Patient First Board Report November 2016 · Development Plan being developed M3 • Focus groups exploring areas for improvement • Staff care and engagement groups (replacing WOW)

Patient First Board Report – November 2016

Family and Friends Score

Budget Management

Staff Engagement

HSMR Patient Safety Thermometer

Referral to Treatment Time

A&E 4 Hours

Reduce the numbers of Falls

Reduce numbers of MFFD patients

Reduce the amount of Agency

spend

Staff are able to make

Improvements

Patient First Improvement Programme

Sustainability & Transformation

Plan

Workforce Transformation

WS Eye Care @ Southlands

CWS MSK Integrated

Services

Junior Doctor Contract

Clinical Document Management

Portal

True North

Breakthrough Objectives

Strategic Initiatives

Corporate Projects

Outpatient Transformation

Acute Surgical Review

Pathology LIMS

Arrows indicate:

Metrics improving

Metrics stable

Metrics worsening

Achieving target/project on track

Not achieving target/not on track

Friends and Family

Score

A&E 4 Hours

True North

Owner : Amanda Parker

What are we trying to achieve? • Aim to achieve rates >97% positive

recommendation • Not to exceed 0.7% of not

recommended • Achieve response rate of >40% for

inpatients

What is it important to know? • Recommendation rates are above

95% for all touch points except Maternity post-natal, which has dipped to 92.9% and A&E, which stands at 87.1%. The reduction in A&E, a continuation of the trend observed over the last three months, has coincided with ongoing difficulties in achieving the A&E 4-hour target.

What’s gone well? • Sustained IP return rate 37.4%

during increased activity in month

What are the current challenges? • Embedding a consistent process in

areas with low return rates? • A&E return rate ↓10.6% and Not

recommend rate ↑8.6% • Print Centre struggling to produce

required volume of FFT cards quickly

What are we doing about them? • Engaging teams where returns are

low • Highlighting to managers when

recommendation rates are low • Outsourcing printing of FFT cards

to support impact of the change of contract (change in card design)

What are the Organisational Risks? • As a result of patients having a

poor experience we incur adverse feedback which impacts on our Friends and Family Test scores

How are we managing them? • Negative FFT scores to form part of

reporting via newly developed strategy Deployment Room

• Pt Experience Objective to be agreed for Strategy Deployment

• New design of feedback will be implemented from January 2017

Status is RED and STABLE

Pati

ent

Target, 97%

85%

90%

95%

100%

Apr-14 Aug-14 Dec-14 Apr-15 Aug-15 Dec-15 Apr-16 Aug-16

Friends and Family Test - Positive Recommendation rate %

source: Dr Foster

Target 6 M1 9

M2 9

M3 9

M4 9

M5 9

M6 9

M7 9

True North

Owner : Karen Geoghegan

What are we trying to achieve? • The Trust is required to deliver it’s

financial plan in order to fund service developments and ensure sustainability

• Metric is variance to financial plan.

What is it important to know? • The Trust reported a surplus of

£0.2m at the end of M7 • Financial plan was deliver a surplus

of £2m at end of M7 and a surplus of £2.5m at the end of Q3

• Improvement in run rate is required to deliver Q3 control total.

What’s gone well? • In October the Trust spent no

more than earnings in the month

What are the current challenges? • Managing the paybill within

budget and reducing agency • Achievement of elective activity

plan • Management of bed apacity in line

with changes in activity levels.

What are we doing about them? • Deep dive of divisional positions and

agreement of recovery actions. • Medical paybill targets agreed with

Divisions and plans developed. • Daily Executive agency review. • Weekly review with Surgery of

elective activity.

What are the Organisational Risks? • Local health economy

sustainability and ability of commissioners to afford activity levels

• Ability to manage patient flow and deliver planned capacity levels

• Ability to right-size workforce based on activity levels

How are we managing them? • Close management of 2016/17

contract with commissioners • Seasonal resilience plan agreed with

CCG and local partners • Executive oversight of income

challenges and progress with resolution.

