NHS Forth Valley New Zealand Visit 2014 Jane Grant CEO
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Transcript of NHS Forth Valley New Zealand Visit 2014 Jane Grant CEO
NHS Forth Valley
New Zealand Visit 2014
Jane Grant CEO
Profile of Scotland
• 5m population declining and ageing
• Urban central belt, remote areas in North
• Reliance on public sector-higher than UK
• Health status-lower than UK
• Inequalities-higher than UK
• Health spend-reaching European average
Health system
• 11 mainland Boards• Responsible for health improvement and service
delivery• Strong governance & public accountability• Board membership• Integrated / regional / CHP approach within
health• Increasing emphasis on public sector
partnership working
NHS Forth Valley
Co-terminous with 3 Local AuthoritiesFalkirkStirlingClackmannanshire
Forth Valley
Population of Scotland
The changing demographic nationally
Projected bed days by age band (All FV Residents only)
Facts and Figures NHS Forth Valley
• Spending just under £500m per annum
• Around 8000 direct employees
• Serving a population of 300 thousand
• Covering an urban and rural area
• Operating 1 major hospital, 4 community hospitals, wide range of primary care and community based services
Facts and Figures(2)
• 45,000 In Patients/Day cases in acute• 260,000 Hospital Out-patients• C1.5 m primary care consultations• 450,000 community nursing contacts• Many other community contacts for
children, psychology etc.• Staffing resource is therefore most
significant
Generic Care Pathway
Tier 0Well
Tier 1Development of Symptoms
Tier 2Established Long Term Condition or Health Problem
Care managed in Community
Tier 3Enduring or complex problem.
Care mostly managed in community but requiring specialist input
Tier 4More serious exacerbations
or single episodesCare needs more complex
Tier 5End of
life care
Home and Community
Primary CareCommunity Pharmacy
Diagnostic, Outreach & Rehab Services
Community Hospital
Acute Hospital
HospiceCommunity HospitalCommunity
DiagnosisEvidence-based System awareness
Self managementRisk assessment Co-ordinated care
Co-ordinated admission, discharge and alternatives
Referral management
Health promotion Signposting
Integrated 24/7 partnership working
Focus on Quality & Safety
• Quality & Safety Priorities– Reducing avoidable mortality– Reducing avoidable harm– Improving patient experience– Ensuring evidenced based care– Contributing to safely reducing costs and
increasing increasing time to care
• Demographic
• Financial context
• Integration of all Health and Social Care
• Delivery of the 2020 Vision
Further Challenges
More on Quality
Peter MurdochInterim Medical Director
Much more than buildingsDesign Principles 2004 • Improved patient flow and separation of
streams
• Ambulatory bias
• Community and integrated focus
• Right care by right person, right place, first time every time
• Multidisciplinary team working
• Flexibility
Challenges
• Continuing drive to improve Quality & Safety• Person centred approach• Community focus• Consistency• Improving access• Optimising efficiency• Demographics and co-morbidity• Information driven improvement
Encouraging Culture Change
• Openness, honesty and candour• Striving for excellence • Reflective learning • Commitment to Improvement and Quality-• Continue to learn and embed range of QI
methods• Effective leadership • Information driven • Clarity and communication
New Vision
• Beyond boundaries – working together for a healthier future
• Radically reviewing systems across all sectors
• Commitment and momentum to radical and transformational change needed
Tom Steele
Director of Strategic Projects & Property
Responsibilities Include
• Operational estates and facilities management services
• Strategic asset planning and development
• Operational services are delivered in house as well as contracted out
• Strategic priorities:– Locality service and infrastructure planning– Current projects:
• Stirling care village• Doune Health Centre• FVRH CHP power plant• IMT strategy• Vehicles and fleet management• Medical Equipment
Fiona Ramsay
Director of Finance
Community Health Partnership £ 92.7mSpecialist and Ambulatory Care £ 78.6mEmergency and Inpatient Services £ 72.0mWomen and Children £ 22.5mPrimary Care Prescribing £ 53.7mGeneral Practitioners £ 40.5mDentists, Pharmacists, Opticians £ 30.1mArea Wide Services/PFI £ 84.2mSpecialist Services outwith Forth Valley £ 43.4m
Total £ 517.7m
Finance
Estimated Scottish Government DEL Expenditure – June 2010 Budget Results (2010/11 Prices)
20,000
22,000
24,000
26,000
28,000
30,000
32,000
£ M
illio
ns
(20
10
-11
Price
s)
2009-10 2025-2616 years
£42 billion
Key issues- Pension Changes- Demographic pressures- Delivery of Waiting Times Targets- Emergency Care demand and flow- Deliver more care in home/community- Prescribing / Technology
Need to reduce costs by 3% per annum to ‘stand still’ and expected to move resources to community…
Finance
Helen Kelly
Director of Human Resources
NationalNHSScotland
• Staff Governance Standard
• Partnership Working with Trade Unions
• Workforce Vision & Implementation PlanEveryone Matters
LocalNHS Forth Valley
• Workforce Strategy
• Staff Experience
• Values Matters Programme
• Workforce Planning
Our PeopleNHS Forth Valley Workforce by Job Family (headcount)
ADMINISTRATIVE SERVICES, 989, 17%
ALLIED HEALTH PROFESSION, 542, 9%
DENTAL, 14, 0%
HEALTHCARE SCIENCES, 189, 3%
MEDICAL (TRAINED), 327, 6%
MEDICAL (TRAINING GRADES), 202, 3%
MEDICAL AND DENTAL SUPPORT, 89, 1%
NURSING / MIDWIFERY, 2122, 37%
NURSING / MIDWIFERY (UNQUALIFIED), 849, 14%
OTHER THERAPEUTIC, 182, 3%
PERSONAL AND SOCIAL CARE, 13, 0%
SENIOR MANAGERS, 28, 0%
SUPPORT SERVICES, 398, 7%
ADMINISTRATIVE SERVICES
ALLIED HEALTH PROFESSION
DENTAL
HEALTHCARE SCIENCES
MEDICAL (TRAINED)
MEDICAL (TRAINING GRADES)
MEDICAL AND DENTAL SUPPORT
NURSING / MIDWIFERY
NURSING / MIDWIFERY (UNQUALIFIED)
OTHER THERAPEUTIC
PERSONAL AND SOCIAL CARE
SENIOR MANAGERS
SUPPORT SERVICES
Challenges
• Workforce Planning and Development – right person, right skills, right time, ensuring our workforce has time to learn
• Developing Leaders and Succession Planning for Emerging Leaders to address the workforce demographic
• Supporting a culture of Quality and Improvement whilst still responding to demand and pace of service delivery
• Embedding Staff Governance Standard and workforce values in practice and recognising staff for ‘Values-based’ performance and achievement
• An integrated future and developing a multi-professional and multi-agency approach to team working