for Jeremy Hunt’s plans. ‘ Everyone ’ says David Evans , “ sees us as weird…we’ve been quietly doing seven-day working since 2004” says Mr Evans , the Medical Director of Northumbria NHS Trust. “ It just so happens that we find we now align with the things coming from the minister.”
  • 11.
  • 12.
  • 13. Continuous improvement •  50k patients independently surveyed every year •  Multi-award winning program •  Leading the way nationally •  Making a real difference at a ward level •  Making a real difference to the experiences for our patients
  • 16. Already  on  our  Journey……    
  • 17. •  Accountable  Care  OrganisaAon  will;   –  Deliver  a  beber  service  to  paAents….at  reduced  costs   –  Use  simple  outcome  measures  that  are  not  burdensome  –  but   collecAvely  owned   –  Develop  contacts  that  incenAvise  integraAon  and  paAent  self-­‐   management   –  Develop  soluAons  to  legal  and  IT  barriers  that  inhibit  integraAon   –  Create  a  culture  to  assist  further  integraAon   –  Joining  up  teams  will  join  up  care   –  Greater  innovaAons,  learning  and  conAnuous  improvement     Evolving  our     Health  System….  
  • 18. What  are  we  trying     to  achieve….  
  • 19. •  Beber  paAent  experience  from  hospital   through  to  community  and  social  care   •  Streamlined  discharge   •  New  model  showing  early  signs  of  significantly   reduced  length  of  stay   •  RelaAonships  are  essenAal  to  success   •  SupporAng  our  collecAve  sustainability   Learning  to  date….