Using the Model Hospital to Improve Productivity

Transcription

1 Using the Model Hospital to Improve Productivity Thursday 6 September nhsi.modelhospital@nhs.net #modelhospital 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 #Expo18NHS

2 Visit the following link on your phone to feedback and ask questions glsr.it/modelhospital

3 Model Hospital is a strategic data and information tool to support improvement Identify your opportunities to improve Tracking and monitoring of delivery Understand the drivers of your opportunities Case studies and best practice to support improvement Identify areas for action Understand detail and develop a plan

4 We re redesigning to focus more on opportunities and where you can find them

5 We re redesigning to focus more on opportunities and where you can find them

6 We re redesigning to focus more on opportunities and where you can find them

7 We re redesigning to focus more on opportunities and where you can find them

8 We re redesigning the metric pages to make them clear and comprehensive

9 We re making the Model Hospital more responsive Desktop Homepage Mobile and tablet friendly design

10 We are incorporating more best practice information, guidance and case studies

11 and expanding to cover more sectors and give a more holistic view of a system

12 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%)

13 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/

14 Consider the factors driving variation Considerations Use of contracted services? Vacancy position? Outsourcing Costs? Overheads for Income Generation? Community service provision? Directly commissioned services?

15 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

16 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) Top 10 Medicines Savings Target Procurement Savings Target

17 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?

18 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 Orthopaedic* & Spinal Surgery 3,085, ,544 X 75.09% 79% 80% Neurosurgery Elective 7,761, ,507 X 79.34% 81% 72% Ophthalmology* Day Case 4,523, ,738 X 75.65% 93% 94% Urology* Elective 3,468, ,744 X 77.04% 67% 76% Plastics* Elective 2,087, ,248 X Plastics* Day Case 4,305, ,813 X 75.22% 70% 73% General Surgery* Elective 9,602, ,238 X 75.39% 67% 67% Breast Surgery* Elective 1,404, ,904 X 85.25% 78% 72% Vascular* Elective 1,814, ,063 X 79.77% 73% 78% Obs and Gynae* Elective 3,038, ,531 X 75.13% 85% 80% Dentistry Day Case 311, ,431 X ENT * Day Case 2,287,547 81,962 X ENT* Elective 1,652,857 60,112 X 76.22% 69% 73% Paediatrics Elective 254,501 32,214 X 73.75% 44% N/A Dermatology Day Case 715, ,224 X Dermatology Elective 61,309 23,941 X Overlaying variance ( ) with response plan Is improvement being achieved? 76.21% 51% 50%

19 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 Obs and Gynae 8,835, ,091 X 71.4/ / /2.4 Urology 2,695, ,072 X Breast Surgery 1,665, ,028 X Cardiology 2,253, ,989 X Neurology 2,149, ,161 X ENT 2,664, ,632 X Paediatrics 4,535, ,513 X Dentistry 1,471, ,667 X Diabetes and Endo 1,746,893 59,432 X 80/ / /15.6 Rheumatology 2,198,109 16,598 X Overlaying variance ( ) with response plan Is improvement being achieved?

20 Model Hospital: Outpatient Cost per WAU Variance Outpatient: Largest Variance: Respiratory Next Steps? Variance ( ) What % is it of the total costs of delivery by setting? 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?

21 Now starting to look at productivity across an STP Is this ok? Do we understand this? Why are we all in different quartiles? What can we learn from each other in driving improvement? Is this ok? Do we understand this? Why is 1 Trust in Q1 (Green) Why are 3 Trusts in Q4 (Red)

22 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.

23 Question? Register at Feedback at or at 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