Stockport Model

Presented by: Donald Menzies

2010 - 2011Every patient

mattersEvery pound counts

Occupational HealthMultidisciplinary team

Talk

• The Stockport Way• Working with partner regional OH Providers• The way ahead

PATIENTSTo Be Caring, Clean and Safe

FINANCETo Deliver Security

SERVICE21st Century Care

STAFFTo Develop Our Workforce

COMMUNITYCorporate Citizenship

Our Top 5 PrioritiesOur Top 5 Priorities

Every Patient Matters

OH Services Provided 2009

• Stockport Foundation Trust• Stockport PCT• Pennine Care Trust• Greater Manchester Ambulance Trust• Private Care organisations• Hospices• Voluntary organisations• Colleges of HFE• Transport companies• Private companies

OH SHH Clinical Team

2009• 1 Consultant Occupational Physician• 4 Occupational Physicians• 1 Clinical Nurse Manager• 4 Occupational Health Nurses• Counsellors• Management Team

• Business Manager• Secretarial and administration staff

• Website

OH Tender Coverage Merseyside, Greater Manchester, Lancashire & Cumbria

Process

Initial Discussions

(OHS services with geographical coverage)

Audit of current facilities• Data collection• Equipment• IT facilities• Counselling• Physio• KPI’s• Opening times• Costs• Use of post, email etc

Website development

NWAS partition • Password protected• Manager access• Employee access• Referral Forms• Physio• Counselling list

OH Services partition• Forms• Policies• Procedures

in-house website developer

Records - sharing: Scanning

Central Unit & Regional Units

Wigan

Carlisle

Barrow

Kendal

Lancaster

Preston

Chester

Aintree

Stockport

Our Regional Clinical Team

• 5 Consultant Occupational Physicians• 10 Occupational Physicians• 5 Clinical Nurse Managers• 25 Occupational Health Nurses• 15 Counsellors• Dedicated 1 WTE contract administrator• Management Team

• Business Manager• Secretarial and administration staff

Understanding your Priorities

• Comprehensive range of clinical services• Flexibility to meet changing requirements• Skilled professionals• Quality service• Value-for-money • Accessible to employees and managers• Prompt feedback

Services we can offer

Comprehensive Occupational Health Service• Pre-employment Health Assessment • Advice on Sickness Absence • Rehabilitation and Re-deployment Advice• Immunisations • Counselling • Health Promotion • Advice on practice legislation i.e. DDA• Periodic / Specialised Health Surveillance• Access to specialist services

Added Value We Offer quality focused

• Investors in People stamp of approval • Commitment to on-going training and

development of staff. • Committed to clinical excellence, audit,

clinical governance and quality assurance procedures.

Added Value Offervalue for money

• No hidden costs• Not profit motivated • Income spent directly on service to you • Cost conscious public sector organisation

Added Value We OfferNHS focused

• Proud to be part of NHS• Provider of choice to large number of NHS

organisations• Committed to supporting patient care by

supporting NHS organisations• Healthy and motivated workforce• We adhere to NHS policies and

governance requirements

Added Value We OfferNHS focused

• One lead provider – Stockport Foundation • Hospital based• Managed through local spokes• One on-line administration system • Local physio and counselling provided • Agreed timescales for appointments

How to run a Hub & Spoke OH programme(or a fictional railway)

• You need:• A Fat Controller (a Director to get the resources

& commitment and support the Engine Driver)• An Engine Driver (a “fired-up” person to do the

day-to day management work, liaison etc). • Red engine, blue engine, green engine etc

Conclusion 1

• Seemed a ‘brave’ project at inception• Supportive cooperative colleagues• Has required a lot of negotiating and influencing skills• IT has proved the most difficult to integrate• SLA’s a problem• BUT - we have found very few real service barriers in

practice

Conclusion 2

• Get to know their organisation• Projections of workload allows resource planning• Service specs – what not how• Comprehensive but few performance measures• Share information generously• Briefings of relevant information

Lessons learned

• IT biggest challenge– Encryption– Records– ESR OH

• Recruitment of counsellors• Regional Physio• Online forms works well• Regular contract meetings• Regular OH meetings• Communication

Relationship management

• Honesty

• Integrity

• Collaboration

• Mutuality

• Passion

• Humour

Working with fellow OH Providers

The recipe for a long term relationship BUT

both partners have to work at it!

Every patient matters Every pound counts

EFFICIENCY PROJECTSEFFICIENCY PROJECTS

Better ValueMaking best use of technology Working with other NHS OH

Challenges facing Occupational Health in the UK

• detachment from mainstream health care

• little communication with other specialties

• limited remit

• uneven provision, only in workplaces

• diminishing workforce

• shrinking academic base

• lack of good quality data

• image and perception

Working for a healthier tomorrow, 2008

Working in silos

The challenge for NHS OHS

Einstein said…

“If you keep on doing the same things and expect things to change, then that’s a definition of insanity.”

The world has changed….

Investing in good health at work

meansorganisational

change….

presents a huge opportunity for our profession

30th November 2010

Public Health strategy launched

Healthy Lives, Healthy People: Our strategy for public health in England.

To change or not to change….that is the question

Investing in good health at work

‘At a Tipping Point’• External Drivers• Internal Drivers

• OH reconfiguration response

The full cost of poor healthfor employers

30% S/A costs

AbsenteeismOvertimeTurnover

Temporary StaffingAdministrative Costs

Replacement TrainingOff-Site Travel for Care

Customer DissatisfactionVariable Service Quality

70% Health-related Productivity Costs

(adapted from R. Loeppke, US National Business Group for Health, Philadelphia 2009)

50 % of deaths

1. Tobacco use

2. Physical

inactivity

3. Poor diet

3 risk factors 4 chronic diseases

Globally, over 50%

of deaths are due to

these four diseases

4 chronic diseases

Three Four Fifty

Chronic

Respiratory

Disease

Cardiovascular

Disease

Obesity

Type 2

Diabetes

Cancer

Changing focus - 3 Risk Factors

3 Main Risk Factors can be attributed to the 4 main chronic diseases which lead to 50% of deaths in the UK. These risk factors provide a clear focus for action.

Proposal• A single collaborative OH service covers the whole of the

Manchester health economy • Provider of choice for OHS for all NHS in the area.• Service capacity and capability to provide a high-quality

occupational health service

• multidisciplinary includes nursing and medical staff with OH technicians, counsellors, cognitive behavioural

therapists, physiotherapists and other professionals • New standard care pathways • Innovative and better working practice

Proposal 2• project group to established of key personnel to agree

the outline service • period of consultation will take place involving all the

Trusts who want to be involved, the service users and

their representatives. • focus on outcomes with flexibility and imagination in the

creative joint working with Trusts • meet emerging demands including the well-being

agenda (Boorman), SEQOHS Standards, NHS

employers standards, etc

Proposal 3

• ANHOPS group to assist with benchmarking/audit • Links with Centre for Occup & Environmental Health,

University of Manchester - Largest postgraduate centre for OM in UK- Big research portfolio – HSE, EU, Research Council- Published on many topics incl backpain assesst & mental ill health

• Need experienced facilitator from SHA to work with experience of multi- trust service reconfiguration required to assist drive the project through to conclusion

The Door is Open

Any questions?