INNOVATION & EFFICIENCY
NHE speaks to United Lincolnshire Hospital NHS Trust’s David Furley about its wide-ranging Transformation Programme. B
usiness as usual is not an option for any NHS organi- sation at the moment, as every- one seeks to cope with a changing health service and a dramatically different financial picture.
But some trusts are convinced they can meet the efficiency chal- lenge and savings targets without just cutting back on services or compromising care.
United Lincolnshire Hospital NHS Trust (ULH), under the new management of chief executive Andrew North following the dis- puted sacking of former boss Gary Walker in February last year, has radical plans in this regard.
NHE spoke to David Furley, ULH’s assistant director of trans- formation, who is co-ordinating the trust’s Transformation Pro- gramme.
He said: “When [Andrew North] came into post, he was very clear that the organisation needed to change, not only to improve qual- ity and safety, but to save money as part of the QIPP agenda in the health service.
“In this year, that requirement is £20m. There were a couple of ways we could have done that: one was to cut services to take those costs out. But instead, the organisa- tion’s strategy is to improve safety and quality and by doing that, re- duce costs. The whole premise of that is based on the fact that there are inefficiencies built into the sys- tem, and that if we take those out, we can reduce costs.”
Moving to seven-day working is a good example of that, Furley explained. Currently, if a patient comes in on a Friday, weekend services might not be sufficient to progress their care as rapidly as if they came in during the week, leading to delays.
He added: “If they’re an elderly patient, with lots of other prob-
lems, then their condition may deteriorate over that period, so the quality of care and safety goes down.
“So, we can start to work towards seven-day services, where we have the same level of service, at the right level, whatever day the pa- tient comes in. Their length of stay will reduce, because we’re treating them rapidly, and the quality and safety will be better.
“We’re taking out waste and de- lays to reduce costs, and we can do that because we know our staffing costs are about 70% of the overall budget, so if we can start pulling out our delays, we don’t need to increase our staffing and may, over time, be able to reduce our staffing costs.”
The Transformation Programme, which has been running since April this year, is expected to take
two years, but this may be extend- ed to three.
It has three key focuses: stand- ards, processes, and workforce improvments.
Furley explained: “In terms of standards, we needed to ask whether we have the right stand- ards in place for patient care with- in our organisation, in urgent care and planned care.
Endoscopy nurses in the endoscopy unit,
from left: Chloe Holly and Danni Whitehouse. On right: Amanda Stewart-Stamp.
CASE STUDY
As part of the wider Transforma- tion Programme, ULH is changing the way runs endoscopy services.
Diagnostic tests are now being carried out at the weekend, in- stead of just Monday to Friday; there are more alternatives to A&E for conditions that are not life-threatening; and more time is being spent planning an individu- al patient’s care and the time they spend in hospital and in theatre.
To cut delays and allow week- end and evening working, three new endoscopy nurses and a GP have been recruited. The trust
42 | national health executive Nov/Dec 11
says that getting patients in and out of hospital more quickly will free up beds for those in need of care and treatment on the wards. Endoscopy nurses Danni White- house, Chloe Holly and Amanda Stewart-Stamp (pictured) have been undergoing further training at Hull University, with practi- cal training in the trust’s depart- ments. Following this they will be able to carry out certain proce- dures themselves.
Trainee Nurse Endoscopist Chloe Holly said: “This is a really excit- ing development for the depart- ment. I previously worked as an
endoscopy nurse at Boston but to be able to develop my skills in this way is fantastic. The extra re- source we will be bringing means we can provide an even more im- proved service for our patients.”
The trust is also planning to open a new endoscopy unit at Pilgrim hospital in Boston in January 2012, costing £2.5m, and a new endoscopy unit is also due to open at Louth in May 2012. The endoscopy unit at Grantham will be refurbished over the Christ- mas period and in Lincoln works have been proposed to enhance the current unit.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100