Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For...

Project

alford’s HHealth IInvestment FFor TTomorrow

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How should NHS services develop over the period of the NHS Plan?

Rt Hon Alan Milburn MP

Secretary of State

for Health

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Key Objectives

Improved performanceReturn on new investmentDevelop intermediate carePrivate Sector capacityMore Staff

More employee commitment Waiting lists

Waiting time reductionsPositive publicity

Sense of urgency

Flexibility

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SHIFT ProjectSHIFT Project

Salford’s Health Investment

For Tomorrow –

The Salford Model

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The SHIFT ProjectThe SHIFT Project

• Salford’s Health Investment For Tomorrow

• Unique approach

• Whole system project

• Buildings, services, IM&T

• Service Redesign

• Partnership

• Regeneration

• Procurement (PFI and LIFT)

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History of the ProjectHistory of the Project

• Strategic Outline Case

• Hospital focus

• Victorian ward blocks

• Salford’s health status

• Other organisations

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Whole system / PartnershipWhole system / Partnership

• Salford Royal Hospitals Trust

• Salford Primary Care Trust

• Salford City Council• Salford University• Manchester University

and• Salford population

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ObjectivesObjectives

• Improve health and well-being

• Improve access• Streamline processes• Provide effective

services• Meet capacity targets• Regeneration

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RegenerationRegeneration

• More than just health services

• Social Care

• Investment

• Effect of building

• Employment opportunities

• Commerce

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“I’VE GOT IT,TOO, OMAR…A STRANGE FEELING LIKE WE’VE JUST BEEN GOING IN CIRCLES”

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“Every system is perfectly designed to achieve the results it achieves”.

Donald BerwickInstitute for Healthcare Improvement

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Service redesignService redesign

• Whole system

• Patient focused

• Meeting expectations

• Right time, right place, by right people

• Best practice standards / Modernisation Agency /

targets

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Service Design GroupsService Design Groups

EmergencyElective Chronic

Disease Management

Diagnostic & Therapies

Intermediate Care

ElderlyPrimary

Care

Childrens Interface Group

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Main categories of patientsMain categories of patients

E m erg e ncy o r u np la nn e d ca re E le ctive o r p la nn e d ca re L o n g te rm co n d it io ns o rC h ro n ic D ise a se M an a g em e nt

S H IF T (W ho le sys te m )S e rv ice R ed e s ign

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How services will change…..How services will change…..

Acute

Intermediate

Primary / community

Old = organisational focus New = Pathway focus

10 20

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SELLING THE

MESSAGE

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THE CHIEF EXECUTIVE’S DILEMMA

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Hope Hospital

Pendleton –Children and Young People

Swinton –Minor surgery & diagnostics

Ordsall

Broughton & Blackfrairs

LIFT Initiative

•4 Health and Social Care Centres with electronic links to Hope Hospital

•Second phase LIFT developments to enhance existing healthcare facilities

•Whole system modernisation of inner city practices throughout LIFT

•Underpinned by IM&T

Walkden –Specialist Therapies

Eccles –Teaching and Learning

Little Hulton

Irlam & Cadishead

Clinical network

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The whole system – starting in The whole system – starting in primary care……primary care……

• Health promotion– Healthy choices

– Opportunities

– Regeneration

• Family care– Access

– Modern facilities

– Flexibility

– Scope

• Case management

(Evercare model)

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New intermediate level

The new Intermediate tier includes:

Improved access to diagnostics and

therapies

New roles to manage

“emergency” demands

Over 100 new beds or equivalent

services preventing hospital admission or facilitating transfer of

careProvision of minor surgery and other

invasive procedures in

Health and Social Care Centres

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Unplanned Care

Urgent advice:

Pharmacist

NHS Direct

Walk-in 8 ‘til late

Receives consistent advice and either self-manages or enters appropriate part of system

Urgent care needs assessed and referred to:

•Rapid Response Team

•GMAS / Emergency Practitioner assessment

•Primary Care clinician

•Intermediate Treatment

•A&E

If admitted to Hope Hospital….

Access to diagnostics to prevent unnecessary admission

Emergency Assessment unit for admissions of up to 72 hours, separated from elective activity and managed by Emergency Assessment Physician

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Emergency Admission UnitEmergency Admission Unit

•772 hour•EEarly diagnosis•IIntervention / treatment•MMedical / surgical response•MMulti-disciplinary teams•PPlanned transfer of care

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Planned Care…………….

Assessment by Primary Care

clinician / Tier 2 panel

Electronic booking

Date of admission agreed with patient

Procedure under LA at Health and Social

Care Centre

Admission to (up to) 72

hour Elective facility at

Hope Hospital

Intermediate / Primary Care recovery

Out patient assessment

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“I CAN’T BE ABSOLUTELY CERTAIN, OF COURSE, BUT YOU DO APPEAR TO BE IN SOME KIND OF TROUBLE, MR HOWARD”

STATING THE BLEEDING OBVIOUS

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Long-term conditionsLong-term conditions

•GGuided self-management•PPrimary care management•IIntegrated healthcare teams•IIncreased complexity

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Out Patient activity will change…………

The out patient cake will be cut in

different ways

Different ways of managing conditions, as an integrated team:•Self management

•Call Centres•Urgent access support

•Telemedicine

Some clinics will be held in Health and Social Care Centres – with on-line access to health records and diagnostics

Some clinics will continue to be provided at hope Hospital, because of the reliance on more complex imaging, etc.

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INVESTMENT + REFORM = NEW SYSTEMINVESTMENT + REFORM = NEW SYSTEM

•4 Health & Social Care Centres

•Ambulatory treatment

•Additional beds

•Investing in Primary Care

•New Hospital buildings

•Weekend and evening sessions

•362 w.t.e. new staff

Redesign Changes

Tier 2

Intermediate care

Pathway led

Performance improvement

82% occupancy

Modernisation Agency

Inappropriate admissions

Upper quartile LOS

IM&TWhole system

Supporting clinical practice

Consistent with National Strategy

Workforce

New roles

New teams

14 session week

Current activity

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“and now there goes theWilsons!…Seems like every one’sEvolving except us!”

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REDESIGN YOUR SERVICES

PASS IT ON

Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For...

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