• Income stock-take undertaken to align income assumptions with CCG

Status is RED and DETERIORATING

Board Assurance Risk Score

Target 12

M1 12

M2 12

M3 12

M4 12

M5 16

M6 16

M7 16

Sust

ain

abili

ty

(5,000)

(3,000)

(1,000)

1,000

3,000

5,000


Financial Variance From Budget (£000s)

Budget Management

A&E 4 Hours

True North

Owner : Denise Farmer

What are we trying to achieve? Ensure that all staff are fully engaged in the work of the Trust. Three key elements: 1. Able to make improvements 2. Healthy culture 3. Motivation at work

What is it important to know? • 86% response rate in October Your

Health and Safety days. • Engagement score levelling off

across clinical divisions • Staff Survey 2016 launched. 55%

response rate at end of week 6.

What’s gone well? • Staff survey 2016 launch and

response rate • Staff conference (2 x 300

attendees) • Ophthalmology consultation

launch

What are the current challenges? • Impact of service changes on staff

engagement (eg. facilities) • Operational pressures and staff

experience

What are we doing about them? • Determining value of weekly v.

monthly score • Developing StaffNet pages for staff

engagement • Theme of the week

What are the Organisational Risks? • Operational pressures and

available capacity impact on staff availability to engage

• Dissonance in organisational values and staff experience

How are we managing them? • Leadership Strategy and

Development Plan being developed • Focus groups exploring areas for

improvement • Staff care and engagement groups

(replacing WOW) in Divisions



Target 9

M1 9

M2 9

M3 9

M4 9

M5 9

M6 9

M7 9

Peo

ple

3.4

3.6

3.8

4.0

4.2

4.4

Jul-16 Aug-16 Sep-16 Oct-16

Staff Engagement Score

source: Staff Survey

Staff Engagement

Score

HSMR

A&E 4 Hours

True North

Owner : George Findlay

What are we trying to achieve? • Reduce the mortality rate for non-

elective patients, we want to reduce the number of potentially avoidable deaths.

• To be in top 20% of trusts as measured by Dr Foster

What is it important to know? • HSMR is 89.8 (12mths to June

2016) this represents 1795 deaths (v 1999 expected)

• Performance in this period puts WSHFT in the top 16%

• HSMR by site SRH 85.5 / WH 93.2 • Crude mortality rate 2.91% year to

date (limit set at 3.13%)

What’s gone well? • Kaizen events supporting sepsis

pathway • Successful pilot of mortality review

tool • Clinical engagement with mortality

workstream • Participation in national mortality

review project

What are the current challenges? • Achieving antibiotic administration

within 1 hour • Time within job plans to review all

deaths

What are we doing about them? • Kaizen support for sepsis pathway

and oversight at CQUIN delivery board

• Engagement with IT to ensure easy process for mortality reviews

What are the Organisational Risks? • Cohorts of patients with high

HSMR are not visible due to focus on Trust wide measure

• Potentially avoidable deaths not highlighted

How are we managing them? • Detailed Dr Foster monthly reports

shared with divisions and oversight via Quality Board

• Mortality Steering Group reviewing all deaths to highlight potentially avoidable cases

Status is GREEN and STABLE


Target 9

M1 9

M2 9

M3 9

M4 9

M5 9

M6 9

M7 9

Qu

alit

y Im

pro

vem

ent

Most recent

Nat. 20th percentile

*, 91

80

85

90

95

100

105

Feb-14 Jun-14 Oct-14 Feb-15 Jun-15 Oct-15 Feb-16 Jun-16

Hospital Standardised Mortality Ratio

source: Dr Foster

True North

Owner : Amanda Parker

What are we trying to achieve? • Reduce the number of patients

suffering harm during their stay in WSHT, this can impact on wellbeing, length of stay and recommendation.

• Harm is measured monthly using the National Safety Thermometer

What are the Organisational Risks? • Safety thermometer is a once a

month prevalence measure and does not measure all harms

How are we managing them? • All harms reported via Datix system • Oversight of all harms via

Triangulation Committee



Target 8

M1 12

M2 12

M3 12

M4 12

M5 12

M6 12

M7 12

Qu

alit

y Im

pro

vem

ent

Target, 99%

90%

95%

100%


% P

atie

nts

au

dit

ed

Patient Safety Thermometer - % Patients with no new harms

source: Board Quality Scorecard

What is it important to know? • 98.19% no new harms in October,

improved compared to September • Falls and pressure damage are the

top causes of harm. • High number of reported VTE on

ST collection day this month

What’s gone well? • Falls Reduction Programme

continues however October saw the worst Trust level performance since project began, (although project wards saw 25% reduction in month)

What are the current challenges? • Wards outside of the project have

seen an increased falls • Pressure ulcers with lapses in care

remain above trajectory.

What are we doing about them? • Further 4 wards have join the falls

project in October. • Purpose-T (new pressure ulcer

assessment tool) successful ‘Go Live’ in October

Patient Safety Thermometer

Referral to Treatment

Times

A&E 4 Hours

Syst

ems

and

Par

tner

ship

s

True North

Owner : Pete Landstrom

What are we trying to achieve? • Reduce the number of patients

waiting an unacceptable time for elective treatments and appointments which leads to a poor patient experience

• Metric is percentage of patient pathways completed in less than 18 weeks

What is it important to know? • Zero patients waiting >52 weeks for

treatment • Achieved 90.1% <18 wks for Oct • Highest Trust % compliance with

National target since Oct 2014 • Less patients >18 wk than STF

trajectory but slightly lower % due to reduced PTL –within STF tolerance

What’s gone well? • Detailed pathway management at

a specialty level improving • Gynaecology, Paeds, General

Surgery compliant 92% national target for 1st time in 18 months

• 8 out of the 16 National specialty groupings now >92% compliance (with all but 4 now above 90%)

What are the current challenges? • Overall PTL size is significantly

below the original STF plan and therefore % compliance is lower than plan

• Operational NEL pressures have impacted some (although minimised) elective activity

What are we doing about them? • Specialty planning & management

of cohort on a daily basis • Delivery of increased activity

planned in Nov and Dec • Capacity increases as per plan

come on line in Nov and Dec • Ophthalmology recovery plan

underway & improving position

What are the Organisational Risks? • Increased volumes, reduced flow,

and non-delivery of activity volumes lead to a poor patient experience and waiting times

• Failure to achieve National RTT 18wk constitutional target (condition of the Sustainability & Transformation Fund).

How are we managing them? • RTT incomplete position discussed

through Strategy Deployment Room • Activity and pathway management

programme in place tracking speciality level delivery

• Weekly specialty level improvement and delivery review with COO

Status is RED and IMPROVING


Target 9

M1 12

M2 12

M3 12

M4 9

M5 12

M6 9

M7 9

Target, 92%

75%

80%

85%

90%

95%

Apr-14 Sep-14 Feb-15 Jul-15 Dec-15 May-16 Oct-16

RTT Incomplete pathways - % waiting less than 18 weeks

source: RTT Monthly Return

A&E 4 Hour Waiting Times

A&E 4 Hours

Syst

ems

and

Par

tner

ship

s

True North


What are we trying to achieve? • Demands in the urgent care

system lead to patient flow being compromised, which leads to a poor patient experience

• Metric is percentage of patients attending A&E seen within 4 hours

• Trust is aiming to achieve 95% patient treated within 4 hours

What is it important to know? • Zero patients waiting >12 hrs for

treatment • Achieved 93.01% <4 hrs for Oct

and cumulatively 94.5% YTD • October attendances 4.3% higher

than same period last year • SRH = 93.7% in month, whilst WH

achieved 92.4%

What’s gone well? • Performance increasingly variable

with both sites achieving >95% for 33% of the days

• Achieved over 90% for 77% of days but some significant days of high volumes of breaches

• Increase in DTOCs & MFFD patient levels increasing pressure on flow

What are the current challenges? • Step up in acute admissions from

3rd October, with WH site particularly challenged with higher admission than discharge volumes

• Fragility in OOH demand and impact on minors stream causing high numbers of breaches on specific days

What are we doing about them? • Additional inpatient escalation

capacity opened (11 beds) at WH • Agreed Winter Resilience schemes

including establishment of GP in A&E at Worthing (Dec/Jan start)

• Over recruited ENPs to support out of hours and minors resilience

• “Perfect Week” Initiative 28/11 What are the Organisational Risks?

• Increased volumes and reduced flow within the A&E units lead to a poor patient experience

• Failure to achieve the National A&E 4hr target (a condition of the constitution and Sustainability & Transformation Fund)

How are we managing them? • A&E 4hr position discussed

through Strategy Deployment Room and A&E Delivery Board

• System wide Resilience Plan and performance to be monitored through A&E Delivery Board

• Daily escalation and monitoring


Target, 95%

75%

80%

85%

90%

95%

100%


A&E - % Patients seen within 4 hours

source: A&E Monthly Return


Target 8

M1 8

M2 8

M3 8

M4 12

M5 12

M6 12

M7 12

Reduce the Number of

Falls

A&E 4 Hours


Owner : George Findlay

What are we trying to achieve? • Reduce the number of

patients that suffer falls in our Trust, this causes harm and has an impact on length of stay and our reputation.

• Falls are measured continuously via Datix

What is it important to know? • October’s Trust performance was

the poorest since the project began, with 185 reported falls.

• Since the project began there have bene 135 less falls compared to the same time last year.

What’s gone well? • Overall,5 of the project wards and 3

of the 4 wards that have progressed to sustaining phase have maintained 50% reduction in October

• The project wards delivered an overall 25% reduction compared to last year’s monthly average.

What are the current challenges? • The Emergency Floors have not

been able to deliver sustained reduction to date.

What are we doing about them? • Emergency Floors quality meeting

is planned during November with leads from Medicine to review the current approach.

What are the Organisational Risks? • Focus on falls prevention

results in other types of harm increasing.

How are we managing them? • All harms reported via Datix system.

Oversight of all harms via triangulation committee.



Target 9

M1 12

M2 12

M3 12

M4 12

M5 9

M6 12

M7 12

Target (30%

reduction), 130 80

130

180

230

Apr-15 Jul-15 Oct-15 Jan-16 Apr-16 Jul-16 Oct-16

Number of Falls

source: Dr Foster

Qu

alit

y Im

pro

vem

ent

Reduce MFFD Delays

A&E 4 Hours

Syst

ems

and

Par

tner

ship

s



What are we trying to achieve? • Reduce the number of patients in

our hospitals that are medically fit for discharge

• MFFD patients in hospital beds can compromise patient flow, and impact on A&E wait and LOS

• Metric is to reduce average patient days delayed by 50%

What is it important to know? • MFFD delays increased in Oct to

1212 days average delays • SRH delays improved again to 397

day (and on average 50 pts) • WH delays deteriorated

significantly to 816 days lost on average (on average 72 pts)

What’s gone well? • SRH overall delays (patients and

days delayed have improved slightly)

• Tocus on community beds has freed up some capacity particularly in west of the region

• Agreed Winter Resilience including increased Community Capacity

What are the current challenges? • WH has seen a further increase in

MFFD over the first 3 weeks of November impacting flow

• Access to PoC and Community Hospitals/Placements are the main delay reasons

• WH locality in particular lacking availability of rehab bed capacity

What are we doing about them? • Increased levels of Executive

escalation with SCFT • Offering mutual support and joint

working to maintain comm capacity • Directed some Arundel bed capacity

to WH to smooth flow • Running a ‘Perfect Week’ initiative

in both WH (28/11) & SRH (12/12)

What are the Organisational Risks? • Failure to reduce MFFD patients

occupying acute hospital beds adversely impacts delivery of services and the achievement of elective and non-elective targets and leads to poor patient experience

How are we managing them? • Weekly MFFD multi agency

meetings on both acute sites as per national recommendations

• Daily Board Round collection of delays and next step information by Discharge Team Daily SITREP reporting of formal DTOC patient numbers and reasons



Target 9

M1 12

M2 12

M3 12

M4 9

M5 9

M6 9

M7 12

Target, 750

80

580

1,080

1,580

Dec-15 Feb-16 Apr-16 Jun-16 Aug-16 Oct-16

MFFD – Average Patient Days Delayed

source: MFFD Database

Reduce the amount of

Agency Spend


Owner : Karen Geoghegan

What are we trying to achieve? • Reduce agency spend from £23m

in 2015/16 to £17.2m in 2016/17 • Comply with capped rates • Recruitment and retention plans

to ensure reduction in agency is sustainable

What is it important to know? • Cumulatively, agency spend remains

below threshold but the monthly cap was again exceeded in October.

• At the current rate of spend the Trust will breach the agency ceiling at the end of December.

What’s gone well? • Medical agency spend below

monthly threshold in M1-M4

What are the current challenges? • Nurse agency expenditure

increased in October and significant reduction in demand is required to bring spend to an affordable level.

• Monthly cap will reduce further in coming months.

What are we doing about them? • Bilateral meetings to review key

areas of spend and exit plans for medical agency

• Agency switch programme underway to reduce reliance on nurse agency

• Bank bonus scheme introduced

What are the Organisational Risks? • Agency expenditure is

unsustainable and Trust is unable to deliver I&E control total and therefore not able to access Sustainability and Transformation fund

How are we managing them? • Weekly reporting at Executive

Agency Review Meeting. • Executive bi-lateral meetings with

Divisions to focus on Agency spend • Weekly scrutiny of agency spend

against overall ceiling trajectory plan.

Status is GREEN and DETERIORATING


Target 9

M1 12

M2 12

M3 12

M4 12

M5 12

M6 12

M7 12

(5,000)

(3,000)

(1,000)

1,000

3,000

5,000


Agency Spend (£000s)

Sust

ain

abili

ty

A&E 4 Hours


Owner : Denise Farmer

What are we trying to achieve? • Enable staff to have the

opportunities, tools and support to identify and make improvements in their area of work

What is it important to know? • Pilot area work progressing with

Western Sussex Way (customer care) sessions commissioned for each area

• Improvement board in place at Southlands

• Staff engagement workshops being developed based on work in dietitics

• An ongoing staff consultation within the portering team poses a risk to the speed and impact of the project

What’s gone well? • Outcome, process and counter

balance measures in place • Baseline engagement score

established for booking team

What are the current challenges? • Capacity in pilot areas delayed

release for staff engagement workshops

• Confidence of yellow belts to support

What are we doing about them? • Standard content for workshops

being developed • Capacity from Kaizen to support

initial pilots

What are the Organisational Risks? • Operational Pressures impact on

individuals staff ability to engage and make improvements.

• Focus activity through PFIS

How are we managing them? • Focus activity through Kaizen Office

and pilot areas.



Target 12

M1 9

M2 9

M3 9

M4 9

M5 9

M6 9

M7 9

Peo

ple

Target, 63%

52%

54%

56%

58%

60%

62%

64%I am able to make improvements in my area of work

source: Staff Survey

Staff are able to make

improvements

Capacity and

Capability

Patient First

Pat

ien

t Q

ual

ity

Imp

rove

men

t


Lean Projects

PFIS

Peo

ple

What are we trying to achieve? How are we doing? What is important to know?

• Development of continuous improvement (Kaizen) Strategy that supports True North and Patient First objectives within the Trust to empower staff to solve problems and make improvements.

• Recent meeting with Jeremy Hunt allowed members of the Team to share their experiences and achievements so far on the Patient First programme – this was extremely well received and he fully supports our thinking !

• Lean management systems (PFIS) implemented across the whole organisation with full support and engagement from all teams, operationalised to the required standard to enable staff to make improvements

• Wave 3 comprising of 6 units within Worthing are progressing to plan.

• Wave 1 and 2 have Yellow Belts as mentors and this has support has started.

• Linking PFIS right up to the Exec is an important and critical process and this is currently under construction.

• To ensure all staff have knowledge, skills to participate in Lean based improvement activities in helping to build a culture of continuous improvement in supporting True North and objectives of Patient First

• Yellow Belts have supported a number of Kaizen Workshops Fractured Neck of Femur and Outpatients. Challenge is to encourage Yellow Belts to drive improvements in their own workspace.

• 8 Yellow Belts ‘mentors’ have been identified to help support and embed PFIS for Wave 1,2 units.

• The SIX Lean Projects are entering testing, pilot and implementation phases for Stroke, Orthopaedics #1, Orthopaedics #2, Bed Turnaround, Discharge Lounge & Endoscopy.

• Support and attendance to all meetings from GB teams inc. Project sponsors is sometimes a challenge.

• Through Weekly Project updates by the Team (with Project Sponsor copied) to the Exec Sponsors helps to address this challenge, and ensures full support / alignment.

Owner: Anil Mathew

Qu

alit

y Im

pro

vem

en

t

215

Sustainability and

Transformation Plan

Coastal Care

Pati

ent

Sust

ain

abili

ty

Qu

alit

y Im

pro

vem

ent


What are we trying to achieve? • Ensure the provision of high quality stroke

services meeting the National Stroke Strategy 2007 clinical standards

• Sussex-wide review of Stroke Services supported by the Sussex Collaborative Delivery Team and funded by the seven Sussex Clinical Commissioning Groups

How are we doing? • CWS CCG and WSHFT have

collaborated to implement the activity, bed capacity and financial analysis re-work recommended by Clinical Senate

What is important to know? • CCG & WSHFT are in process of

agreeing a joint recommendation which will to take into account the STP planning process

What are we trying to achieve? • Deliver a system wide plan to deliver

the 5 year forward view and close gaps in health and wellbeing, care and quality and finance across Sussex and East Surrey.

How are we doing? • Key milestone of STP submission

on 21st October achieved

What is important to know? • Individual Placed based plans submitted

as part of the overall STP submission. • STP’s reviewed centrally and feedback

expected end of November, concern regarding STP overall Financial gap.

What are we trying to achieve? • A population based approach for Coastal

West Sussex delivered through increasing integration in order to improve standards, manage demand and make the system financially sustainable.

• Strategy includes Health and Social Care.

How are we doing? • New project structure and PMO being

recruited to. • Business case : @Coastal Care;

inspiring healthier communities together approved and submitted.

What is important to know? • Further work required to ensure all

stakeholders aligned. • Memorandum of Understanding

(MoU)being presented to Trust Board for approval 1 December .

• MoU to partners organisations Boards in November.

Stroke Reconfiguration

Owner: Andy Gray

Outpatient Transformation

Time taken to process referrals

Pati

ent

Sust

ain

abili

ty

Qu

alit

y Im

pro

vem

ent


Demand and Capacity

Patient on-site waiting

times

What are we trying to achieve? • To improve every outpatient

appointment interaction • To improve patient experience and

simultaneously make the best use of Trust resources

What is important to know? • Outpatient Steering Group being

redesigned into a ‘Performance System’

• Kaizen Booking value stream mapping completed in October – 3xA3s identified and progressing

What is important to know? • Procurement of system underway

and specification being drafted. Expressions of interest from 5 suppliers. Demonstrations for project team planned for 7th December

• Expected contract award Feb 2017 for deployment in 2017/18

What is important to know? • Outpatients included in PFIS Wave 2

cohort. • SRH OPD to commence in wave 4 • Driver metric: F&F response, showing

positive increase

What are we trying to achieve? • When patients come to our

Outpatients, they are waiting too long to be seen. Our objective is to reduce these waiting times - prioritising specialties with longer waits

Syst

ems

and

Pa

rtn

ersh

ips

What are we trying to achieve? • Once a referral is received,

manual processes are needed. Achieving best practice could reduce the time taken to manage and grade referrals by an average of 8 days

What are we trying to achieve? • This transformational programme

will support specialties to review clinic capacity . We anticipate this will reduce on-day delays and improve overall capacity to see more patients with the same resource.

What is important to know? • Progress on this workstream impeded

by unforeseen lack of resource • Contract with telephony supplier agreed

to roll-out text reminder to improve DNA rate, implementation plan being developed

How are we doing? • New Clinic Utilisation Report has

been created and in use by operational teams

• DNA rates increasing compared to a national decreasing trend

Week ending

WH 2WW

SRH 2WW

WH Regi-stration

SRH Regi-stration

MSK Regi-stration

Standard <24 hrs <24 hrs < 3 days < 3 days < 3 days

14/11 <24 hrs <24 hrs 5 d 2 d 3 d

07/11 <24 hrs <24 hrs 12 d 5 d 5 d

31/10 <24 hrs <24 hrs 8 d 5 d 3 d

24/10 <24 hrs <24 hrs 13 d 7 d 3 d

Owner: George Findlay

Workforce Transformation


Peo

ple

Owner: Denise Farmer

What are we trying to achieve? • 3-5 year plan to address long standing

workforce gaps. • Specific initiatives to increase the

supply of groups of professional staff: Junior Doctors, Registered Nurses, Therapists and Scientists to be taken forward alongside consideration of new roles and new models of care, which require a different skill mix.

What is important to know? • Four key areas have been identified and

a range of options are emerging. A baseline has been established for each area

• Staff group meetings have been held through July/August to develop Project Charters to inform A3s. For nursing, Training and International Recruitment Project Charters are developed. A range of approaches to tackle Jnr Dr shortfalls have been discussed.

How are we doing? • Phased production of project

charters (delayed, key work delegated to project leads 19 October 2016)

• Baby A3’s and prioritisation exercises (delayed, phased delivery from November 2016

• Project plan with recommendations by 30 November 2016

Pati

ent

Corporate Projects

CWS MSK Integrated

Service

Owner: Karen Geoghegan

What are we trying to achieve? • Relocate Worthing Ophthalmology to

Southlands • Provide capacity to achieve 18 week RTT

and meet anticipated future demand • Improve patient experience by redesigning

patient pathways

What is important to know? • Potential building delay of 3.5 weeks due

to asbestos, mitigation being sought • Equipment schedule re-costed,

purchase/delivery schedule drafted and presented to Executive team – initial purchases raised

• Nursing & Admin staffing consultation commenced wc 14th Nov

Key Risks: • Risk that development is delayed

causing cost or time over-run. • Risk that operational services are not

reorganised in readiness for opening of new unit.

• IT solution (Evolve) needs further work to meet needs of the service

• Risk of equipment overspend • Car parking solution not in place for

patients and staff on go live

Mitigations: • Robust programme management in place

to reduce likelihood of unanticipated building programme over-run

• Operational programme team in place to oversee service changes and manage risk

• Equipment costs being tightly managed • Joint work with Estates to identify number

of car parking spaces required –potentially 60-70 spaces needed – funding source and planning application required – Exec approval needed – paper being drafted for consideration 5th Dec at next Executive Steering Group.

Target Date

Workstream Progress

Spring 2017

Building programme

On track

Mid-Sept 2016

Equipment schedule On track

Mid-Nov 2016

Staffing consultation On track

tbc Car parking Risk

Dec 2016 Pilot of redesigned patient pathways

On track

Owner: Pete Landstrom

Target9

M1 9

M2 9

M3 9

M4 12

M5 12

M6 12

M7 12

West Sussex Eye Care @ Southlands

Corporate Projects

CWS MSK Integrated

Service

What are we trying to achieve? Improved patient outcomes, shorten waiting times & control health economy costs by: • Redesigning MSK Pathways for elective and

outpatient care • Lead on delivering an integrated service

collaboratively with SCFT & 3rd parties.

Syst

ems

and

Pa

rtn

ersh

ips

Target 8

M1 12

M2 12

M3 12

M4 12

M5 12

M6 15

M7 15

Owner: Pete Landstrom What is important to know? • Memorandum of Understanding

and Non Disclosure Agreement awaiting sign off by WSHFT and SCFT

• MSK Steering Board agreeing next steps to progress to implementing some service changes ahead of Commercial decision

Key Risks: • Lack of contractual agreement with

CCG impacts on ability to implement full service model.

• Delays in progress towards start date mean loss of momentum and staff engagement

Mitigations: • On-going dialogue with CCG at

executive level to resolve. • Revised Coms and Engagement

plan. • Progress to mobilisation to deliver

agreed service changes without commercial impact

What are we trying to achieve? • Implementation of new terms and

conditions for junior doctors by August 2017

Peo

ple

Owner: Denise Farmer

Target tbc

M1 tbc

M2 tbc

M3 tbc

M4 tbc

M5 tbc

M6 tbc

M7 4

What is important to know? • Industrial action by BMA called off • 55 FY1s moving to TCS 30.11.16 • Exception reporting software in

place and education supervisors and trainees receiving training

• Planning for next transfer due 01.02.17

Key Risks: • Exception reports highlight safety

issues or education breaches • Disengaged doctors moving onto

the new TCS

Mitigations: • Educational supervisors training in

place • Awareness sessions for GP’s and

Psychiatry placements scheduled for Feb 2017

• Medical HR team in regular contact with juniors transferring

Junior Doctor Contract

Corporate Projects

Pati

ent

Clinical Portal

Pati

ent

Clinical Document

Management Portal

Key Risks: • Risk of lack of resources to support and

develop programme to agreed timescale

Mitigations: • Plans in place to use current

resources as efficiently as possible

What are we trying to achieve? • All patient records to be

paperless at WSHFT by 2020

Owner: Ian Arbuthnot

Target 9

M1 n/a

M2 n/a

M3 n/a

M4 9

M5 9

M6 9

M7 9

Go live dates

Action Progress

July 2016 Paediatric Outpatients Achieved

Nov 2016 Paediatric Inpatients At risk

Jan 2017 Ophthalmology On track

What is important to know? • The feedback we have obtained from staff

within Paediatric Outpatients has, on the whole, been encouraging

• As a result of lessons learnt we have re-scheduled the Paediatric Inpatient implementation to allow us to: 1. Improve the system through resolution

of the majority of the outstanding issues to better support the clinicians and

2. Embed more efficient and practical processes

Corporate Projects

Pati

ent

Target 6

M1 n/a

M2 n/a

M3 n/a

M4 6

M5 6

M6 12

M7 12

How are we doing? • Programme Board established • Initial communications undertaken • Engagement sessions - completed • Survey monkey completed • Data analytics group in situ (6 weeks) • Clinical Experts contacted and external

sites visited • Stakeholder feedback session early 2017 • Newsletter to be published Dec 16 to

update all stakeholders of progress to date

What are we trying to achieve? • Service review to ensure we are

operating emergency and urgent surgery across the St Richard’s and Worthing sites in the most effective way.

What is important to know? • Data mining exercise underway • Over 115 responses to survey

monkey • Over 25 consultants interviewed

Owner: George Findlay

Key Risks: • Potential for negative public

perception due to misunderstanding of scope

• Risk of lack of engagement by staff • Data analysis must be robust – tight

timeframe to complete this work

Mitigations: • Robust communication and

engagement plans in place • 6 clinicians identified to help lead

data review • Project governance further

supported by PMO

Acute Surgical Review

Owner: Pete Landstrom

What are we trying to achieve? • Install a new laboratory information

management system and order comms system as part of the Abbott pathology managed equipment service which will support full service integration and delivery of the process and workforce efficiencies associated with the planned automated hot and cold site lab configuration for WSHFT.

How are we doing? • The LIMS implementation project

has run into several technical difficulties, resulting in an 18 month go-live delay

• Project teams from supplier and Trust have been working through these issues

• It is planned that a move to a new version of the LIMS will overcome some of the obstacles to go live.

• Contract change control as yet unsigned.

What is important to know? • Commercial negotiations in progress to

recoup some Trust costs as a result of delay and agree zero cost for system changes made by Clinisys to date.

• Upgraded software agreed by supplier and demonstration of functionality provided

• New project plan, enhanced governance arrangements and go-live date to be established on conclusion of negotiations

• Legacy system support cost associated financial risk increases associated with post March 17 go live.

Key Risks: • