using the model hospital to improve productivity nhsi.modelhospital@nhs.net using the model hospital

Download Using the Model Hospital to Improve Productivity nhsi.modelhospital@nhs.net Using the Model Hospital

Post on 15-Mar-2020

0 views

Category:

Documents

0 download

Embed Size (px)

TRANSCRIPT

  • https://model.nhs.uk

    nhsi.modelhospital@nhs.net

    Using the Model Hospital to Improve Productivity

    Thursday 6 September 2018

    Dr David Ashby

    Director of Model Hospital and Analytics

    Dan Cariad

    Policy and Strategy Lead, Model Hospital

    Laura Langsford

    Model Hospital and GIRFT Programme Manager,

    University Hospitals Plymouth NHS Trust

    @ExpoNHS #Expo18NHS

    https://model.nhs.uk nhsi.Modelhospital@nhs.net

    @model_hospital #modelhospital

    https://model.nhs.uk/ mailto:nhsi.modelhospital@nhs.net https://model.nhs.uk/ mailto:nhsi.Modelhospital@nhs.net

  • Visit the following link on your phone to feedback

    and ask questions

    glsr.it/modelhospital

  • Model Hospital is a strategic data and information tool to

    support improvement

    Identify your opportunities to

    improve

    Understand the drivers of your opportunities

    Identify areas for action

    Understand detail and develop a plan

    Case studies and best practice to

    support improvement

    Tracking and monitoring of delivery

  • We’re redesigning to focus more on opportunities and

    where you can find them

  • We’re redesigning to focus more on opportunities and

    where you can find them

  • We’re redesigning to focus more on opportunities and

    where you can find them

  • We’re redesigning to focus more on opportunities and

    where you can find them

  • We’re redesigning the metric pages to make them clear

    and comprehensive

  • We’re making the Model Hospital more responsive

    Mobile and tablet

    friendly design Desktop Homepage

  • We are incorporating more best practice information,

    guidance and case studies…

  • …and expanding to cover more sectors and give a more

    holistic view of a system

  • Plymouth have put the Model Hospital at the centre of their

    Carter Programme

    • Lord Carter’s Feb 2016 report identified wide variation in acute hospital productivity and efficiency, with

    unwarranted variation as well as warranted variation.

    • It made a set of recommendations to make efficiencies over the next few years, of which the Model

    Hospital was one of them.

    NHS Efficiency Challenge

    • £55.6bn spend annually by Acute Hospitals

    • Reduce unwarranted variation

    • Save £5bn (nearly 10%)

  • Selecting the right peers is critical

    • How can Peers be used well? • What does Peer median tell us? • What makes a good Peer Selection? • When to use STP, and CQC Outstanding Peer Groups/

  • Consider the factors driving variation

    Considerations Use of contracted services? Vacancy position? Outsourcing Costs? Overheads for Income Generation? Community service provision? Directly commissioned services?

  • Deep Dive into priority areas in detail

    Pay • Track back to the metric • Use ESR data – Obtain visibility • Engage with Stakeholders • What costs to move to an improved quartile? • So, what would we need to do differently?

    Supporting Tools: • Example: Medical Staff Cost per WAU?

    • % Direct Clinical Care time • % SPA time • Consultant Costs • WLI Costs • WTE to Staff Ratios

  • Non-pay requires a different approach

    Non Pay • Use Trust accounts as the reference source • Align it in the Model Hospital methodology • Review separate categories • Model Hospital Supporting tools?

    • Individual Dashboards for each element • Procurement (PPIB Performance unit costs) • Drugs (Top 10 Savings Performance) • Estates and Facilities (Unit Costs)

    Procurement – Savings Target

    Top 10 Medicines – Savings Target

  • Care settings are critical to understanding Clinical

    Service Line Productivity

    Getting Trust Oversight Getting visibility – By setting? What are you biggest challenges? Delivering a Response Plan?

  • Elective, and Day Case Cost per WAU Variances: Overlay with Theatre Utilisation Performance

    Service Activity

    Reported 16/17

    Reference Costs

    16/17 Variance to

    National Average (£)

    Q1 Q2 Q3 Q4 Job

    Planning % DCC

    Theatres % Utilisation Pre-Persist

    17/18

    Theatres % Utilisation July 2018

    Orthopaedic *& Spinal Elective £13,875,298 £2,120,627 X 75.09% 79% 80%

    Orthopaedic* & Spinal Surgery £3,085,309 £212,544 X

    Neurosurgery Elective £7,761,956 £899,507 X 79.34% 81% 72%

    Ophthalmology* Day Case £4,523,600 £736,738 X 75.65% 93% 94%

    Urology* Elective £3,468,871 £418,744 X 77.04% 67% 76% Plastics* Elective £2,087,740 £403,248 X

