Using the Model Hospital to Improve Productivity · [email protected] Using the Model...

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Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of Model Hospital and Analytics Dan Cariad Policy and Strategy Lead, Model Hospital Laura Langsford Model Hospital and GIRFT Programme Manager, University Hospitals Plymouth NHS Trust @ExpoNHS #Expo18NHS https://model.nhs.uk [email protected] @model_hospital #modelhospital

Transcript of Using the Model Hospital to Improve Productivity · [email protected] Using the Model...

Page 1: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

https://model.nhs.uk

[email protected]

Using the Model Hospital to Improve Productivity

Thursday 6 September 2018

Dr David Ashby

Director of Model Hospital and Analytics

Dan Cariad

Policy and Strategy Lead, Model Hospital

Laura Langsford

Model Hospital and GIRFT Programme Manager,

University Hospitals Plymouth NHS Trust

@ExpoNHS #Expo18NHS

https://[email protected]

@model_hospital #modelhospital

Page 2: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Visit the following link on your phone to feedback

and ask questions

glsr.it/modelhospital

Page 3: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Model Hospital is a strategic data and information tool to

support improvement

Identify your opportunities to

improve

Understand the drivers of your opportunities

Identify areas for action

Understand detail and develop a plan

Case studies and best practice to

support improvement

Tracking and monitoring of delivery

Page 4: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

We’re redesigning to focus more on opportunities and

where you can find them

Page 5: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

We’re redesigning to focus more on opportunities and

where you can find them

Page 6: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

We’re redesigning to focus more on opportunities and

where you can find them

Page 7: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

We’re redesigning to focus more on opportunities and

where you can find them

Page 8: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

We’re redesigning the metric pages to make them clear

and comprehensive

Page 9: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

We’re making the Model Hospital more responsive

Mobile and tablet

friendly designDesktop Homepage

Page 10: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

We are incorporating more best practice information,

guidance and case studies…

Page 11: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

…and expanding to cover more sectors and give a more

holistic view of a system

Page 12: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Plymouth have put the Model Hospital at the centre of their

Carter Programme

• Lord Carter’s Feb 2016 report identified wide variation in acute hospital productivity and efficiency, with

unwarranted variation as well as warranted variation.

• It made a set of recommendations to make efficiencies over the next few years, of which the Model

Hospital was one of them.

NHS Efficiency Challenge

• £55.6bn spend annually by Acute Hospitals

• Reduce unwarranted variation

• Save £5bn (nearly 10%)

Page 13: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Selecting the right peers is critical

• How can Peers be used well?• What does Peer median tell us?• What makes a good Peer Selection?• When to use STP, and CQC Outstanding Peer Groups/

Page 14: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Consider the factors driving variation

ConsiderationsUse of contracted services? Vacancy position? Outsourcing Costs? Overheads for Income Generation? Community service provision? Directly commissioned services?

Page 15: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Deep Dive into priority areas in detail

Pay• Track back to the metric• Use ESR data – Obtain visibility• Engage with Stakeholders• What costs to move to an improved quartile?• So, what would we need to do differently?

Supporting Tools:• Example: Medical Staff Cost per WAU?

• % Direct Clinical Care time • % SPA time • Consultant Costs• WLI Costs• WTE to Staff Ratios

Page 16: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Non-pay requires a different approach

Non Pay• Use Trust accounts as the reference source• Align it in the Model Hospital methodology • Review separate categories• Model Hospital Supporting tools?

• Individual Dashboards for each element• Procurement (PPIB Performance unit costs)• Drugs (Top 10 Savings Performance)• Estates and Facilities (Unit Costs)

Procurement – Savings Target

Top 10 Medicines – Savings Target

Page 17: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Care settings are critical to understanding Clinical

Service Line Productivity

Getting Trust OversightGetting visibility – By setting?What are you biggest challenges?Delivering a Response Plan?

