Blackpool Teaching Hospitals NHS Foundation Trust Aidan Kehoe Chief Executive.
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Transcript of Blackpool Teaching Hospitals NHS Foundation Trust Aidan Kehoe Chief Executive.
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Blackpool Teaching Hospitals NHS Foundation Trust
Aidan Kehoe
Chief Executive
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The Trust and its services….
• 330,000 catchment (1.6m Cardiac & Haematology)• Sites:
– Blackpool Victoria Hospital (577 beds)– Clifton Hospital (64 beds)– Bispham Nurse Led therapy Unit (40 Beds). Social Enterprise– Rossall Hospital (40 beds)– Wesham Hospital (40 Beds) – Currently unused– Fleetwood Hospital (Outpatients)– National Artificial Eye Service
• Turnover: £260m
• Employees: 4,000
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Background…..
• 2006 Financial Turnaround• Development of the Blackpool Way• Foundation Trust status December 2007• Patient safety – Infections / Mortality• Investment for the future
– £65m capital schemes– Alert Electronic Patient Record– Service development
• 2010/11 Financial challenge & Monitor
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Awards / Recognition…..
• National Patient Safety Awards• Investors in People Gold Award• The Information Standard Kite Mark for patient
leaflets• NHS Litigation Authority Risk Management Standard
Level 3• Imaging services accreditation scheme• Sunday Times Top 75 2010• Boorman / Macloed Reviews• Healthcare 100 – Top Acute Trust & Best Large
Employer• Healthcare People Management Association Award –
Joint working with Trade Unions
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Awards…
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Our Vision
• Quality
• Safety
• People
• Delivery
• Environment
• Cost
Quality Safety People Delivery Environment Cost
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Our Values
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Blackpool Way
• Deep Employee Engagement
• 4 Key Pillars
– Recognition
– Management style
– Communication
– Continuous improvement
• Vision and Values
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Policy Context
• Independent NHS Board
- Resource allocation
- Guide commissioning• Greater transparency• Concentration on outcomes – Advancing Quality• Communication of change• Prevention & public health• White paper – decision awaited • Real NHS growth
- Impact on other sectors
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NHS Growth Rates
0 1 2 3 4 5 6 7
Annual real spend increasesince 1948
20th century average annualincrease
21st century average annualincrease
Lowest annual average byGovernment administration
(1951 - 63)
Highest annual average byGovernment administration
(1997 - 2011)
Budget commitment for realgrowth across public sector
2011/12 onwards
Percentage Real Growth in NHS Expenditure
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Policy Context
• Patient led NHS Strengthen role of GPs in commissioning
• Primary Care Trust role commissioning• Patient choice extended to GP• Out of hospital care• More front-line control
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We know the current system has……
• High levels of avoidable hospital attendance and admission – utilisation management
• Wide variations in Length of Stay• Unacceptably high rates of readmission• Suboptimal management of chronic illnesses• An unacceptable rate of harm and error
leading to avoidable suffering and even death
• Concentration on beds rather than pathways
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The “Quality, innovation productivity & prevention gap”
Expenditure
Income
Time
£
The QIPP gap - £15 to £20 bn
BFWH - £45m
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Five Levels of Action5 - National
4 – Regional
3 - Whole health economies
2 - Organisations and their main bilateral partners
1 - Individual organisations
Lobbying upwards
Sharing best practice
Reconfiguration - doing the right thing
Not being an island of success in a sea of failure
Systematic collaboration - managers, clinicians &
support teams to improve
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Transforming Community Services (TCS)
• National policy of commissioning/provider spilt
• Requirement for Primary Care Trusts (PCTs) to divest themselves of provider arms
• Preferred providers • Development of better integrating patient
pathways• 1500 staff 60 million budget
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Transforming Community Services - Staff
Main staff groups
339 Whole time equivalent (WTE) District Nurses
172 WTE Allied health professionals (therapists)
365 WTE Paediatric services
38 WTE Community Matrons
64 WTE Community Dental
48 WTE Prisons
39 WTE Community Management
39 WTE Learning difficulties
75 WTE Sexual Health
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Transforming Community Services - Timeline
• July 2010 - Commenced working with Blackpool and North Lancs. Primary Care Trusts to prepare a business case
• September 2010 - PCTS received approval for the business case from the Strategic Health Authority
• November 2010 – March 2011 the Trust undertook a comprehensive review of the Community finance and governance arrangements
• April 2011 – present day the Trust is undergoing a review by Monitor. (Trust regulator)
• 27th June 2011 - The Trust Board will be interviewed by the Monitor Board
• 1st August 2011 - The Community services transfer and the Trust become a “New “ organisation
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Whole systems alignment
The need for partnership ….
Organisational development
Clinical systems improvement
Patients who
experience better care
without delay
High-performingpatient-centred
teams
Organisations that facilitate the work of
patient-centred teams
Environment that facilitates
the work of organisations
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Level 1 opportunities
• Workforce – staffing/pay/sickness absence
• Better Care Better Value
• Threshold management
• Innovation and informatics
• Lifestyle modification (smoking; alcohol; eating)
• Care pathways – alternatives to hospital, telehealth, self care, work with Practice Based Commissioners
• Patient centred-care. Quality costs less
• Standardisation
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Level 2/3 Issues
• Variability in risk management strategies • Standardisation• Demand management• Mutual Interdependency trumped by individual
interest• Practice based commissioning • Vertical & horizontal integration• Different models of ownership –
Collaboratives/federations/Social Enterprises
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Mindsets doomed to fail • It won’t happen• If it does, we’ll grow our way out of trouble• I’ll do what I’ve always done • No-one up there will let me make the changes I need to do • The public won’t let us do what we want to do• I’ll be OK if I do it all myself because we can never agree if
everyone’s involved• It’ll be someone else’s fault when it goes wrong• It’ll be OK if we all fail • I’ll wait ‘til it starts to bite• I’ll talk the talk• Even if it does happen, I can dodge the bullet• We can do this on our own• We’ve had to do this before and done it, so we’ll do it
again• I’m retiring anyway
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Mindsets offering best chance of success
• I’ll ensure that we’re open and transparent• We will work collaboratively• We stand together • We need to act now• Patient safety and quality will be uppermost• Success will be delivered through the Blackpool Way• We will work with partners to better manage patient
pathways• We will invest in programmes to support new ways of
working and staff development
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Admissions per ‘000 population 2008/9 By Primary Care Trusts
– England (152 PCTs)
0
50
100
150
200
250
300
350
1 8 15 22 29 36 43 50 57 64 71 78 85 92 99 106 113 120 127 134 141 148
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Admissions per 1000 population
0
50
100
150
200
250
300
350
England North West Blackpool Knowsley
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Key Projects and Measures
• Top 50% for lowest Mortality rates• Reduction in Hospital Acquired Infections• Reduction in Inpatient falls• Reduction in Hospital Acquired pressure
ulcers• Implement risk assessments to reduce risk
of blood clots• Reduction in avoidable harms – e.g
medication errors• Global Trigger Tool
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Key Projects and Measures
• Patient Experience Surveys• Nursing Indicators - Change to Nursing Care
Indicators• Advancing Quality• Productive Ward – Releasing Time to Care• Blackpool Nurses 10x10• Quality Framework• Map of Medicine
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The Way We Do Things
“Counter clockwise, Red Eagle, Always counter clockwise”
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Any Questions?
Quality Safety People Delivery Environment Cost