gerald coteman, chairman taking control foundation trust clinical and patient empowerment (inc....
TRANSCRIPT
Gerald Coteman, Chairman
Taking Control
• Foundation Trust
• Clinical and Patient Empowerment (inc. commissioning)
• Health versus Hospitals
Health• Long term Conditions • Long term Conditions• Long term Conditions
• Biggest global disease burden facing the modern world
• PAH - reinforcing our role in both managing and preventing ill-health
• Deep and sustainable reform of commissioning and Local Health Economy
What Else is Important?• Stronger and more visible Board
• Higher priority for patient quality and safety
• Engagement with staff and patients has improved
• Dialogue with our partners and stakeholders has increased and improved
Other Things that Matter
• To you –
– Dementia
• To me –
– Carers
Managing Long Term ConditionsRory McCrea, GP
Jane Herbert, Chief Executive
The Princess Alexandra Hospital NHS Trust
Now and In the Future
Our Five Year Vision and Mission
“To become the best general hospital in the East of England”
“To deliver the best possible care in a safe, reliable, effective and
respectful environment”
• Quality: patient safety, outcomes and patient satisfaction
• Capacity and demand
• Money
• Compliance and access target
• Strategy and strategic relationships
Findings and Priorities
Foundation Trust Application
Quality• Patient safety and
outcomes: clinical working groups in place helping to deliver safe care and best practice
• Patient perceptions: big improvement but A&E still an issue
• Board focus: new assurance systems being refined
• Patient experience - more action needed in some areas
Capacity and Demand
0
500
1,000
1,500
2,000
2,500
3,000
Janu
ary
Febr
uary
Mar
ch
Sept
embe
r
Oct
ober
Nov
embe
r
Dec
embe
r
Apr
il
May
June July
Aug
ust
2009/10 2010/11
Spel
ls
Activity - Emergency - Actual v PlanActual
Plan (I)
0
500
1,000
1,500
2,000
2,500
3,000
3,500
Janu
ary
Febr
uary
Mar
ch
Sept
embe
r
Oct
ober
Nov
embe
r
Dec
embe
r
Apr
il
May
June July
Aug
ust
2009/10 2010/11
Spel
ls
Activity - Elective - Actual v PlanActual
Plan (I)
Capacity and Demand Management• Significant mismatch
between demand and capacity
• Causes inefficiencies• Jeopardises access
targets• Poorer patient
experience• Workforce issues • Threatens the
Foundation Trust application
• Change in strategy needed
• More support for Care Closer to Home
• Internal work to reduce demand
• Refresh bed strategy
Finance – Headline ResultsSteady delivery of surpluses since deficit in 2005/06
-8000
-6000
-4000
-2000
0
2000
4000
6000
2005/06 2006/07 2007/08 2008/09 2009/10 2010/11
Income & ExpenditureSurplus / -Deficit
Planned Actual
Continued growth of the Trust which will decrease
125.0 136.8
149.2 161.3
172.6 168.4
2005/06 2006/07 2007/08 2008/09 2009/10 2010/11
TurnoverTurnover
7,500 6,714
9,848
5,816
8,781 8,474
4,200 4,470 5,266 5,392
7,133 7,290
2005/06 2006/07 2007/08 2008/09 2009/10 2010/11
Capital Cashflow & DepreciationCapital DepreciationCapital Investment
Where We Spent Our Money
Medical£36,080
21%
Nursing£37,119
22%
Other staff£31,855
19%Domestics
£6,4224%
Operating expenses£48,887
28%
Depreciation£7,133
4%
Financing£4,163
2%
Expenses
0
500
1,000
1,500
2,000
2,500
3,000
2005/06 2006/07 2007/08 2008/09 2009/10 2010/11
Staff (WTE)
Medical Nursing Other Clinical Scientific & Technical Non Clinical
The Auditors Local Evaluation (ALE)
2 2
1
2 2
1
2 2 2 2 2 2
3 3 3
2
3 3
2
3
4
2
3 3
2
3
4
2
3 3
Financial Reporting
Financial Management
Financial Standing
Internal Control
Value for Money
Overall
Auditors Local Evaluation"Use of Resources"
2005/06 2006/07 2007/08 2008/09 2009/10
Excellent (4)Good (3)Adequate (2)Inadequate (1)
Compliance and Access Targets
• Delivery is varied• Problems from increased
demand
• Focus on underlying capacity/demand mismatch
• Prioritise • Ensure milestones for key
targets with tight performance management systems
Strategy and Strategic Relationships
• Relationship with PCT must be constructive
• White paper maintains drive to FT for acute hospitals by 12/13
• GPs to become commissioners
• New FT application with less not more activity in the future
• Collaborate with PCT over joint targets
• Continue to build links with GPs, community services, local acute hospitals
What does this mean for our Foundation Trust Application?
Summary• Top priority: work with PCT on “Care Closer to
Home” to address capacity and demand imbalance to underpin other key issues
• Strategy therefore based on doing less, not more• Continue to drive quality agenda and refine
assurance/governance• Focus on finance and cost improvement• Build performance management culture• Lots to be proud of!
21st Century Care in Orthopaedics
Paul Allen, Lead Clinician and Consultant
Orthopaedic Surgeon
The Department
• 11 Surgeons• All branches of orthopaedics
– Hip and knee replacement– Upper limb surgery– Spine and foot surgery
Trauma
Young Patients
High Energy Injuries
Sport, Road Accidents
Older Patients
Hip Fractures
Low Energy Injuries
Osteoporosis
Trauma
National Data
Relative Performance
Compares How We are Doing
Where Were We Three Years Ago?
High mortalityLong length of stayNo significant care of the elderly inputPatients all over the hospital
Where Are We Now?
Harold Ward opened 1 September 2010
Care of the Elderly Physician, Dr Jane Snook, started December 2009
Where Are We Now?
0
20
40
60
80
100
120
Sept09
Oct09
Nov09
Dec09
Jan10
Feb10
Mar10
April10
May10
June10
July10
Aug10
% having falls assesment and osteoporosis treatment
Last 12 Months
Us SHA National
Average time to Ward 31.82 9.17 10.00
Average time to Theatres
32.73 36.68 41.04
Average LOS 23.10 18.54 21.31
Pre op Assesment 93.89 56.12 61.82
Orthopaedics
Wide range of services- Joint replacement- Upper limb surgery- Spinal surgery including neck- Foot surgery
Joint replacement
CompetitionDeveloped a new way to educate our patients
Mr Mahaluxmivala
Animated video to explain Total Hip and Total Knee Replacement to patients prior to surgery
Hip & Knee Videos