Changing the WorldImprovement Conference

24 November 2011

NHS Efficiency and Productivity Framework

Stephen GallagherDeputy Director for Health Performance

Gerry MarrChief Executive, NHS Tayside

Quality & Efficiency = Value

Identify Priority Areas

Waste, Unwarranted Variation & Harm

Prescribing – Variation in per capita FHS drug expenditure

0

50

100

150

200

250

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

NHS Board

£ sp

end

per

hea

d a

dju

sted

fo

r n

eed

Series1

How?

• A Single Portfolio • Leadership and buy-in from NHS Chief

Executives• Efficiency Portfolio Board• 6 Work-streams supported by a

transformational narrative 20/20

Linked to Performance

• Agreement that EPB identifies, tests and champions priorities

• Actions enabled by Quality & Efficiency Support Team (QuEST)

• Boards challenged to adopt or justify• Annual Plans set out in Local Delivery

Plans• Tailored Performance Support available

Tailored Performance Support

• Leadership, Governance, Grip

• Productive Opportunities identified through Whole Systems Data Analysis

• Support for specific local schemes

1) Change the world

2) Create the conditions

3) Make the improvement

Macro system –Vision, aim and context.

Meso system –Culture, capacityAnd challenge. How much and by when?

Micro system –

Implementation, measurement and improvement

The 3-step Improvement Framework for Scotland’s public services

TACTICAL STRATEGIC

DEALING WITH THE 5%

SPENDING THE 95% BETTER

PRODUCTIVITY & EFFICIENCY

CRES

SERVICE OPTIMISATION

TRANSFORMATION

2009 - 2011

2010 - 2013TACTICAL STRATEGIC

DEALING WITH THE 5%

SPENDING THE 95% BETTER

PRODUCTIVITY & EFFICIENCY

CRES

SERVICE OPTIMISATION

TRANSFORMATION

Steps to Better Healthcare

Mental Health

OutPatients

Theatre Capacity / Planned

Care

Workforce Integrated care

communities

Child health

Optimisation of Health Facilities across Tayside

Prescribing and

Medicines

Finance Support

Workforce Support

Scenario Planning, Financial Baselines, Benefits Tracking, Business Cases

Workforce Modelling, Engagement & Communications with staff

Comms SupportCommunications with public and staff

Other

OE SupportOrganisational Effectiveness support

Labs

Maternity

2010 - 2012TACTICAL STRATEGIC

DEALING WITH THE 5%

SPENDING THE 95% BETTER

Prevention of admissionImproved Day care

Improved service liason and discharge

Reduced hospital stays and bed days

Case management – improved pathwaysIntermediate care

Care home interfaceMedications reviewsHousing/home care

supportTechnologies

Maximise Community hospitals

Cost minimisationWorkforce efficiencies

Teleheath/telecare

Virtual wardsWorkforce redesign

Self care and enablement

New models of care in dementia, falls, end of

life careWorking with communities - coproduction