The Pressures of Sustainability in the NHS. Paul Holt Director of Estates

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1 The Pressures of Sustainability in the NHS Paul Holt Director of Estates

2 Defining Sustainability The management of an organisation s total impact upon both its immediate stakeholders and upon the society within which it operates..accounting for a wide range of criteria relating to the financial, environmental and social implications of business operations. DTI/CRG Report Changing Manager Mind-sets (2003)

3 Pressure or Pleasure

4 Pressure or Pleasure THE DAY JOB

5 The Trust s values & mission Provide high quality, accessible and responsive services by putting the patient at the heart of everything we do

6 Corporate Objectives FINANCE COMMUNITY STAFF SERVICE PATIENTS Strategic objectives 3-5 year timeframe Corporate objectives 1 year timeframe Department / team objectives 1 year timeframe Individual objectives 1 year timeframe

7 Strategic objectives Avoid needless harm by providing safe and clean care to all patients Avoid needless deaths by providing effective, evidence-based care, reducing HSMR to 80 by 2012 Continually improve patient and family experience: achieve top 10% in national patient satisfaction survey Develop and sustain a valued, motivated and skilled workforce to deliver excellent patient care Leaders use lean techniques to inspire, drive and sustain a culture of continuous improvement Be in the top 5% of Trusts nationally by April 2013 Ensure national targets are met, achieving NHS Operating Framework requirements each year Ensure financial security: achieve a Monitor risk rating of 4 or better every year in the medium term plan Business Groups and Directorates proactively contribute to corporate social responsibility (CSR)

8 Trust Business Plan by Strategic Objective Provide high quality, accessible and responsive services by putting the patient at the heart of everything we do Avoid needless harm Avoid needless deaths Patient experience Workforce development Improvement culture Top 5% of of Trusts National targets Financial security CSR Reduce MRSA to to zero Improve care through Advancing Quality Improve minimum ward standards Comprehensive workforce plans created and implemented Improvement embedded in in business groups agendas Efficient and effective utilisation of of beds and theatres Reduce MRSA to to zero Deliver clinical income targets Include CSR objectives in in bg bg business plans Reduce hospital acquired C.diff. improve recognition of of the acutely unwell patient Reduce harm from patient falls improve outcomes for for patients with #NoF Increase survival through additional, effective evidencebased practices Meet mixed sex accommodation standards Address reasons for for patient complaints reliably Create efficient & effective complaint response and resolution process 80% of of Trust staff have an an annual appraisal 96% of of staff demonstrate commitment by by reliable attendance First class leaders undertaken by by 75% per cent of of clinical managers Productive ward objectives met Reduce ALoS for for Medical patients from 8.5 to to 8.0 days Deliver 4% improvement in in efficiency and productivity CQC rates Stockport FT FT as as excellent for for use of of resources Screen 100% of of elective patients for for MRSA Reduce hospital acquired C.diff. Deliver minimum standards for for all all cancer patients Deliver planned activity and performance within expenditure budget Deliver 4% improvement in in efficiency and productivity Implement and use service line reporting system for for bg bg monitoring Extend VLS to to more departments and increase placements Achieve CMIP target reductions Reduce staff travel to to work in in single occupant cars by by 0.5% Improve efficiency and reliability of of patient identification Engage with patients & service users to to obtain feedback Act on on all all areas for for development identified in in patient surveys Ensure all all services and policies are impact assessed for for E&D Stockport NHSFT Deliver minimum referral to to treatment pathway standards (18 wks) Consistently deliver ED waiting times performance standards Deliver performance standard for for thrombolysis Deliver capital programme within budget Standardise existing and new Service Level Agreements Reduce nonclinical landfill and increase recycling Increase local purchasing Increase membership involvement and activity

9 Business Group Delivery Medicine W & C D&CS Elective Services Estates Facilities Ensure CSR objectives in Business Group by March 2012 Continue to develop relationships with 3rd sector providers Reduce staff travel costs Organise open days for local community Encourage staff to use public transport, car sharing & cycling Encourage staff to use public transport, car sharing & cycling Identify areas with all depts to extend and increase placement for VLS Sustainable CapitalProgram Facilities Liaison Sustainable Agenda Reduce dependence on landfill Continue involvement and Commitment to VLS Continue to develop links with Children s Trust and sub-groups to improve links with other orgs Increase number of volunteers Offer work experience placements Provide school talks about careers in the NHS Ensure all new equipment is energy efficient Identify key areas and materials for which recycling can be increased by raising awareness Ensure all new equipment is energy efficient to contribute towards carbon footprint Reduce amount of paper usage & maximise opportunities within digital dictation Source equipment & materials locally where possible by communications with procurement Sustainable Agenda CMIP Agenda Energy Management Water Management Deliver CSR Extend use of electric vehicles Deliver a workable solution to encourage car share Deliver recycling plan Identify local purchasing opportunities Improve education for clinical waste

10 Progress against the Strategic Objective Include CSR objectives in bg business plans Extend VLS to more departments and increase placements Achieve CMIP target reductions Reduce staff travel to work in single occupant cars by 0.5% Reduce nonclinical landfill and increase recycling Increase local purchas/ ing Increase member s involve/ ment and activity RAG rating

11 CSR Current Performance Increased our performance by 13% Achieved 60 % score of the Good Corporate Citizenship score card

12 Estates & Facilities - Specific Highlights Environment 1 st Impressions Regular Inspection agenda & scoring mechanism Focussed investment in those areas of most need Reducing clutter & improving storage Brightening up clinical areas Developing plans to create a Ward charter standard that we all aspire to maintain Strong/positive PEAT scores

13 Estates - Specific Highlights Carbon Management Implementation Plan Exemplar document Carbon Trust Mitie Energy Partners preparing a strategic plan Capital Investment of 300k per annum Seeking external Salix funding to complete the Big Bang Influencing the development of the site through advice and guidance Appointment of energy champions Helps deliver the CRP

14 Facilities - Specific Highlights Transport Travel Plan Ratified by the Board & the Local Authority Regular TRICS survey Roll out of bike facilities Improved walking access across the site for people wheelchair users Promoted through the Team Brief

15 Facilities - Specific Highlights Waste Recycling Commercial plastic bottles Waste Cardboard Waste paper Majority of construction waste Procurement methods reduce waste at source Recycling of computers Food waste is reduced to a liquid and put down the drain

16 Finance Specific Highlights Procurement How to guide is allowing greater access to local contractors to tender Involved in Meet the Buyer events Probably 80% of companies we use are Manchester based Design development considerate of the BREEAM standard Southern Sector main supplier MTX Expect P 21+ partners to procure through the local economy

17 Summary Despite the increasing economic pressure A good start Demonstrated through the values being embedded within the Corporate Objectives Delivered through Divisional objectives Evidenced with a growing list of real outcomes Saving Money & the environment We can keep our ethical principles whilst facing the economic challenges remembering.

18 The Trust s values & mission Provide high quality, accessible and responsive services by putting the patient & Sustainability at the heart of everything we do