Welcome Shared Services Health Portfolio Laboratories A Distributed Services Workshop 14/12/16
Agenda What we will cover today Time Subject 10:00 Registration 10.20 Welcome & Progress Update 11:10 Exercise 1. Distributed Service Model: A view of the future 12:00 Lunch & Networking 12:50 Exercise 2. Enabling the future through convergence 13:30 Coffee & Networking 13.45 Q&A / Next Steps 14.30 Close
Objectives for the workshop Aims for the day Endorse the guiding principles that apply to the delivery of a distributed service model Confirm and further develop a common understanding of the vision for the laboratory distributed service model Identify mechanisms to enable convergence of services by reduction of variation Begin development of a strategic approach to delivery of the model
Rules Please remember to.. Leave your Health Board and ology at the door Represent the views of your wider profession Think whole system, be ambitious Listen there are no bad ideas Be open to the views of others House rules
Getting to know you Introductions Who is in the room?
Laboratory Update
Where are we now? Mandate Positioning Paper Visioning Workshop 1
Summary Visioning Workshop 15/09/16 Participants agreed: That there is case for change to laboratory services in Scotland A high level distributed service vision of the way forward for laboratories
Themes from the day Visioning Workshop 14/12/16 There is value in taking a Shared Services approach in laboratories and working better across Board boundaries National approach to governance, planning and coordination of laboratories services, including point of care testing Joined up planning with users of laboratory services Workforce development, education and training, variation in bandings and job roles There is currently significant variation in what services are offered and how they are offered need for consistency and standardisation across the country Address the concern and burden around accreditation IT is a key enabler Need to deliver new technologies in a joined up way Consistent, accurate data is a key enabler
Summary Visioning Workshop 15/09/16 You said.. Communication like this, in the wider lab community is important. There is a huge willing in the laboratory community for this to work. We need to make this happen! Leaving boards and 'ologies' back at the workplace has enabled brave thinking. Still unsure of the vision in terms of how we can make it happen
Outcome Visioning Workshop 15/09/16 Progression to a distributed services model for laboratories in Scotland is appropriate. This formed the basis of the positioning paper taken to the Chief Executives.
Progress since workshop 1 Workshop data consolidated Identified enablers and guiding principles Information from the workshop, SWOT & PESTLE - Positioning Paper Positioning paper accepted by Board of CEs Mandate given 4 projects identified as early enablers Work commenced on 2 projects Workshop 2 A Distributed Service: Strategy
Where are we now? Positioning Paper Strategic Paper Business Case Implementation MANDATE Data IT Innovation Reduce Variation
Chief Executives mandate A request for: A strategic paper on the proposed distributed service model Progressing enabling projects Data Improving laboratories data IT To enable a distributed service Innovation Reduce Variation Exploring innovative solutions Digital pathology as an initial pilot Reduction in variation of laboratories service
What do we want to achieve?
We want to achieve A future proof model Service resilience across NHSScotland A sustainable, resilient workforce Delivery of 2020 Vision and support transformation Value for money
Future proof model What is causing the need for change? Increasing demand and new models of care developing Why do we need to change? Existing configuration unable to respond (ageing, silos) Why now? Increasing risk of failure / investment need What do we want to achieve? To put in place a flexible, scalable configuration of facilities that can meet future demand
Service resilience across NHSScotland What is causing the need for change? Variation in form and function across Boards Why do we need to change? Service model does not facilitate cross border working Why now? Risk of failure as service model not resilient What do we want to achieve? To enhance service resilience through minimising variation and enabling cross border working
Workforce What is causing the need for change? Staff supply issues right skills and knowledge, right place Why do we need to change? To provide a sustainable, resilient workforce Why now? Imminent risk to service sustainability and development What do we want to achieve? To provide a sustainable, resilient, adaptable workforce linked to a credible workforce plan
Delivery of 2020 Vision and support transformation What is causing the need for change? 2020 Vision improving quality of healthcare Why do we need to change? Need to refresh outdated technology/ageing infrastructure and spread good practice currently happening in silos. Why now? Change required/happening now support delivery of the NHSScotland Clinical Strategy What do we want to achieve? To provide improved and equitable outcomes for patients (2020Vision) by reconfiguring to support NHS transformation
Expenditure/Investment What is causing the need for change? Financial pressures across the health care system Why do we need to change? Shrinking budgets and competing demand for revenue and capital Why now? Need to make savings meet CRES targets at a time when investment is needed What do we want to achieve? Deliver demonstrable value for money, reduce/avoid expenditure to enable appropriate investment in effectiveness
We want to achieve A future proof model Service resilience across NHSScotland A sustainable, resilient workforce Delivery of 2020 Vision and support transformation Value for money
A Distributed Service Model
A Distributed Service Functional distribution NOT centralisation Functional distribution of laboratory resource that enables equitable delivery of high quality health care independent of location. Right test Right place Right time
Defining the future landscape Distributed Services
Distributed service Affordable Efficient Clinical services Effective Interface and infrastructure that: - delivers what is needed by the users supports efficient, appropriate and effective use and delivery of diagnostics hides from the user from the organisational complexity of the provider Resilient Equitable Efficient Users Affordable Distributed Effective Provider Laboratory services Resilient Equitable
Challenge Requesting reporting interface Primary care Users Secondary care Right test Right place Right time Providers Others
Towards a future state: Distributed services Functional distribution of services NOT centralisation Right test Right place Right time
Labs in Scotland 1 Nation 5.25 Million people 14 Territorial boards 7 Special boards 32 Local authorities 31 Integrated joint boards
National Pie Functional distribution NOT centralisation
Issues Definition of a basic service requirement for health care units of varying size and complexity Form of delivery of specialities may vary Resilience Workforce Common IT Governance Innovation and technology Point of care testing Demand optimisation Reduction of variation Logistics Right test Right place Right time Affordable Resilient Efficient Distributed Laboratory Services Equitable Effective
Towards a future state: distributed service Efficient Affordable Effective Distributed Laboratory Services Resilient Equitable
Towards a future state: distributed service Vision Shared common understanding? Delivery Strategy Design
Road map with organisational alignment
Guiding Principles Were constructed from outputs of Visioning Workshop and managed diagnostic networks Were circulated in survey format for your consideration to enable discussion and endorsement Results of the survey...
How will they be used? They will lay the foundations for the distributed model They will enable identification of design principles for the design of the model They will support the development of a road map to delivery of the model which will require interim organisational alignment.
Group Exercise 1 Distributed Service Model: A view of the future
Group exercise 1 Distributed Service Model: A view of the future In this first exercise we would like to think ahead to the laboratories distributed service in 5 10 years in the future where all of the enablers are in place. Governance IT Data Workforce Innovation Standardisation Logistics Leadership What would this service look like?
Group exercise 1 Distributed service model: A view of the future 1. Produce a visualisation of what the service would look like in 5 10 years 2. Simultaneously populate the grid with attributes to describe your picture CONSIDER: The guiding principles Form should follow function Population density & demographics Greater focus of delivery of healthcare in primary care environments The need to deliver equitable access to large repertoires of testing of varying degrees of complexity to the population of Scotland (e.g. turn around times) High cost innovative solutions Delivery of education & training Maintaining a resilient workforce
Why a picture? Models the overall systems and helps the owner understand and clarify the problem and the problem domain Summarises all that is known about the situation Exposes differences of opinion Self explanatory Two purposes: Clarifies your understanding Communicates your understanding to others
Examples
Group exercise 1 Distributed service model: A view of the future 40 minutes for exercise 10 minutes for a walk around Facilitator will stay at the table Can also view at lunch / coffee Please take pictures and share ideas
Group exercise 1 Distributed service model: A view of the future 1. Produce a visualisation of what the service would look like in 5 10 years 2. Simultaneously populate the grid with attributes to describe your picture CONSIDER: The guiding principles Form should follow function Population density & demographics Greater focus of delivery of healthcare in primary care environments The need to deliver equitable access to large repertoires of testing of varying degrees of complexity to the population of Scotland (e.g. turn around times) High cost innovative solutions Delivery of education & training Maintaining a resilient workforce
Lunch & Networking
Group Exercise 2 Enabling the future through convergence
Group exercise 2 Enabling the future through convergence In your groups we would like you to discuss: What are the most important areas for convergence of existing services to enable transition to your future vision of a distributed laboratory service? Identify: The area of convergence What do we need to do? Who needs to do it? What benefit will this create? Timeline
Group exercise 2 Enabling the future through convergence Area of convergence What do we need to do? Who? Benefits Timeline for delivery Standard operating procedures (e.g. Test / Examinations) Ensure SOPs available nationally and uniformly applied Managed diagnostic networks Best care across Scotland enabling cross locality working Development of a timeline for delivery = 6 months?
Coffee & Networking
Q&A
Recap Objectives, next steps & close
Objectives for the workshop Aims for the day Endorse the guiding principles that apply to the delivery of a distributed service model Confirm and further develop a common understanding of the vision for the laboratory distributed service model Identify mechanisms to enable convergence of services by reduction of variation Begin development of a strategic approach to delivery of the model
Next steps Working towards the strategic direction Produce flash report to summarise today s activity Refining the shared vision of a distributed service model Consider options for potential service models Continue information collection to establish a baseline Inform the direction of the 4 project streams: Data IT Innovation Standardisation Workshop 3 (March 2017)
Next steps Your role You have an important role to play As clinical experts we are looking for your endorsement that this vision is safe, patient-centred, effective, and sustainable Your input will be key in developing and assessing options Please share information with colleagues
Thank you for your participation today Please give us your feedback