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LEADERSHIP & MANAGEMENT


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NHE visited The Christie and spoke to Shaw just before the trust’s annual mem- bers’ meeting in September, at which it launched its 2020 Vision consultation.


Shaw told us: “The board and I have got some very clear ideas about what we’d like to be doing in 2020, but we’re going to con- sult with our patients, the general public, our key stakeholders such as the commis- sioners and the universities we work with to get their views – to get a tangible view – and to get some reality on what people want to commission for cancer, and what kind of academia and trials the universi- ties want to develop. When we’ve got that wealth of information, we’ll develop the strategy, our 2020 Vision. Then, we’ll have a better understanding of how we develop future services.


“We’re centering it on specifi c themes and questions: what research should we focus on and develop? Are people happy for us to further develop the private patient sector and do people feel comfortable with that? We do radiotherapy and chemotherapy on this site and another site – how many oth- er sites would people want us to go on to? Would people be happy for us to go some- where else in the UK? Another theme is sur- gery: we only do very specialised surgical operations at the moment. Would we and should we do more routine cancer surgery?


“They’re wide questions, but with quite a specifi c view – some are quite ambitious things for people to think about. To under- stand that wealth of information, we’ve de- veloped a 2020 Vision forum group for the hospital: 20 people from all disciplines and levels across the organisation to look at it and report back.


“The forum group is about, in a diffi cult time for the NHS, getting the engagement of our staff, from a domestic up to the top researcher in the country. We’ll get these views in, and place them in a framework, and say to our staff, ‘what do you think’ – so when it goes to our management board and board of directors, we’ll have already triangulated the information.”


The bottom line


Making effi ciency savings is a key concern for health sector managers at the moment, and managers throughout the public sector. Last fi nancial year, The Christie turned up savings worth around £6m through Lean techniques, Service Line Management, and an internal working group on costs, while also boosting its income signifi cantly. This


28 | national health executive Sep/Oct 11


allowed it to show a £5.5m surplus (before exceptional items) in its fi nal accounts, al- though over the coming four years it, like virtually every other NHS organisation, will lose posts.


Shaw talked us through some of the sav- ings that have helped cut costs and in- crease income, saying: “We’ve moved from patients being in-patients, to ambulatory care. That’s given us the ability to reduce our bed numbers. That’s been quite a big piece of work.


“We’ve done things in radiotherapy, such as extending the day, and the fl ow-through of patients. In research, we’ve engaged with the private sector and the pharmaceuticals and we do organised trials for them, so they support us with an income line. Then there are the educational studies – we’ve put on more programmes, which we sell to other health organisations across the country.


“We’ve also looked at things that every- one in the organisation has an idea about – even if it’s only a small saving, it’s worth doing it. For example, we’ve looked at the patient menu and the wastage on food, and the nurses have come up with a menu of what the patients really want to eat, so we’ve changed the way we provide food, and offer meals at more times. We’ve en- gaged the whole organisation in doing this.


“We’re using purist general management processes, which are about being very clear about the management structure – who’s accountable and who’s responsible. I’m currently doing the Provider Development job across the region until this December, and quite a lot of organisations I’ve seen need more clarity on that, and about out- comes and targets.


“It’s also about using service line report- ing, which has been exceptionally useful in understanding where our costs are, where we’re making money and not making money, and getting it down to the level of patient details. Those approaches are fan- tastic. We’ve also been getting people in- volved in Lean and doing things to improve the patient experience, which I don’t think should ever be underestimated.”


Listening to patients


“We’re also currently doing an administra- tion review,” she continued. “Obviously staff were worried about that, but we’ve brought the patients in to tell their stories of what happens to them when they come to The Christie; how they book in, how they get their notes. They identifi ed wastage for us and we’ve used that experience to


change our processes and to actually make the experience better for our patients.”


While these reforms and improvements have certainly helped the bottom line, it doesn’t seem to have been at the expense of the trust’s reputation for clinical services or research, with it being offi cially accredited this summer as a ‘Comprehensive Cancer Centre’ by the Organisation of European Cancer Institutes (OECI) – the fi rst UK centre to get the prestigious accreditation.


Shaw is very proud of the acknowledge- ment and said: “It’s a bit like a peer review: they come in and check you out. We were the fi rst in the country to get it, and out of all the trusts and organisations in Europe, we scored the highest. It means we can offi cially call ourselves a Comprehensive Cancer Centre – that means we have an integration of service, research and educa- tion, which I think is crucial for patients and crucial for people who work here. It’s an offi cial stamp of excellence.”


Read all about it


The trust is not scared of highlighting its successes. Like all hospital trusts, it has a busy media and PR team, but its status and ‘brand’ means it is of special interest to broadcasters and the media. It recently gave behind-the-scenes access to a team from BBC Radio 5 Live for a two-part doc- umentary about cancer trials, for example, broadcast in August.


Shaw said: “The Christie’s always been a big brand in Manchester. That’s predomi- nately because one in three people get can- cer, and as a tertiary centre, people have experienced The Christie in some form. For us, part of our strategy is to keep that brand


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