Introduction to the NHS Providers Annual Conference 2019: The current provider landscape - Hot topics and issues facing our members

Speaker: Mark Stevenson, Chief Operating Officer, NHS Providers

About NHS Providers

NHS PROVIDERS STRATEGIC POLICY UPDATE

September 2019

The big five

Politics / external New Government: initial honeymoon

leads to division and controversy. NHS

helpfully top of list of domestic

priorities. No deal threat looms.

Money: 19/20 revenue looks on

track; 19/20 capital cut reversed; strong

current focus on designing future

financial architecture

Performance: ever increasing demand causing real worries around urgent and

emergency care performance and

risk of winter / flu / no deal Brexit triple

whammy

System architecture / regulation /

planning: Collaborative

working continues at pace and brings opportunities but

also challenges, esp. in social care.

Workforce: People plan

implementation beginning to gather pace but pressures still universal and will take time to

solve

An uncertain autumn ahead

General election?

• Summer focus on Brexit, NHS, education & justice – getting on an election footing?

• Lead in the polls (taking back support from the Brexit party) but a lot of polling volatility

• Queen’s speech on 14 October

Make hay whilst the sun shines

• “Fill the grid” with NHS announcements

• Capital, pensions, Health Education England budget increase…… hospital food….. migrant cost recovery……

Extended series of fiscal events

• One-year revenue-focused spending review took place on 4 September; Emergency Budget expected November; CSR next year

No deal Brexit on the cards?

• NHS and wider no deal preparations stepped up

• Five week prorogation of Parliament

The Long Term Plan - The NHS is changing!

FROM • Ruthless focus on small basket

of centrally set priorities: small number of acute metrics, CQC rating and financial surplus

• Focus on individual institutions • Heavy top down performance

management / oversight • Focus on one year

organisational plans • Regulatory intervention if

performance slips vs plan • Purchaser / provider split

TO • Much broader range of priorities beyond

acute access targets: mental health, integrated care, joining up primary care and community services; population health

• Local health and care system working • Multi year strategic planning • Four tiers: national, regional, STP / ICS,

individual organisation • Vertical and horizontal collaboration • Culture of learning, support, improvement

and staff empowerment • Changed behaviours to support above

System working latest

• Clear focus on finalising five year strategic plans… …despite gaps in information. Risks becoming a protracted process if plans need to be re-opened. • A period of considerable change: Ambition all STPs become ICSs by 2021 CCG consolidation at pace Emergence of Primary Care Networks at the neighbourhood level

New government’s £1.8bn capital boost

• £1bn increase to CDEL for 2019/20 – reverses planned 20% cut

• Most will come from provider reserves – but is still additional spending power not otherwise available

• £850m of improvements for 20 trusts across several years also approved

• Government signals it will prioritise NHS and infrastructure

Trust unable to recover performance

• A&E: Highest number of A&E attendances ever in July – 4% higher than July last year • RTT: Elective care waiting list is now 4.4 million – it increased by 10,000 since the previous month • Cancer: Missing 3 key targets – 2 week urgent referral (90%), 31 day (95.96%), 62 day wait (76.7%) • Diagnostics: 3.8% of patients waiting six weeks or longer from referral, missing the 1% target • Mental health: 795 out of area mental health placements – 19% increase on last year • Ambulances: Missing the Category 1 and category 2 average response times

The run up to winter 2019/20 • Tough summer with no bounce back in

performance • Brexit – no deal exit on 31 October? • Potential bad flu season ahead • Trusts piloting new standards • Pensions adding to workforce pressures • Ongoing capital constraints • No NHS winter money expected

‘Winter’ pressures – what does the provider sector need? Last winter

• Better preparation • Improving local

relationships • Flu less prevalent • Milder weather • Increase in

respiratory conditions • Successful reduction

in length of stay, ambulance handover delays, 12 hour waits

• Extra money for some trusts, but very rushed

• Fewer interventions from the centre

This winter

• Starting in an even more challenging position

• Capacity an issue for almost everyone

• Even bigger push on flu immunisation expected

• Independent sector expected to help with elective care/diagnostics

• Concern about staff wellbeing with all year round pressures

NHS People Plan

• Working from interim plan to final framework – early stages of working group activity

• NHSI/E workforce directorate coming together quickly under Prerana Issar

• Multiple subgroups operating – our main focus on: Leadership and culture, including Kark Review, central-local

compact Workforce architecture and “new operating model” Best place to work priorities, including new staff offer and

review of HR practice

• Advisory group providing inclusive environment, gradual progress

• December / January publication the target

Our view – ongoing workforce challenges

Vacancies are clearly impacting performance, particularly in A&E, while rural trusts are looking at an increasingly difficult recruitment picture

