Chief Operating Officer
Lesley McLay, 13th April, 2012
Operational UnitOperational Unit is responsible for delivery of all services across NHS Tayside, which include Acute; Community and Primary Care and Mental Health.
NHS Tayside in numbers:
• 400,000 population• 74 services• 23 main sites • 14,000 staff• £700 million total revenue budget
Services
Arts Therapy Accident & Emergency Histopathology
Blood Borne Virus Managed Care Network Adult Learning Disability Services Homeopathy
The Centre for Brain Injury Rehabilitation Adult Mental Health Services Infectious Diseases
Community Nursing (HIV) Area Clinical Psychology Service Intensive Care Unit
The Corner Breast Screening Maternity Services
DARTS Diabetes Audit & Research in Scotland
Breast Surgery Medicine for the Elderly
Dental Cancer Medicine Neurology and Stroke
Dundee Midwifery Unit Cardiovascular & Coronary Care Unit Neurosurgery
The East of Scotland Research Ethics Service Child Health Occupational therapy
Health Protection Clinical Haematology Ophthalmology
Keep Well Clinical Oncology Oral and Maxillofacial
Neurological Sciences Clinical Radiology Orthopaedic Electives
Pre-School Orthoptic Vision Screening (POVS) Community Dental Services Orthopaedic Trauma
Out of Hours Community Health Services Pharmacy
Primary Care Services Dermatology Physiotherapy
Public Health Diabetes and Endocrinology Plastic Surgery
Respiratory Managed Clinical Network Emergency Medicine Psychiatry of Old Age Services
Sexual Health Services Endoscopy Regional Vascular Service
Smoking Cessation ENT Renal Unit
Specialist Palliative Care Family Planning Services Respiratory
Tayside General Practices Forensic Psychiatry Services Rheumatology
The Wolfson Hyperbaric Medicine Unit Gastro-intestinal Medicine Speech and language therapy
General Adult Psychiatry Services Substance Misuse Services
General Surgery Tayside Rehabilitation Engineering Services
Genetics Theatres and Anaesthetics
High Dependency Unit Urology
Key Locations
Aberfeldy Community Hospital
Arbroath Infirmary
Armistead Child Development Centre
Ashludie Hospital
Blairgowrie Community Hospital
Brechin Infirmary
Carseview
Crieff Community Hospital
Dundee Dental Hospital
Dundee Midwifery Unit
Pitlochry Community Hospital
Little Cairnie Hospital
Montrose Royal Infirmary
Murray Royal Hospital
Ninewells Hospital
Perth Royal Infirmary
Royal Dundee Liff Hospital
Royal Victoria Hospital
Roxburghe House, Dundee
St Margaret's Hospital, Auchterarder
Stracathro Hospital
Strathmartine Hospital
Whitehills Health and Community Care Centre
Young People's Unit
Breakdown of activities & sites
Operational Unit Management & Governance
Lesley McLay Chief Operating Officer
Directorates CHPs Operations Functions
Medicine David Johnston AMD Gillian Costello ANDCarol Goodman GM
Perth & KinrossBill Nicoll GMMorag Martindale CDGilliam Costello AMD
WorkforceGeorge Doherty Director Janice Torbet ADW
SurgeryJohn Colvin AMDEvelyn Fleck AND Audrey Warden GM
Dundee David Lynch GMDavid Dorward CDEileen McKenna AMD
Finance Colin Masson Director
eHealth Ian Fenton Director
AccessAlan Cook AMDEileen McKenna AND Lorna Wiggin GM
AngusSusan Wilson GMEvelyn Fleck AND
vacancy
Operations Ken Armstrong Director
•Integrated Clinical Leadership and General Management model•Devolved Management structure•Fortnightly meetings of Executive Management Team •Bi-monthly Performance Review Meetings
Operational Unit Priorities
• Productivity and Efficiency
• Clinical Quality
• Whole System Integration
• Performance Management
• Facilities Management
Operational Unit Priorities
Productivity and Efficiency• Sickness Absence Management• Staff eRostering • Service Capacity Review
Clinical Quality• Clinical Governance Review• Clinical Strategy Development
Whole System Integration• Health & Social Care Integration • Prisoner Healthcare integration • 24/7 day service
Performance Management• Complaints Redesign • Business Unit establishment• Performance Dashboards • National and Local Access Targets e.g. 18 weeks RTT
Facilities Management• Facilities Optimisation
Steps to Better Health Care Programme
• Triple Aim• Transformational Change Model- 95:5• Measures for Improvement• Aligned to LDP and Strategic Financial
Plan• Clinically Lead
Health of the Population
Experience of Care
Best Value for Money
Steps to Better Health Care Triple Aim
2010 - 2013
TACTICAL STRATEGIC
DEALING WITH THE 5%
SPENDING THE 95% BETTER
PRODUCTIVITY & EFFICIENCY
CRES
SERVICE OPTIMISATION
TRANSFORMATION
Steps to Better Health Care Transition 2011-2013
TRANSFORMATIONAL PROGRAMMES
•Mental HealthIntegrated Community ServicesPalliative Care Services
PROGRAMMES ALIGNED WITH STRATEGIC FINANCIAL PLAN
Clinical Improvement & ProductivityElectronic Patient RecordOutpatientsClinical Benchmarking Patient PathwaysLow Impact InterventionseRosteringReleasing Time to Care
