Future Plans - Becoming a Foundation Trust

Phil MorleyChief Executive

Trust Vision‘Great Staff, Great Care, Great Future’

• Our aims:

– Deliver excellent quality outcomes and great patient experience;

– Work in partnerships that add value and in ways that use public money wisely;

– Have buildings that are fit for purpose; and

– Provide assurance to our regulators and commissioners that all necessary standards are being met.

We employ approx 7500

(WTE) staff

Castle Hill Hospital is a mostly a site for planned patient care with some emergency cardiology services. There are also more Outpatient and Diagnostic Services based here.

We provide medical and

surgical services for approx

600,000 people In Hull and East

Yorkshire. We also provide

specialist services such as,

cancer, neurosciences,

cardiology, cardiothoracic surgery, renal medicine and

dialysis to a wider geographical area in North Yorkshire and Lincolnshire.

Hull Royal Infirmary is mainly an emergency site, but also has women’s and children’s services, an Eye Hospital, and extensive Outpatient and Diagnostic services.

In 2010/2011 we saw:• 90,000 Emergency patients • 87,000 Elective (planned) patients

• 154,000 New Outpatients

GREAT CARE

Quality and Safety StrategyThe quality priorities for the Trust over the

next five years are:

Safety

To reduce all avoidable deaths.

To reduce all avoidable harm.

Effectiveness

To ensure the Trust always treats the right patient, in the right place,

at the right time.

To aspire to achieve the best clinical outcomes for all.

Experience

To improve communication through patient and staff engagement.

 

Friends & Family Test

“How likely are you to recommend this

ward/department to friends & family if

they needed similar care or treatment?”

•Ward Areas

•Emergency Department

•Outpatient Departments

•Maternity Services

Compassion in Practice

• Transparency: Benching local & national

• Quality Boards at the entrance to every ward

• “you said” “we did”

• Intentional Rounding (Dec 2013)

• Chief Nurse agreeing appropriate staffing levels

• 6Cs in appraisals

Setting the StandardWard to Board

Led by the Chief Nurse

Clinical Areas are assessed against 12 Essential standards

NHS Safety Thermometer

Patients received HARM FREE CARE 95.33%Harm Free Care is defined as the number/percentage of patients who have not suffered any of the

four harms measured by the safety thermometer before or since admission to hospital.

  May 13

June 13

July 13

August 13

September 13

No Patients

1040 1038 1022 954 962 953

% Harm Free

92.1%

94.6%

94.1%

94.1%

94.5% 93.3%

New Harm

30 18 28 30 22 19

Old Harm 52 38 32 26 30 49

Hospital Acquired Pressure

Ulcer70% Reduction and the percentage continues to reduce

•Skin Care Bundle Trust wide

•Stricter control of interactive dressing

•Expected £50K savings by stopping inappropriate use of incontinence products

ED Children’s Waiting

ED Adults Self-Triage Kiosks

Improving our services • Stroke services • Palliative care network • Reconfiguration of Acute Assessment unit• Accreditation as a Major Trauma Centre• Transforming our surgical services • Theatre improvement programme• Pathway redesign • Developing maternity services • 59 Clinical Service Strategy

Francis Report 290 recommendations

27 Key Recommendations to take forward by HEY

11 Prioritised

•A Common set of Core Values & Standards

•Assessing Core Values at interview

•Supervisory Status for Ward Managers

•E Observations

•E Prescribing & Administration

•Relative Surgeries on Wards

•Promoting our desire to learn from

comments / complaints

Key R&D Strategic Objectives

• Microfluidics ‘Lab-on-a-microchip system’ aims to understand how current treatments (i.e. chemotherapy and radiotherapy) respond to specific tumour types allowing to develop more individualised care to patients. A current project sponsored by HEY and funded by the European Commission looks at the use of the device to detect biomarkers in non-small cell lung cancer. Inflammatory Bowel disease is also being studied for microfluidic use.

• Telehealth Telehealth is a broad term that refers to the use of technology to enable the remote delivery of healthcare or promotion of well-being. It is just one part of ‘eHealth’ – a term that also encompasses electronic patient records and other areas of health informatics.

Working with the University of Hull, the Trust is playing an active role in supporting the bringing together of telehealth expertise from academia, primary and acute care, local authorities, industry and third sector partners that will form the future basis for telehealth service delivery in the NHS and elsewhere

• Nasogastric Tubes Nasogastric tubes have been in existence since Egyptian times but until now, there has been no safe mechanism to ensure these tubes are inserted into exactly the right place. A team from the University of Hull working with colleagues in the Trust has set out to create a fail-safe detection mechanism for the placement of feeding tubes that is reliable and cheap to manufacture.

Great Staff

Communicating and engaging with our staff

• No surprises! Tell staff before they find out from someone else

• Be honest even if the message is difficult or unpopular• Make it easy for staff to find out information• Use face-to-face conversations• Invite staff to tell us how we can improve our services• Involve staff in decisions about changes which affect them• Help staff to deliver on the things they believe are important• Communicate the good things we do• Foster good relationships and partnership working with

unions

Big Conversations

Over 1000 staff attended.

Key themes identified and project teams allocated to deliver on the main issues

Pioneer Teams – staff-led initiatives, championed by a Trust Director20 teams have completed the programme•A 70% increase in referrals in to the cancer survivorship service•The creation of an IBD biologic unit in the gastroenterology ward•Access to remote paperless working for all neurology nurses•Hip fracture patients are now 28% less likely to die whilst in hospital•One lift in HRI is now isolated for patient use only to improve privacy and dignity•6 out of 7 anaesthetic rooms in HRI theatres have been remodelled•Patient therapy sessions to be scheduled through the Cayder boards•A standardised Bereavement service has been developed for the relatives of deceased patients•Freed up almost 20 hours a week for community midwives to spend with their patients•Implemented significant changes to the catering services being provided to staff•Telephone calls reduced by up to 30% on our pilot wards•Improved recovery for breast care patients •Four beds ring-fenced for neuro patients in ICU, resulting in fewer delays for patients•Significant progress made towards reducing the amount of paper pathology results

Great Leaders programme240 of our managers to undergo the programme

Each will learn how to empower and enable staff

Each will deliver on their own personal commitment and improvement programme through Big Conversation engagement with their teams and colleagues

Are you a transformer?

Great Future

Keeping Services LocalSpecialist services will be concentrated in fewer centres (to increase quality of care), with some patients travelling for these ‘once in a lifetime’ events

More routine services will be provided locally, with travel time for all patients minimised. These are services that patients may need to access frequently during their care pathway.

Centralisation

Localisation

Partnerships • Clinical Alliance with York Teaching Hospital NHS Foundation Trust

(February 2013)

• ‘Working Together for Our Future’ conference 8th November, bringing together clinicians from all specialties, in York and Hull

• ‘Strategic conversations’ with Northern Lincolnshire and Goole Hospitals NHS Foundation Trust.

Affordable Quality Service: The future in financial terms

What does this mean for us?•Planning to deliver a 1% surplus each year requires a minimum of 5% increase in productivity and efficiency

•Hugely challenging given the requirement to maintain and in some areas improve quality – eg: improve privacy and dignity in A&E

•Will need to work increasingly in partnership with others, notably York FT and NLAG FT to develop stronger clinical networks for patients

•Change is unavoidable given the numbers involved. We would prefer to be in control of that process rather than have it dictated to us

•What is key is that all change will have to be directed by patient requirements

Affordable Quality Services: The future in financial terms

•Our aim is to provide the best quality services for the money that is available

•It is vitally important that we have a stable financial platform from which we can deliver quality clinical services

•Extremely challenging agenda:

Estimated £30bn gap nationally by 2021

The Future

Acu

te H

osp

ital

sSocial Care

CommunityServices

• £20m investment supporting clinical excellence and collaborative working

• Making it easy for clinicians and patients to take the right action, at the right time, with confidence

• Getting rid of paper and joining things up so care professionals can look at whatever information they need, wherever they are working

• Making it easier for our patients to access our services and engage with us using modern, user friendly technology

• Reduce risks, deliver benefits, accelerate the pace of service transformation

‘Technically Enabled’

Our FT Application

Become a Governor and be part of our future