north east nhs response to national imperatives chris willis regional director – transition 7...
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North East NHS
Response to national imperatives
Chris Willis
Regional Director – Transition
7 September 2011
2
Purpose of presentation
To describe:
• An overview of our current position• How we are maintaining delivery and continuous
improvement• How we are supporting staff• How we are supporting the implementation of the health
reforms
Grip and momentum!
3
North east NHS is in a relatively good position
100% of hospitals
are FT
Track record of good
performance
Track record of
satisfaction
All organisations
in financialbalance
30 % management
cost reductiondelivered
Rapidly improving outcomes
Historical levels of poor
population health
PCTs workingas clusterssince 2006
4
But still facing significant challenges
Over relianceon hospitals
£859 mQIPP challenge
Poor health of the public
Needing to changeactivity patterns
5
Maintaining delivery and continuous improvement
• Realistic and stretching 2011/12 contracts agreed by 1 April• Community services transferred to providers• Strong performance management in place • Constantly seeking to ensure that essential capacity and
expertise are in place and that morale is maintained• Cluster ISOP meetings with PCTs, FTs, CCGs, LAs show
strong local alignment, balancing delivery and transition• Transformation fund to drive real change in FTs• A focus on the QIPP agenda …….
6
QIPP challenge - £859m
• Good progress in 2010/11 with management cost savings• Strong Integrated strategic and operational plans developed
with GP commissioners, Local Authorities and FTs • Investing more than other SHAs on health improvement• Majority of savings secured in contracts via tariff• Focus now on delivery of allocative savings • North East Transformation System is helpful to all of this
2008/9 2009/10 2010/11 2011/12 2012/13 2013/14 2014/153500
4500
5500
6500
4.33b 4.54b 4.85b 4.95b 5.06b 5.17b 5.28b
38m304m
498m 686m859m
Column1QIPP challenge
0
7
Putting patients and the public first
Promoting choice and competition
Relative market contestability and choice index (HHI)
Higher than averageAverageLower than average
8
Improving health and healthcare outcomes• Preventing premature death
• LTC - GPs good at managing their ‘at risk’ population• Recovery – Primary PCI and comprehensive stroke services in place• Experience – Top results in patient satisfaction surveys• Safe care – Safer Care North East
9
An agreed clinical vision to tackle poor outcomes
• Facilitated ASE events for clinicians
• Issues tackled included:• variations in delivery• long term conditions• alcohol• deaths in hospital
• Created a strong clinical consensus and innovative solutions to problems
• Now in the process of implementing
10
Commissioning for patients
• Effective collaboration by GP leaders• Contracting, performance management and data• Governance and scheme of delegation• Patient involvement and engagement• Coordinating decisions on individual cases
• Programme to identify and meet support needs
Jan 2011 Feb 2011 Jul 2011Apr 2011
= 9 36%
= 1157%
= 20100%
= 1572%
11
Transitional commissioning arrangements
PathfinderCommittee
PathfinderCommittee
PathfinderCommittee
PathfinderCommittee
Shared Support
Integrated Board(including a single cluster chair and executive)
12
Local democratic legitimacy
Excellent relationships with local authorities
• All local authorities are early implementer sites for H&WB• H&WB development being supported by a team led by a
local authority chief executive• Innovative health and social care system diagnostics• 3 Healthwatch pathfinders (Northumberland, Gateshead &
Hartlepool)
13
Developing healthcare providers
• Transforming community services• Education and training – single provider skills network• NEAS to complete FT application• Strong public accountability – 180,000+ members• Big reconfigurations being progressed
TransformingNewcastle Hospitals
NorthumbriaEmergency
Care Hospital
Durham Seizing the
Future
North of TeesMomentum
14
Supporting staff
• Staff satisfaction is still good • Strong regional social partnership forum• TCS – listened to staff• Management cost reduction exercise behind us; supported
voluntary redundancies, limited compulsory redundancies and fair process
• HR transition group to manage risks and ensure consistency• Suite of support packages for staff• Regular events with all SHA/PCT chief execs and directors• North East Leadership Academy (hosted by CD&D FT)
1515
Managing the transition
A two year programme, coordinating the implementation of new commissioning arrangement in the north east
1616
Goals…
...to establish a single transition plan for the north east covering the following functions:
• How we maintain and improve the quality of health outcomes
• Development of the workforce• Provider development• Public health services• Commissioning arrangements • Support for local authorities to establish health and
wellbeing boards
17
Managing the transition
Transition programme directorChris Willis
Corporate and HR transitionworkstream
Development of health and
wellbeing boards workstream
Commissioning developmentworkstream
Public health services
workstream
Provider developmentworkstream
Outcomes and quality
workstream
Workforce developmentworkstream
Transition programme boardChair David Stout
Neil NicholsonKaren Straughair
Ian ParkerWendy Balmain
Richard BarkerYasmin Chaudhry
Peter KellyChris Willis
Aidan Mullan Stephen Childs
Stephen SingletonKen Bremner
Aidan MullanMartin Barkley
• Local authority representatives• PCT cluster chief executives• GP consortia leads
• Workstream leads• Staff side representation• HealthWatch
1818
Managing the transition together...
• A clear leadership role for local authorities and GP consortia
• A partnership of equals – recognising the interdependence of services
• Jointly using the learning from previous large scale change
• Listening to stakeholders and enabling proactive engagement
• Robust governance and programme management• Sharing risks to ensure stability• A commitment to full staff and staff side engagement in
change management
19
In summary
• The north east NHS is in a good position, but with much more to do
• We are clear of our role in supporting the successful transition to the reformed NHS
• We are working closely with our partners to build a successful future for patients and the public and avoid unintended consequences
And• The aim is to ensure that when the SHA and PCTs come to
an end that the arrangements in place, together with the momentum, will ensure that the transition continues to a satisfactory conclusion
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