Staff burnout has reached a critical point and it’s clear we need to do more to improve the NHS employment offer. A focus on culture, inclusion and diversity will only increase in emphasis

Creating the right “new operating model” will be challenging. Workforce responsibilities need to be devolved at the right place and pace; new system implementation plans will be key; and there’s a risk of a zero sum game with PCNs

Training new and current staff – trusts are finding it difficult to invest in training and uncertainty remains around the medium-term workforce development budget

Clinical review of standards – where are we now? • Trust pilot sites for new A&E, RTT and cancer standards all

announced • Testing began during summer 2019 • Clinical Standards Oversight Group convened • Waiting for mental health sites to be announced • NHS England is commissioning an independent evaluation • Six local Healthwatch sites looking at the impact of the new urgent & emergency care standards Concerns: 1. Will timeframes, targets and trajectories be realistic? 2. Has engagement with public been realistic? 3. What support will be offered to trusts to implement new

standards?

An evolving NHSE/I

Seven NHSE/I Regional Directors

Phase three staff consultation on proposed NHSE/I restructure closed 29 August

Regional teams establishing ways of working with providers and commissioners

Moving to new ways of working and a coalition for change?

NHS Providers activity O

ver

the

sum

mer

… Big push on capital –

#RebuildOurNHS

Big push on pensions – including briefing on local schemes

On the day briefings – ICP contract, oversight framework, mental health implementation framework, prevention green paper, new government

Reports: regulation survey report, Primary care networks: a quiet revolution (with Confed)

Co

min

g u

p…

Campaigns: capital and winter including a briefing and the launch of winterwatch

Roundtables: on pensions, financial architecture and the Kark review

New reference group: On subsidiary companies

Briefings: on clinical review of standards, dual chairs and winter

Reports: State of the NHS provider sector report; Providers Deliver

Overview of Programme and member priorities Speaker: Mark Stevenson, Chief Operating Officer, NHS Providers

Ambition to Reality

• This is a policy led event – our members chance to discuss current and future hot topics

• This year we are exploring how members are embracing new opportunities to: • Recover performance • Stabilise finances • Invest to transform • Work with partners

The big issues

What are the challenges? • Increasing demand • Workforce shortages and pressures • Constrained finances • Backlog of infrastructure issues • Outdated practices and ways of

working

What are the solutions? • System working and population

health management • Innovation to redesign processes ,

free up time and cash and improve patient experiences

• Staff retention, deployment, efficiency

• Efficiency savings

Plenary Sessions

• Leading and embedding a compassionate, inclusive and collaborative culture

• Transforming patient care and experience through digital transformation

• Playing a critical role in prevention and early intervention

• Plus Matt Hancock, SoS and Simon Stevens, CEO NHS England

• Farewell from our retiring Chair

Breakout strand 1

• Focus on sustainable quality improvement • Embedding improvement to deliver lasting change in the care of

patients and service users • Embedding a culture of improvement • Journey’s from ‘requires improvement’ to ‘good’ • TBC

Breakout strand 2

• Practical and innovative short and long-term solutions to workforce challenges • Diversity and inclusion on boards • Short-term workforce solutions • Kark and the role of an NHS director

Breakout strand 3

• Exploring how organisations can work across traditional boundaries to improve how care is delivered • Working in collaboration with primary care • Accountability and autonomy • Making the money work in a system

Exhibition logistics Speaker: Jamie Trevor, Exhibition Logistics Manager, NHS Providers

Venue Access • Access for exhibitors, delegates and vehicles are all via Windmill Street • Address is:

NHS Providers annual conference & exhibition 2019 08-09 October 2019 – Exchange Hall Manchester Central Convention Complex Exchange Hall Windmill Street Manchester M2 3GX

• Parking is via NCP carpark under the venue off of Lower Mosley Street, opposite Bridgewater Hall

Exhibition Timings Monday 07 October – Build up

08:00 – 22:00 Space only stand build up / contractor access

14:00 – 22:00 Shell scheme stand build up

Exhibition Timings

Tuesday 08 October – Exhibition Opens

07:30 – 08:30 Exhibitor access to exhibition hall – final dressing of stands

08:30 – 09:00 All stands completed – health and safety check of exhibition hall

09:00 Exhibition hall and Registration opens

10:00 – 17:45 Conference programme – see website for timings

17:45 – 18:45 NHS Providers drinks reception – held at the NHS Providers stand

18:45 Exhibition hall closes

19:00 Conference dinner (held at the Midland Hotel)