WorkforceReview Supplementary PayReview Absence
Drugs & PrescribingMedicines Leadership
Estates & FacilitiesRealignment of ServicesOptimising Healthcare Facilities
Steps to Better Health Care 2012/2013 Plan
Appendix 1. Strategic Aims
Steps to Better Healthcare underpins all NHS Tayside Strategic Aims, which are as follows:
• Contribute to closing the health inequalities gap within a generation
• Improve healthy life expectancy by supporting people to look after themselves
• Ensure that services meet agreed quality standards, especially patient experience
• Be cost effective in all decisions, actions and services
Appendix 2. Operational UnitDirectorate – Key Parameters
Operational Unit Surgical Directorate
Directorate
Leadership team
Scope Staff number
s
Budget Key activities
Key outputs
Surgical Audrey Warden General ManagerJohn Colvin Associate Medical DirectorGillian Costello Associate Nurse Director
The Directorate provides OP, IP, DC and emergency services for the following:General SurgeryBreast surgeryPaediatric SurgeryUrologyOrthopaedics & Trauma(TRES) Anaesthetic Services & Assessment (APA)Critical Care Services (ICU & HDU) Pain Services TheatresNephrology ServicesOncology and Acute Palliative CareHaematology PathologyRegional Plastics Service Oral Maxillofacial SurgeryNeurosciencesGeneticsOphthalmologyENT SurgeryAudiologyDermatology & PhotobiologyRegional clinical networks: East of Scotland Breast Screening ServiceEast of Scotland Vascular NetworkEast of Scotland Upper GI Network
2300 WTE
£131M.
To provide a robust model for Clinical Governance, Quality and Clinical Effectiveness Optimise Productivity and Efficiency promoting transformational changeCo-ordinate and manage the functions within the allocated resources Provision of integrated care pathways for patients in NHS Tayside with clear lines of joint working arrangements ;Establishing strong clinical structures to support integrated way of working and shift the balance of care and resourcesNational performance indicators & Waiting Times and Cancer guarantees.Improved patient outcomes.Genetics.
Services that consistently meet recognised quality standardsImproved patient experience of servicesEfficient & effective use of allocated funding and resources within the Surgical DirectorateOptimise Productivity and Efficiency18-week RTT targets as per HEAT Cancer targets 62 day and 31 day Establish Day Surgery as the ‘norm’ Infection control reducing infection.Promote care in local communities and people’s homes Clinical Strategy for Genetics, in line with the National Genetics vision
Operational Unit Medicine Directorate
Directorate Leadership team Scope Staff number
s
Budget Key activities
Key outputs
Medicine Carol Goodman GMDavid Johnston AMD Evelyn Fleck AND
All adult in patient and outpatient medicine services:-Acute Medicine/General medicineMedicine for the elderlyDiabetesCardiology (including intervention)RheumatologyGastroenterology/EndoscopyAcute StrokeRespiratory medicineInfectious diseasesInvestigations unit- pan Tayside Emergency Department services- pan TaysideOut of Hours GP Service – pan TaysideAll maternity services including hospital and community based provision- pan TaysideAll Gynaecology services including surgery – pan TaysideChildren's services including community paediatrics, child and adolescent mental health, children with complex needs, AHP services and Neonatal intensive care services– pan Tayside
2124 WTE
£101M.
Provision of inpatient care for all medical specialties for adults and children
Antenatal, perinatal and post natal care and gynaecological sugical and medical care of women
Provision of inpatient and outpatient care for all surgical and mental health specialties for all children
Provision of Emergency dept services including Trauma team response service
Safe, effective high quality care for all patients
Achieving HEAT targets and standards
Providing a responsive service to meet need within the resource envelope available
Operational Unit Access Directorate
Directorate Leadership team Scope Staff number
s
Budget Key activities
Key outputs
Access Lorna Wiggin GMAlan Cook AMDEileen McKenna AND
Diagnostic Services – labs, radiology and medical physics.
Integrated Dental Services – CDS & Dental School
SRTC & OP Perth / Angus
Medical Records
Business Unit Corporate portfolio – cancer, waiting times performance
1476 WTE
£59M Provision. Of direct patient care services.
Provision of services which support the delivery of patient care.
Provision of information for improvement, performance & assurance
Monitor and report on progress cancer, waiting times, data quality
Governanceassurance &performance management to CE /COO
Staff engagement
High quality patient experience & care
Fair /equitable / timely access to services
Data validation, analysis and reporting.
