HEALTH GROUP REPORT

1. HEALTH GROUP REPORT Russell Patmore Medical Director, Clinical Support

2. Structure • 4 Health Groups for the clinical services • Medicine • Surgery • Family and Women’s Health • Clinical Support • Each led by a Medical Director supported by Nurse and Operations Directors • Autonomy earned on the basis of performance

3. Challenges • Clinical performance • Increasing demand in many areas • Poor local health outcomes and an ageing population • Financial environment How do we improve quality and deliver much greater efficiency?

4. Health Groups United • Work together and use all our talents • Deliver better care for our patients • Improve our pathways to reduce harm, time in hospital and waste • Maximise efficiency to deliver savings and allow investment without compromising on quality What did we achieved over the last year?

5. Enhancing Patient Safety • Dedicated sessions for anaesthetists to optimise patients for surgery • Enhanced recovery project • Reductions in C-Diff and MRSA • Antibiotic drug chart • National early warning score introduced • Reduction in all mortality measures • Revalidation of medical staff

6. Enhancing Patient Experience • Charge nurses now supervisory • Antenatal day unit and early pregnancy assessment centralised in W+C hospital • 2 new neonatal ICU cots opened • Intestinal failure team established and peer reviewed • Interventional Radiology granted exemplar status after national review

7. Enhancing Patient Experience • Butterfly project to identify dementia • Non-cancer palliative care service established • Reduced turn around in cellular pathology • Nurse led community outreach neurology clinics • Friends and Family survey results

8. Innovation and Efficiency • Structure • Surgical admissions lounge at CHH • New gynaecology inpatient and day case unit in W+C hospital, Cedar Ward • New ED for children and minor cases • New ED majors department by July

9. Innovation and Efficiency • Equipment • Digital breast screening introduced • New radiotherapy machines installed • New radiology screening room at CHH • Pathology analysers replaced • ARIA electronic chemotherapy prescribing

10. Innovation and Efficiency • Pathways • Productive operating theatre project now trust wide • Rapid access children’s clinics established • Midwives trained to treat tongue tie • Multidisciplinary elderly short stay unit model at HRI with national recognition • Move to 7 day working

11. Partnerships • Palliative Care Network • Community based chronic pain service developed with CCG’s • Palliative and Elderly medicine support to East Riding Hospital • HIV and Hepatitis C networks with York and South Bank • Neuropathology linked with Sheffield

12. Partnership • York • Pathology • Head and Neck Cancer • Renal • Cardiology • Opthalmology • Paediatric Surgery • Urology • Orthodontics

13. Can we see the future?

14. Can we see the future? • There will be less money around

15. Can we see the future? • There will be less money around • Everyone is getting older

16. What Pyramid?

17. Can we see the future? • There will be less money around • Everyone is getting older • All roads lead to the emergency department

18. Increase in over 80s 11.6% 17.5%

19. Increase in ‘Majors’ attendances 1.8% 5.8%

20. Can we see the future? • There will be less money around • Everyone is getting older • All roads lead to the emergency department • If your in, your in

21. AAU Admissions (2006-)

22. Can we see the future? • There will be less money around • Everyone is getting older • All roads lead to the emergency department • If your in, your in • We will try to fix you, like it or not

23. Can we see the future? • There will be less money around • Everyone is getting older • All roads lead to the emergency department • If your in, your in • We will try to fix you, like it or not • Its hard to say goodbye

24. Can we see the future? • There will be less money around • Everyone is getting older • All roads lead to the emergency department • If your in, your in • We will try to fix you, like it or not • Its hard to say goodbye • The system will collapse

25. It can be different • Avoid admissions • Not the default • Expand ambulatory care • Community based pathways • Frail Elderly • End of life • Chronic lung diseases • Heart failure

26. It can be different • Minimise hospital stay • Discharge planned from admission • PREDICT project • CAYDER electronic patient management • Expected Date of Discharge • Electronic patient record and prescribing • Rapid discharge and community support • Discharge Hub • Community partners

27. HGU Summary • Another successful year delivering significant improvements in patient care and experience whilst releasing greater efficiency savings than ever before • Clear risks for the future if we are to continue to deliver great care for our community

28. We need your help • Our staff • Focus on patients • Identify and report poor quality • Ask yourself how this could work better • Our partners • Work with us to develop new pathways • Our patients • Tell us if its not working and what you need • Be prepared to embrace change