Update from NHS Improvement

Transcription

1 Update from NHS Improvement Adam Sewell-Jones Executive Director of Improvement June

2 Agenda State of the nation Financial turnaround The efficiency factor Building improvement capability 2

3 3 Performance comparison

4 4 Winter resilience preparation 2017/18

5 5 Financial performance overview by sector

6 6 Income and expenditure

7 7 Agency ceiling performance

8 8 Efficiency savings

9 9 Implied provider productivity

10 Recognising the need to minimise the burden of support The most challenged trusts often receive support from a range of sources including NHSI, consultancies and other trusts. If this support is not properly prioritised and coordinated, rather than helping it can make the situation worse. This is why NHS Improvement has been piloting an approach with a small number of trusts to streamline our interactions and coordinate all of our work through a single Executive Sponsor, supported by a Relationship Manager.

11 NHSI SUPPORT OFFERS Support is built around each trust The Executive Sponsor and Relationship Manager help the trust s leadership to coordinate various types and support and report into more streamlined oversight meeting. OVERSIGHT MEETINGS Executive Sponsor Trust Relationship Manager EXTERNAL SUPPORT OFFERS 11

12 Improving NHS productivity: understanding acute sector quality and efficiency - Approach and what we have learnt so far Phase 1: Initiation Phase 2: Implementation Phase 3: Learning 2 weeks 3 months Executive Sponsor and Relationship Manager works with each trust to: Assess financial, quality and operational issues and identify improvements desired over 3 months Perform a stocktake of existing interventions and professional services interventions in each trust and and form a view on whether these continue, are modified or stopped Identify any additional input needed from NHSI or elsewhere Agree the improvement objectives and delivery plans over 3 months Adjust existing governance arrangements if necessary Any necessary recalibration of existing work Mobilisation of any new work with trusts Implementation of plans and monitoring of progress against objectives Progress meetings with trusts Review of outcomes Evaluation of approach Discussion with trust on next steps Early feedback Trusts and NHS Improvement s own staff feel that coordination has improved and there is a better understanding of priorities Trusts would like to get more involved in shaping this approach for future waves

13 Beliefs Weak process is at the heart workplace frustration and efficiency Enormous potential locked in the processes of every organisation Lean principles key to unlock this potential Staff and patients see this potential everyday but don t have a method to release it Lean is just a method to allow them to release this potential Believe in Safety then Quality then Productivity then Cost improvement in that order 13

14 The Eight Types of Waste Type of Waste Brief Description Hospital Examples Defects Overproduction Transportation Waiting Inventory Motion Over processing Human potential Time spent doing something incorrectly, inspecting for errors, or fixing errors Doing more that what is needed by the customer or doing it sooner than needed Unnecessary movement of the product (patients, specimens, materials) in a system Waiting for the next event to occur or next work activity Excess inventory cost through financial costs, storage and movement costs, spoilage, wastage Unnecessary movement by employees in the system Doing work that is not valued by the customer or caused by definitions of quality that are not aligned with patients needs Waste and loss due to not engaging employees, listening to their ideas, or supporting their careers Surgical case cart missing an item; wrong medicine or wrong dose administered to patient Doing unnecessary diagnostic procedures Poor layout, such as a catheter lab being located a long distance from the ED Employees waiting because workloads are not level; patients waiting for an appointment Expired supplies that must be disposed of, such as out-of-date medications Lab employees walking miles per day due to poor layout Time/date stamps put onto forms, but the data are never used Employees get burned out and quit giving suggestions for improvement

15 15 Building improvement capability

16 16 Developing People - Improving Care: #ImprovingTogether

17 17 Five conditions

18 National pledges Pledge 1: We will support local decision-makers through collectively reshaping the regulatory and oversight environment. In particular, we owe local organisations and systems time and space to establish continuous improvement cultures Pledge 2: We will model in all our dealings with the sector and in our own organisations the inclusive, compassionate leadership and attention to people development that establish continues improvement cultures Pledge 3: We will use the framework as a guide when we do anything at a national level concerning leadership, improvement and talent management so we engage across the sector with one voice. 18

19 It s hard work!!!!!! Senior Leadership (vision, priority, guidance, resources, accountability) Shared Values Clinical Leadership Local Team Redesign cycle Clinical Leadership Local Team Redesign cycle Clinical Leadership Local Team Redesign cycle Data & reporting Data & reporting Data & reporting Support team 19 Source: Bohmer RMJ. The Hard Work of Health Care Transformation. New England Journal of Medicine, 2016; 375(8):

20 It s hard work!!!!!! In % of NHS trusts and foundation trusts mentioned lean in their annual report. But lean done properly is like taking your organisation to the gym. Many of these trusts just bought the trainers! Alan Martyn, Director of Lean Transformation, NHS Improvement 20

21 Mainstream improvement approaches Measurement for improvement Better board reporting Process visualisation tools for operational management Open source tools created and free to use Online community of practice 21

22 Building knowledge Quality, Service improvement and Redesign (QSIR) College Delivered by the ACT Academy Fully funded 22

23 In-house consultancy offers 23