project hift alfords health investment for tomorrow project hift alfords health investment for...
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Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
How should NHS services develop over the period of the NHS Plan?
Rt Hon Alan Milburn MP
Secretary of State
for Health
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
Key Objectives
Improved performanceReturn on new investmentDevelop intermediate carePrivate Sector capacityMore Staff
More employee commitment Waiting lists
Waiting time reductionsPositive publicity
Sense of urgency
Flexibility
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
SHIFT ProjectSHIFT Project
Salford’s Health Investment
For Tomorrow –
The Salford Model
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
The SHIFT ProjectThe SHIFT Project
• Salford’s Health Investment For Tomorrow
• Unique approach
• Whole system project
• Buildings, services, IM&T
• Service Redesign
• Partnership
• Regeneration
• Procurement (PFI and LIFT)
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
History of the ProjectHistory of the Project
• Strategic Outline Case
• Hospital focus
• Victorian ward blocks
• Salford’s health status
• Other organisations
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
Whole system / PartnershipWhole system / Partnership
• Salford Royal Hospitals Trust
• Salford Primary Care Trust
• Salford City Council• Salford University• Manchester University
and• Salford population
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
ObjectivesObjectives
• Improve health and well-being
• Improve access• Streamline processes• Provide effective
services• Meet capacity targets• Regeneration
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
RegenerationRegeneration
• More than just health services
• Social Care
• Investment
• Effect of building
• Employment opportunities
• Commerce
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
“I’VE GOT IT,TOO, OMAR…A STRANGE FEELING LIKE WE’VE JUST BEEN GOING IN CIRCLES”
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
“Every system is perfectly designed to achieve the results it achieves”.
Donald BerwickInstitute for Healthcare Improvement
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
Service redesignService redesign
• Whole system
• Patient focused
• Meeting expectations
• Right time, right place, by right people
• Best practice standards / Modernisation Agency /
targets
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
Service Design GroupsService Design Groups
EmergencyElective Chronic
Disease Management
Diagnostic & Therapies
Intermediate Care
ElderlyPrimary
Care
Childrens Interface Group
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
Main categories of patientsMain categories of patients
E m erg e ncy o r u np la nn e d ca re E le ctive o r p la nn e d ca re L o n g te rm co n d it io ns o rC h ro n ic D ise a se M an a g em e nt
S H IF T (W ho le sys te m )S e rv ice R ed e s ign
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
How services will change…..How services will change…..
Acute
Intermediate
Primary / community
Old = organisational focus New = Pathway focus
10 20
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
SELLING THE
MESSAGE
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
THE CHIEF EXECUTIVE’S DILEMMA
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
Hope Hospital
Pendleton –Children and Young People
Swinton –Minor surgery & diagnostics
Ordsall
Broughton & Blackfrairs
LIFT Initiative
•4 Health and Social Care Centres with electronic links to Hope Hospital
•Second phase LIFT developments to enhance existing healthcare facilities
•Whole system modernisation of inner city practices throughout LIFT
•Underpinned by IM&T
Walkden –Specialist Therapies
Eccles –Teaching and Learning
Little Hulton
Irlam & Cadishead
Clinical network
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
The whole system – starting in The whole system – starting in primary care……primary care……
• Health promotion– Healthy choices
– Opportunities
– Regeneration
• Family care– Access
– Modern facilities
– Flexibility
– Scope
• Case management
(Evercare model)
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
New intermediate level
The new Intermediate tier includes:
Improved access to diagnostics and
therapies
New roles to manage
“emergency” demands
Over 100 new beds or equivalent
services preventing hospital admission or facilitating transfer of
careProvision of minor surgery and other
invasive procedures in
Health and Social Care Centres
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
Unplanned Care
Urgent advice:
Pharmacist
NHS Direct
Walk-in 8 ‘til late
Receives consistent advice and either self-manages or enters appropriate part of system
Urgent care needs assessed and referred to:
•Rapid Response Team
•GMAS / Emergency Practitioner assessment
•Primary Care clinician
•Intermediate Treatment
•A&E
If admitted to Hope Hospital….
Access to diagnostics to prevent unnecessary admission
Emergency Assessment unit for admissions of up to 72 hours, separated from elective activity and managed by Emergency Assessment Physician
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
Emergency Admission UnitEmergency Admission Unit
•772 hour•EEarly diagnosis•IIntervention / treatment•MMedical / surgical response•MMulti-disciplinary teams•PPlanned transfer of care
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
Planned Care…………….
Assessment by Primary Care
clinician / Tier 2 panel
Electronic booking
Date of admission agreed with patient
Procedure under LA at Health and Social
Care Centre
Admission to (up to) 72
hour Elective facility at
Hope Hospital
Intermediate / Primary Care recovery
Out patient assessment
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
“I CAN’T BE ABSOLUTELY CERTAIN, OF COURSE, BUT YOU DO APPEAR TO BE IN SOME KIND OF TROUBLE, MR HOWARD”
STATING THE BLEEDING OBVIOUS
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
Long-term conditionsLong-term conditions
•GGuided self-management•PPrimary care management•IIntegrated healthcare teams•IIncreased complexity
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
Out Patient activity will change…………
The out patient cake will be cut in
different ways
Different ways of managing conditions, as an integrated team:•Self management
•Call Centres•Urgent access support
•Telemedicine
Some clinics will be held in Health and Social Care Centres – with on-line access to health records and diagnostics
Some clinics will continue to be provided at hope Hospital, because of the reliance on more complex imaging, etc.
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
INVESTMENT + REFORM = NEW SYSTEMINVESTMENT + REFORM = NEW SYSTEM
•4 Health & Social Care Centres
•Ambulatory treatment
•Additional beds
•Investing in Primary Care
•New Hospital buildings
•Weekend and evening sessions
•362 w.t.e. new staff
Redesign Changes
Tier 2
Intermediate care
Pathway led
Performance improvement
82% occupancy
Modernisation Agency
Inappropriate admissions
Upper quartile LOS
IM&TWhole system
Supporting clinical practice
Consistent with National Strategy
Workforce
New roles
New teams
14 session week
Current activity
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
“and now there goes theWilsons!…Seems like every one’sEvolving except us!”
Project
alford’s HHealth IInvestment FFor TTomorrow
Project
alford’s HHealth IInvestment FFor TTomorrow
REDESIGN YOUR SERVICES
PASS IT ON
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