Page 18: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Elective, and Day Case Cost per WAU Variances: Overlay with Theatre Utilisation Performance

Service Activity

Reported 16/17

Reference Costs

16/17 Variance to

National Average (£)

Q1 Q2 Q3 Q4Job

Planning% DCC

Theatres% UtilisationPre-Persist

17/18

Theatres % UtilisationJuly 2018

Orthopaedic *& Spinal Elective £13,875,298 £2,120,627 X75.09% 79% 80%

Orthopaedic* & Spinal Surgery £3,085,309 £212,544 X

Neurosurgery Elective £7,761,956 £899,507 X 79.34% 81% 72%

Ophthalmology* Day Case £4,523,600 £736,738 X 75.65% 93% 94%

Urology* Elective £3,468,871 £418,744 X 77.04% 67% 76%Plastics* Elective £2,087,740 £403,248 X

75.22% 70% 73%Plastics* Day Case £4,305,273 £405,813 X

General Surgery* Elective £9,602,292 £320,238 X 75.39% 67% 67%

Breast Surgery* Elective £1,404,608 £252,904 X 85.25% 78% 72%

Vascular* Elective £1,814,738 £153,063 X 79.77% 73% 78%

Obs and Gynae* Elective £3,038,370 £130,531 X 75.13% 85% 80%

Dentistry Day Case £311,412 £119,431 XENT * Day Case £2,287,547 £81,962 X

76.22% 69% 73%ENT* Elective £1,652,857 £60,112 X

Paediatrics Elective £254,501 £32,214 X 73.75% 44% N/ADermatology Day Case £715,372 £347,224 X

76.21% 51% 50%Dermatology Elective £61,309 £23,941 X

Overlaying variance (£) with response plan Is improvement being achieved?

Page 19: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Model Hospital: Outpatient Cost per WAU Variances:

Overlay with Outpatient Programme Utilisation Performance (last Quarter)

Service

Reported 16/17

Reference Costs

16/17 Variance to

National Average (£)

Q1 Q2 Q3 Q4

OP Clinic Utilisation

Pre Start of OP Project

(Aug- Sep 17)

OP Clinic Utilisation

Latest Quarter(Apr - Jun 18)

% Change?

Respiratory £3,856,209 £1,135,598 X 86.5 88.8 2.3Obs and Gynae £8,835,833 £584,091 X 71.4/88.3 64.3/90.7 -7.1/2.4Urology £2,695,219 £551,072 X 86 83.7 -2.3Breast Surgery £1,665,444 £399,028 X 91.8 90.9 -0.9Cardiology £2,253,439 £130,989 X 89.4 90.7 1.3Neurology £2,149,496 £316,161 X 86.5 85.2 -1.3ENT £2,664,268 £243,632 X 87.4 90 2.6Paediatrics £4,535,013 £192,513 X 79.3 82.5 3.2Dentistry £1,471,573 £191,667 X 81.1 80.7 -0.4Diabetes and Endo £1,746,893 £59,432 X 80/58 80.6/73.6 0.6/15.6

Rheumatology £2,198,109 £16,598 X 87.8 88.8 1

Overlaying variance (£) with response plan Is improvement being achieved?

Page 20: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Model Hospital: Outpatient Cost per WAU Variance Outpatient: Largest Variance: Respiratory

Next Steps?

• Job Plan % Direct clinical care?• Job Planned time v Clinic delivered time?• Clinic utilisation?• Consultant led/Nurse led clinics?• DNA rate?• Clinics/Procedures with highest variation (£)?• Is all activity being recorded – Tel Clinics?• Procedure steps – Are we under recording

activity that is being delivered?• Benchmarking with One Stop clinics?• Complexity of procedure by setting; Are we

delivering higher complex work in an OP setting?

Variance (£) What % is it of the total costs of

delivery by setting?

Page 21: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Now starting to look at productivity across an STP…

Is this ok?Do we understand this?Why are we all in different quartiles?

Is this ok?Do we understand this?Why is 1 Trust in Q1 (Green)Why are 3 Trusts in Q4 (Red)

What can we learn from each other in driving improvement?

Page 22: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Model Hospital Trust Ambassador Programme

• Benefit from exclusive previews and learning opportunities within the

Model Hospital;

• Help shape and influence the Model Hospital as a trusted local expert

for your organisation, with knowledge of local context and practices;

• Champion the Model Hospital within your trust. Acting as a key contact

for your organisation, sharing the latest developments and supporting

colleagues to actively use the tool;

• Network nationally with other trust ambassadors sharing ideas, best

practice and learning between trusts.

Page 23: Using the Model Hospital to Improve Productivity · nhsi.modelhospital@nhs.net Using the Model Hospital to Improve Productivity Thursday 6 September 2018 Dr David Ashby Director of

Question?

• Register at https://model.nhs.uk

• Feedback at http://feedback.model.nhs.uk or at [email protected]

• View our Animations: ‘Introduction to the Model Hospital’ and ‘What is a WAU?’,

• Watch our series of Masterclass webinars available on demand

• Become a Model Hospital Trust Ambassador: [email protected]