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Annual General Meeting 17 September 2013

An Associated University Hospital of

Brighton and Sussex Medical School

Agenda

• Chairman’s Welcome and Opening Address

Alan McCarthy, Chairman

• Presentation and Adoption of the Annual Accounts for 2012/13

Paul Simpson, Chief Financial Officer

• Looking to the Future: 2013/14 and beyond

Michael Wilson, Chief Executive Officer

• Getting discharge right

Joe Chadwick-Bell, Director of Operations

• Open questions

• Closing Remarks

Alan McCarthy, Chairman

An Associated University Hospital of

Brighton and Sussex Medical School

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Chairman’s Welcome

and Opening Address Alan McCarthy, Chairman

An Associated University Hospital of

Brighton and Sussex Medical School

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Annual Accounts

Paul Simpson, Chief Financial Officer

An Associated University Hospital of

Brighton and Sussex Medical School

Trust Financial Performance

Trust reference Costs

Summary of Trust Financial Strategy

Ratio of non-elective activity

to elective

• Non-elective activity provides

a lower contribution than

elective activity, and a part of

this activity is paid at 30%.

The Trust is an outlier in

comparison with its peer

group.

• Therefore the Trust needs to

rebalance the ratio. The plan

sees assumptions around

less non-elective work and

repatriated elective work.

Summary - Finance

2012/13

• Agreed a break even plan and a £10million cost improvement and efficiency plan.

We successfully delivered both, as well as our continued extensive capital building

programme.

• The underlying position was better than expected and the Trust repaid some of the

one-off funding.

Forward Plan

• This is no change to the plan – the Trust must balance the ratio of non-elective to

elective work by reducing the former and repatriating the latter, while being more

productive and delivering savings.

• In 2013/14 we have significantly reduced our outsourcing of elective work. Non-

elective activity remains high although agreements over additional community

capacity will help reduce this activity, as well as help to manage winter pressures.

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END

An Associated University Hospital of

Brighton and Sussex Medical School

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Looking to the Future

2013/14 Michael Wilson, Chief Executive

An Associated University Hospital of

Brighton and Sussex Medical School

An Associated University Hospital of

Brighton and Sussex Medical School

Looking to the Future -

Performance – everyone plays a part

Looking to the Future –

Forming Partnerships: Radiotherapy Unit

An Associated University Hospital of

Brighton and Sussex Medical School

Looking to the Future –

Forming Partnerships:

BOC Respiratory Centre

Looking to the Future –

Improving our patients’ experience: New Theatres

Looking to the Future –

Improving our patients’ experience: Birthing Unit

Looking to the Future –

Improving our patients’ experience: Comet ward at Crawley

Looking to the Future –

Improving our patients’ experience: Research and Development

New

Looking to the Future –

Integrated Community Care

An Associated University Hospital of

Brighton and Sussex Medical School

Looking to the Future –

Safety, Quality, Patient Experience and Patient Outcomes

An Associated University Hospital of

Brighton and Sussex Medical School

Slide 21

Foundation Trusts have to deliver on national targets and

quality standards like the rest of the NHS, but they can

decide how they achieve this.

Looking to the Future –

Foundation Trust

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END

An Associated University Hospital of

Brighton and Sussex Medical School

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Joe Chadwick-Bell, Director of Operations

An Associated University Hospital of

Brighton and Sussex Medical School

Getting discharge right

Why are ‘well’ patients still in hospital?

Slide 24

Around 100 patients per day who no longer require acute

medical or surgical or care.

This group of patients are delayed for reasons including:

• Completion of complex discharge documentation

• Awaiting assessments

• Awaiting funding decisions

• Placement

• Family delays and choice

Delays are a whole system issue.

Delays impact patient care and experience – both for the

individual and those waiting for a bed to become available.

What we are doing to improve the discharge process

Slide 25

• Established enhanced clinical site team

• Developed Trust-wide professional standards

• Discharge documentation processes shared with wards,

supported by training

• Discharge liaison nurse and social worker to join daily Multi-

disciplinary teams, pilot in 4 wards in September

• Multi-disciplinary team based in Emergency Department and

Assessment Areas

• Multi-disciplinary team based on wards

• Patient passport to document the discharge journey

Surrey Rapid Improvement Programme

Slide 26

• Recognise discharge planning is a complex whole health

system issue

• Working with other hospitals, social and community care to

improve the flow of patients out of hospital

• Common issues identified across whole health system

• Sharing good practice

• Agreed standards

• Move to a ‘discharge to assess’ model

• Chief Executive sponsored initiative

Working together to achieve

Slide 27

• Positive multi-disciplinary teams in accident and Emergency,

and Assessment wards

• Improved patient information and expectations

• Continuing Health Care processes

• Reducing patient transport delays

• Community providers ‘pull’ people out of the acute hospitals

• Create capacity for short term intermediate support in the

community and grow 72 hour clinical support provision

• Surrey wide discharge strategy and standards

Integrated Discharge Team

Slide 28

• 7 day, 365 days per year service

• Single point of contact

• Work flexibly across organisational boundaries to assess

patients and facilitate discharges

• Reduces paperwork through single referral documents

• Discharging patients quickly from the acute hospital beds to

on-going care with nursing or therapy support

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END

An Associated University Hospital of

Brighton and Sussex Medical School

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Open Questions

Alan McCarthy, Chairman

An Associated University Hospital of

Brighton and Sussex Medical School