Exhibition Timings

Wednesday 9 October – Exhibition and Breakdown

07:00 – 07:30 Exhibitor access to exhibition hall

07:30 Exhibition hall opens

(Breakfast sessions start 08:00 and the first main session starts 09:15)

14:30 Exhibition hall closes

14:30 – 21:00 Breakdown – shell scheme only stands (no contractor access until 15:30)

15:30 – 21:00 Breakdown – Space only stands and contractor access

Shell scheme stands • Shell scheme structure – built by Freeman Co

• fascia name board on each open side of the stand, gold colour board

with black writing

• 2 x 35w spot lights, 1 x 500w plug socket

• hall is pre-carpeted with grey/blue carpet tiles

• all lunches and refreshments (tea/coffee, etc) provided free of charge

• your 80 word profile and logo printed in the exhibitor section of the

conference and exhibition guide

• your profile and logo hosted on the NHS Providers website

• free delegate place

• opportunity to register two further conference delegates at half-price

• up to 10 two day exhibitor stand staff

Space only stands

Space only stands

• space in the exhibition hall (no lights or power supplied). The hall is already carpeted • all lunches and refreshments (tea/coffee, etc) provided free of charge • your 80 word profile and logo printed in the exhibitor section of the conference and exhibition guide • your profile and logo hosted on the NHS Providers website • free delegate place • opportunity to register two further conference delegates at half-price • up to 10 two day exhibitor stand staff

Exhibitor technical manual – mandatory forms

Forms for both shell scheme and space only - required or optional Via the exhibition webpage - https://nhsproviders.org/courses-events/annual-events/annual-conference/nhs-providers-2019-exhibitor-form

• Exhibitor company profile plus logo • Health & safety declaration form • Build up/breakdown and vehicle passes • Exhibitor stand staff – registered via website • Free/half-price delegate places – registered via website • Conference dinner ticket or table bookings (email for details) • Risk assessment (NOT required by shell scheme stands)* • Method statement (NOT required by shell scheme stands)* • CPP - Construction Phase Plan (NOT required by shell scheme stands)* • Stand plans and elevations (NOT required by shell scheme stands)* • Contractor public liability insurance (NOT required by shell scheme stands)*

Additional forms

• AV/IT equipment order form – ITR • Electrical order form – Freeman Co • Graphics – Freeman Co • Floorcoverings order form– Freeman Co • Furniture order form – Freeman Co • Internet/WiFi order form –Manchester Central • Hotel/accommodation order form – Reservation Highways • Logistics services – AJM Transport • Shell scheme extras order form – Freeman Co • Stand catering order form – Manchester Central Catering

Key points

Badges and passes

• Build up passes required for anyone entering the hall on Mon build and Wed breakdown

Build up/Breakdown

• Hi-viz and sensible footwear

Internet and WiFi

• Free wifi available but other event taking place in Central halls so might be affected

• You will need to purchase wireless or hard line connection if demoing via web

• Use offline content if possible

Key points

Stand catering

• Venue supplied or own supply – forms and fees apply

• Barista – needs certification

Power

• 500w – covers most basic set up

• More power needed if more screens and barista machines

• Extension cables – please bring them if you need more sockets!

Questions

Getting the most out of exhibiting Speaker: Jamie Trevor, Exhibition Logistics Manager, NHS Providers

Why are you there?

• Who do you want to speak to? • Primary and secondary targets • What are your messages? • How are you measuring success?

A very senior NHS audience Currently 471 delegates which include:

• 79 Chairs

• 60 Chief executives

• 151 NHS Directors inc NEDs

Different shows, different audiences • Substance – more than just a freebie giveaway

• Something to cut through the ‘noise’

• Conversations

Stand design and graphics • Get rid of barriers

• Furniture – what’s it for?

• Where’s your literature?

• Don’t say everything

• Clear concise messaging – what can you

help the delegates achieve?

• Make it visible

What stops delegates talking to you? • Have you noticed them?

• Will they be interrupting you?

• Are you making the first move?

• Difficult for them to start the conversation

Stand personnel • There’s a reason why we’re generous with stand

personnel places

• The right people at the right times

• Look after your staff

• Give them authority

Stand personnel • Let them know why they are there and

what they’re doing

• Let them make the event their priority

• Keep them fresh

• Stand behaviour – good retail staff

Questions