Ensure best value
Staff well being
Operational Unit Community Health Partnerships
Directorate Leadership team
Scope Staff numbers
Budget Key activities
Key outputs
Perth & Kinross
Bill Nicoll GMMorag Martindale Clinical Director Gillian Costello AND
All primary and community healthcare, mental health, drug and alcohol support for P&K population and prisoner healthcare
1047 WTE £106M. Integrated care deliveryPartnership workingCommunity Planning
Early Years,Child development and protection,Health & well-being & equity, Anticipatory care, long term conditions, care at home, prevention of admission, care of the elderly, improving discharge, dementia care and palliative care
Dundee CHP
David Lynch GMEileen McKenna ANDDavid Dorward Clinical Director
All primary and community healthcare, mental health, drug and alcohol support for Dundee population
1350 WTE £144M. Integrated care deliveryPartnership workingCommunity Planning
Early Years,Child development and protection,Health & well-being & equity, Anticipatory care, long term conditions, care at home, prevention of admission, care of the elderly, improving discharge, dementia care & palliative care.
Angus CHP Susan Wilson GMEvelyn Fleck AND
3 patient pathways: Adult Services, Child & Family Health; Mental Health. Services include Community Hospitals, Community Nursing Services, Psychiatry of Old Age, AHPs, Medicine for the Elderly, Palliative Care, Minor Illness & Injuries Units, Integrated Mental Health Services, and hosting of Tayside Substance Misuse Service
1400 WTE £50M. Partnership & Integrated Working; Community Medicine & Rehabilitation Service Redesign;Substance Misuse Service Redesign; Introduction of C2 Approach;
Introduction & development of See & Treat Service; Poly-Pharmacy Reductions;Dementia Liaison Team;Generic AHP workers; Programmes to support Long Term Conditions/Self Management
Operational Unit Operations Directorate
Directorate Leadership team
Scope Staff numbers
Budget Key activities
Key outputs
Operations Ken Armstrong Director
To provide a wide range of Site/Support Services and key infrastructure in delivering ongoing improvement re patient care
2000 WTE £60M.
Procurement spend £120M.
Site/Support Services
Production Unit
Procurement & Logistics
Property
Environmental Management
H & S/Fire Safety
Unlicensed Medicines
Provision of high quality catering, cleaning and portering services together with rapid and intelligent response to site “issues”
Clean equipment and linen as and when required
The right product at the right time in the right place
Sustainable/fit for purpose accommodation
“A greener environment”
“A safer environment”
Provision of niche medicines internal and external
Appendix 3. Operational UnitBreakdown of activities & sites
Services
Arts Therapy Accident & Emergency Histopathology
Blood Borne Virus Managed Care Network Adult Learning Disability Services Homeopathy
The Centre for Brain Injury Rehabilitation Adult Mental Health Services Infectious Diseases
Community Nursing (HIV) Area Clinical Psychology Service Intensive Care Unit
The Corner Breast Screening Maternity Services
DARTS Diabetes Audit & Research in Scotland
Breast Surgery Medicine for the Elderly
Dental Cancer Medicine Neurology and Stroke
Dundee Midwifery Unit Cardiovascular & Coronary Care Unit Neurosurgery
The East of Scotland Research Ethics Service Child Health Occupational therapy
Health Protection Clinical Haematology Ophthalmology
Keep Well Clinical Oncology Oral and Maxillofacial
Neurological Sciences Clinical Radiology Orthopaedic Electives
Pre-School Orthoptic Vision Screening (POVS) Community Dental Services Orthopaedic Trauma
Out of Hours Community Health Services Pharmacy
Primary Care Services Dermatology Physiotherapy
Public Health Diabetes and Endocrinology Plastic Surgery
Respiratory Managed Clinical Network Emergency Medicine Psychiatry of Old Age Services
Sexual Health Services Endoscopy Regional Vascular Service
Smoking Cessation ENT Renal Unit
Specialist Palliative Care Family Planning Services Respiratory
Tayside General Practices Forensic Psychiatry Services Rheumatology
The Wolfson Hyperbaric Medicine Unit Gastro-intestinal Medicine Speech and language therapy
General Adult Psychiatry Services Substance Misuse Services
General Surgery Tayside Rehabilitation Engineering Services
Genetics Theatres and Anaesthetics
High Dependency Unit Urology
Key Locations
Aberfeldy Community Hospital
Arbroath Infirmary
Armistead Child Development Centre
Ashludie Hospital
Blairgowrie Community Hospital
Brechin Infirmary
Carseview
Crieff Community Hospital
Dundee Dental Hospital
Dundee Midwifery Unit
Pitlochry Community Hospital
Little Cairnie Hospital
Montrose Royal Infirmary
Murray Royal Hospital
Ninewells Hospital
Perth Royal Infirmary
Royal Dundee Liff Hospital
Royal Victoria Hospital
Roxburghe House, Dundee
St Margaret's Hospital, Auchterarder
Stracathro Hospital
Strathmartine Hospital
Whitehills Health and Community Care Centre
Young People's Unit
Breakdown of activities & sites