What future now? a sustainable health service: case for action

[template presentation for NHS Boards –May 2010]

Agenda

0:00 introduction

0:10

0:20

aim of today

big issues exercise

0:30 sustainable health service: presentation

1:00 exploring the business case

1.20 making it happen

2.25 action planning

3.00 close

Explore how [name of Trust] can use ‘sustainable development’ to secure the most appropriate services for addressing health needs

The next three hours…

Explore how [name of Trust] can use ‘sustainable development’ to address its challenges in putting patients’ needs at the core

The next three hours…

Looking forward to 2015…

What are the big issues keeping you up at night?

- in your NHS role?- thinking about the wider world?

Key themes

1. the big global challenges

2. the pressures facing the NHS

3. how these interact

4. how we can resolve these issues simultaneously

5. why this makes good business sense

Numbers + Growth in Economic + Growth in Human Output …

has resulted in

HUGE Growth in our

Environmental Footprint

tightening planetary boundaries

Lancet edition

A changing context

EU Targets20% reductions in CO2 by 2020

20% Renewables by 2020

United States80% reduction in CO2 by 2050

UK Climate Change Act34% cut by 2020; 80% by 2050

Independent Committee; annual report to Parliament

Carbon Reduction Commitment

looming budget cuts

looming budget cuts

Business as usual?

increased patient

demands

increased patient

demands

ageing & growing

population

ageing & growing

population‘diseases of affluence’

‘diseases of affluence’

wider citizenship

expectations

wider citizenship

expectations

Lifestyle diseases

There are as many obese people in the world today as there are starving or undernourished people

Marmot Review

Sustainabilityis…

meeting human needs without compromising nature or society

Sustainable development is…

the process by which we get there

Sustainability is…

meeting human needs without compromising nature or society

Sustainable development is…

the process by which we get there

Key synergies with NHS priorities:

• avoid harm

• cut waste

• reduce variation• shift to prevention

1. develop understanding of future trends as they relate to health and business continuity

2. evolve business models/ strategies to meet risks and opportunities

3. align activity with promoting determinants of health

4. cut cost base by shifting to preventative care not ‘salami slicing’ services

5. systematically manage tensions between short and long-term measures of success

sustainable development in the NHS sustainable development in the NHS

1. develop understanding of future trends as they relate to health and business continuity

2. evolve business models/ strategies to meet risks and opportunities

3. align activity with promoting determinants of health

4. cut cost base by shifting to preventative care not ‘salami slicing’ services

5. systematically manage tensions between short and long-term measures of success

sustainable development in the NHS sustainable development in the NHS

Use resources more efficiently

Illustrative slide – insert relevant MAC curve for the Trust you will be

talking tohttp://www.sdu.nhs.uk/page.php?page_id=160

rising energy costs+

increased volatility+

cost of carbon=

material business risk

Build resilience

1. develop understanding of future trends as they relate to health and business continuity

2. evolve business models/ strategies to meet risks and opportunities

3. align activity with promoting determinants of health

4. cut cost base by shifting to preventative care not ‘salami slicing’ services

5. systematically manage tensions between short and long-term measures of success

sustainable development in the NHS sustainable development in the NHS

Join-up the benefitsJoin-up the benefits

• transport• procurement• new buildings

• employment & skills• community engagement• facilities management

Promote health now

1. develop understanding of future trends as they relate to health and business continuity

2. evolve business models/ strategies to meet risks and opportunities

3. align activity with promoting determinants of health

4. cut cost base by shifting to preventative care not ‘salami slicing’ services

5. systematically manage tensions between short and long-term measures of success

sustainable development in the NHS sustainable development in the NHS

• Quality total picture to be considered

• Innovation achieve multiple objectives

• Productivity platform for collaboration and working across boundaries

• Prevention opportunities to act upstream to manage demand, make

resilient investments, community dialogue

Transform care

1. develop understanding of future trends as they relate to health and business continuity

2. evolve business models/ strategies to meet risks and opportunities

3. align activity with promoting determinants of health

4. cut cost base by shifting to preventative care not ‘salami slicing’ services

5. systematically manage tensions between short and long-term measures of success

sustainable development in the NHS sustainable development in the NHS

Show leadership

The leadership spectrumThe leadership spectrum

strategic• Senior-level drive• SD integrated policy/

plans/ business case• Evident in priorities• Communications and

actual performance

incremental• Clutch of ‘good

practice’ projects• Focus on estate and

environment not SD• A competing priority

systemic• SD is hardwired

into business model• Tensions between

short/ long-term priorities systematically managed

compliance-led• SDMP not integrated

EnvIronmental factors/ objectives are separate

• Inadvertent undermining of health objectives

application & impact

knowledge & engagement

at risk compliance-led incremental strategic systemic

low impact

medium impact

high impact

Where are you?

impact trajectory of embedding sustainability in NHS Trusts

application & impact

knowledge & engagement

at risk compliance-led incremental strategic systemic

low impact

medium impact

high impact

Where are you?

SD seen as one board member’s job QIPP makes no reference to SD

impact trajectory of embedding sustainability in NHS Trusts

application & impact

knowledge & engagement

at risk compliance-led incremental strategic systemic

low impact

medium impact

high impact

Where are you?

use of MAC cost curves to cut cost base

SD integral to business case,QIPP & World Class Commissioning

future trends/ scenarios shape strategy & service models

structured dialogue about investment/ disinvestment

new health economy collaborations

impact trajectory of embedding sustainability in NHS Trusts

Conclusions

1. there are big global challenges

2. these add to the pressures facing the NHS

3. these problems are interlinked

4. they can be resolved together using sustainable development

5. this makes good sense for business, patients and wider health

[written case study template]

Issue: [insert business issue here]

Action: [insert facts of what took place]

1. key benefit or result 1

2. key benefit or result 2

3. key benefit or result 3

picture or quote

[written case study template]

Issue: [insert business issue here]

Action: [insert facts of what took place]

1. key benefit or result 1

2. key benefit or result 2

3. key benefit or result 3

picture or quote

[role play scenario template]

Insert relevant role play scenario from the accompanying Resource Pack as an instruction slide for the ‘Making it Happen’ exercise

Explore how [name of Trust] can use ‘sustainable development’ to address its challenges in putting patients’ needs at the core

The last three hours…

Explore how [name of Trust] can use ‘sustainable development’ to secure the most appropriate services for addressing health needs

The last three hours…