Understanding the Challenge for the

East Midlands

Gavin Boyle

Chief Executive

Chesterfield Royal

NHS FT

A Chief Executive’s Perspective

• It’s the right thing to do

• Hard wired into the ‘system’ e.g. regulators, contracts etc.

• Not just hospitals

The Chesterfield Experience

• Early HFMA work

• NHS IQ National Pilot

• EM SCN & Senate

• Working Together – S. Yorks.

HFMA - Costing Workstream

• 1 of 8 trusts involved in Finance workstream of 7 Day Service Forum – HFMA

• Fieldwork Summer 2013 (Emergency and Urgent Services + Supporting Diagnostics)

• Not currently meeting all standards Mon-Fri e.g. time to first consultant review.

• Main cost driving standards

• Standard 2 - Consultant Time to Review

• Standard 3 – MDT Review

• Standard 5 – Diagnostics

• Standard 8 – On-going Review (daily consultant ward rounds)

HFMA - Potential Costs

• Pilots – £1.4m investment = £1.7m Saving (reduced LOS)

• Gross Investment of £3.8m ( to meet all standards)

• This is equivalent to 2.9% of Pay bill

• Or 2.0% of patient care income

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wte's

Other

Therapies

Nursing

Radiology

Our Local Schemes

• Successful pilots made recurrent with 7 day services as a key theme:

• Acute Re-ablement Unit (Frailty Unit)

• Transitional Care Ward – including Social Care Workers

• Senior Clinical Decision Makers – increased presence

• Therapy and Diagnostic Services

• Primary Care support co-located with ED

• Over half a day per General Medicine NEL spell already achieved >9000 bed days circa £1.7m

7 Day Collaboration

• North Derbyshire – NHSIQ National Pilot

• East Midlands SCN & Senate (10 Acute Trusts)

• NHS IQ self–assessment tool

• Data Collection

• Case note audit

• Service level interviews

• South Yorkshire – Working Together Programme

• Smaller specialities e.g. Ophthalmology, ENT, OMFS

• Radiology