    75.22% 70% 73% Plastics* Day Case £4,305,273 £405,813 X

    General Surgery* Elective £9,602,292 £320,238 X 75.39% 67% 67%

    Breast Surgery* Elective £1,404,608 £252,904 X 85.25% 78% 72%

    Vascular* Elective £1,814,738 £153,063 X 79.77% 73% 78%

    Obs and Gynae* Elective £3,038,370 £130,531 X 75.13% 85% 80%

    Dentistry Day Case £311,412 £119,431 X ENT * Day Case £2,287,547 £81,962 X

    76.22% 69% 73% ENT* Elective £1,652,857 £60,112 X

    Paediatrics Elective £254,501 £32,214 X 73.75% 44% N/A Dermatology Day Case £715,372 £347,224 X

    76.21% 51% 50% Dermatology Elective £61,309 £23,941 X

    Overlaying variance (£) with response plan Is improvement being achieved?

  • Model Hospital: Outpatient Cost per WAU Variances:

    Overlay with Outpatient Programme Utilisation Performance (last Quarter)

    Service

    Reported 16/17

    Reference Costs

    16/17 Variance to

    National Average (£)

    Q1 Q2 Q3 Q4

    OP Clinic Utilisation

    Pre Start of OP Project

    (Aug- Sep 17)

    OP Clinic Utilisation

    Latest Quarter (Apr - Jun 18)

    % Change?

    Respiratory £3,856,209 £1,135,598 X 86.5 88.8 2.3 Obs and Gynae £8,835,833 £584,091 X 71.4/88.3 64.3/90.7 -7.1/2.4 Urology £2,695,219 £551,072 X 86 83.7 -2.3 Breast Surgery £1,665,444 £399,028 X 91.8 90.9 -0.9 Cardiology £2,253,439 £130,989 X 89.4 90.7 1.3 Neurology £2,149,496 £316,161 X 86.5 85.2 -1.3 ENT £2,664,268 £243,632 X 87.4 90 2.6 Paediatrics £4,535,013 £192,513 X 79.3 82.5 3.2 Dentistry £1,471,573 £191,667 X 81.1 80.7 -0.4 Diabetes and Endo £1,746,893 £59,432 X 80/58 80.6/73.6 0.6/15.6

    Rheumatology £2,198,109 £16,598 X 87.8 88.8 1

    Overlaying variance (£) with response plan Is improvement being achieved?

  • Model Hospital: Outpatient Cost per WAU Variance Outpatient: Largest Variance: Respiratory

    Next Steps?

    • Job Plan % Direct clinical care? • Job Planned time v Clinic delivered time? • Clinic utilisation? • Consultant led/Nurse led clinics? • DNA rate? • Clinics/Procedures with highest variation (£)? • Is all activity being recorded – Tel Clinics? • Procedure steps – Are we under recording

    activity that is being delivered? • Benchmarking with One Stop clinics? • Complexity of procedure by setting; Are we

    delivering higher complex work in an OP setting?

    Variance (£) What % is it of the total costs of

    delivery by setting?

  • Now starting to look at productivity across an STP…

    Is this ok? Do we understand this? Why are we all in different quartiles?

    Is this ok? Do we understand this? Why is 1 Trust in Q1 (Green) Why are 3 Trusts in Q4 (Red)

    What can we learn from each other in driving improvement?

  • Model Hospital Trust Ambassador Programme

    • Benefit from exclusive previews and learning opportunities within the

    Model Hospital;

    • Help shape and influence the Model Hospital as a trusted local expert

    for your organisation, with knowledge of local context and practices;

    • Champion the Model Hospital within your trust. Acting as a key contact

    for your organisation, sharing the latest developments and supporting

    colleagues to actively use the tool;

    • Network nationally with other trust ambassadors sharing ideas, best

    practice and learning between trusts.

  • Question?

    • Register at https://model.nhs.uk

    • Feedback at http://feedback.model.nhs.uk or at tickets@nhsi.uservoice.com

    • View our Animations: ‘Introduction to the Model Hospital’ and ‘What is a WAU?’,

    • Watch our series of Masterclass webinars available on demand

    • Become a Model Hospital Trust Ambassador: nhsi.modelhospital@nhs.net

    https://model.nhs.uk/ http://feedback.model.nhs.uk/ mailto:tickets@nhsi.uservoice.com https://youtu.be/sAZZDVTmlT0 https://youtu.be/5LBUULouhrw http://feedback.model.nhs.uk/knowledgebase/articles/1846981 mailto:nhsi.modelhospital@nhs.net

Recommended

View more >