Delivering the Productivity & Efficiency Plan GETTING eQIPPd WITH IM&T ( E nergising Q uality, I nnovation,

1. Delivering the Productivity & Efficiency PlanGETTING eQIPPd WITH IM&T(Energising Quality, Innovation, Productivity, Prevention & Delivery) Martyn Smith Deputy Director of Finance & MTPEP Programme Manager 9th APRIL, 2010

2. IM&T – THE ART OF THE POSSIBLEor(what has IT ever done for me?) INFORMATICS DEPARTMENT CUSTOMER SERVICES

3. QIPP Why do we need a QIPP Transformation Programme? • Predicted £15 to £20bn shortfall in NHS Funding from 2011 • Historic income growth trends are not sustainable • Increased focus on risk, outcomes, location • Increasing demand: Older people; Drugs; A&E; etc • We need a combination of: • 21st Century Care Models • Clinical Excellence • Productivity & Efficiency • Assiduous cost control • Future (financial) health depends on this:

4. QIPP The Operational Plan • MORE SERVICES CLOSER TO HOME • Shut down acute capacity • LESS VARIATION FOR ALL SECTORS • Defined, mandated, Pathway based Commissioning • NHS MONEY SPENT WISELY, TO BEST EFFECT, WITH THE BEST POSSIBLE OUTCOMES • Drive out waste and duplication, reward excellence, penalise poor care and poor care models COST DOWN QUALITY UP

5. QIPP What Does This Mean For Us? £12m savings in 09/10 £21m savings this year Circa £20m savings year on year to 14/15

6. QIPP Making Savings: A Workstream Approach DELIVERING PATIENT CARE Outpatients Theatres Clinical Pathways STAFFING PATIENT CARE Management Costs & Back Office Workforce Corporate / Business Units Procurement Energy & Sustainability Estates Leasing SUPPORTING PATIENT CARE Risk Management Decontamin-ation Transform-ation BEST VALUE Income Growth

7. QIPP Governing The Transformation Programme FINANCE COMMITTEE Exec & Non-Exec representation MTEP Board All Exec Directors Programme Management Team Martyn Smith(Programme Manager) Matt Clark MTPEP Accountant Peter Tindall Proj Dir: Pathways Kevin Downes Proj Dir: Theatres Service Improvement Planning Nicky Rowan Proj Dir: Workforce Sue Richards Proj Dir: Outpatients John Taylor Information Lead Workstreams Workforce Clinical Pathways Theatres Outpatients Leasing Estates Clinical Governance Transform-ation Energy & Sustainab-ility Procurement & Drugs Management Costs & Back Office Decontamin-ation

8. QIPP is not a Financial Savings Programme QIPP Clinical & Operational Governance Financial Controls

9. QIPP Developing Robust Deliverability Plans STAGE 4Delivery & Closure STAGE 1DROS Development STAGE 3Test, Review, Implement STAGE 2Detailed Planning Development Framework Formal Sign-off and Project Closure FINALISED DROS ADDED TO TRACKER GANTT PLANS Identified efficiency project Stages & Processes OUTCOMES BED REDUCTION THEATRE CLOSURE OPD RATIONALISATION STAFF REDUCTION ETC Planning & Scoping BUDGET ADJUSTMENT Indicative savings opportunity added to MTPEP overview Projects underway Live Project is signed off by BU Triumvirate or Directors Governance PROJECT OVERVIEW MONTHLY STATUS REPORTS RESOURCE REMOVED DRAFT DROS STATEMENT BASELINE BUDGET REDUCTION SIGN OFF EXECUTIVE REPORTS

10. QIPP ‘Better Value’ intentions – A Commissioner View • Standardisation of tariffs and contracts • Focus on high volume care –BCBV metrics • Increase day surgery rates over in patient elective • Changes in practice –stop procedures with no or limited clinical benefit/low cost alternatives • Coding and invoice validation Acute Providers • Utilise and embed ‘Productive’ methodologies • Skill mix changes - increase ratio of non clinical to clinical • Increase clinician to patient facing time • Faster diagnostics and tests • Reduce variation in LOS All providers • Better medicines management • Eradicate waste –back room functions • Improve inventory management • Collaborative/joint procurement to improve buying power Supply Chain/ procurement • Admission management for planned and unplanned • Care planning –changes in location, follow up and patient care • Increased use of technology to support independence • Personalisation – empowered user and carers Care pathway management

11. IT’s the future QIPP ‘the widespread use (of computers) in hospitals and physician’s offices will instantaneously give a doctor or a nurse a patient’s entire medical history, eliminating guesswork and bad recollection, and sometimes making the difference between life and death’ Thomas J Watson Jnr – Chairman IBM - 1965

12. Has Our Time Finally Arrived? QIPP Directors of ICT Group – 2007 Time Out Conference

13. What Do Our Organisations Want From IT Systems? QIPP • High Performance: • Fast; Reliable; Available; Sexy; Easy to Use • Accessible & Flexible: • Enough where they are needed; Use it anywhere • Joined up (but I don’t want to lose sovereignty...) • Improve what I do: • Governance / Decision Making / Risk / Security • Make my job easier not harder …… • Cheap as Chips: but the highest quality ….. • Solve every problem we’ve got .......

14. Business Cases – A Tribute to Arthur C Clarke QIPP • Improve Governance • Improve the patient experience • Reduce Risk • Make it easier to ‘manage’ • Richer, more accessible information • Eliminate errors, ‘misses’, non-compliance • Reduce costs: • Staff; Paper; Transport; Stock; Treatment; etc • Increase Income • Minimal Support (after negotiation!) • It’s a Bargain! • You can have it tomorrow

15. We Have The Answer QIPP

16. QIPP So How Was It For You? • You never told me about the support army! • What do you mean we didn’t buy that functionality? • But the old one did it – and faster! • But Google never crashes ...... • Another day, another invoice! • Why can’t I access that? • Benefits – what benefits? • But they’re only £200 at PC World? • Don’t my opinions count?

17. Doing Business In A Cold Climate Of Austerity QIPP • Review value added & non value added activities • Improve current value added processes • Introduce ‘leaner’ processes: 10% more for 10% less • Stop / Decommission non value added • Manage impact on patients, targets, etc • New ideas – maximum bang for $ • Provide evidence of business value contribution & tangible, cash releasing benefit: if it doesn’t ‘earn’ then we don’t invest

18. The Reality QIPP • 50% cut in Capital Spending (as a start) • 87 Developments – 10 Approved (Provisionally) • £21m year on year Revenue Savings • Improved VFM (3 E’s) is non-negotiable • QIPP Demands Innovation • IM&T has to be at the heart of this – doesn’t it? • High-Impact Changes for IT • Delivery: converting hypothetical opportunities into tangible, measurable, sustainable, improvements • Failure isn’t an option

19. QIPP Critical Questions For IM&T • Do we bring IMPETUS and DRIVE to the challenge? • Can we really help the NHS become 20% more efficient? • What answers do we have? • Do the figures stack up? • How can our own services become 20% more efficient? • What do we need to start doing? • What can we stop doing? • What can we do differently: faster; slicker; lower cost • Where are we not adding value? • Have we got the resources & capacity for the job? • What is the VISION • What are we doing about it?

20. Delivering the Productivity & Efficiency PlanGETTING eQIPPd WITH IM&T(Energising Quality, Innovation, Productivity, Prevention & Delivery) Martyn Smith Deputy Director of Finance & MTPEP Programme Manager 9th APRIL, 2010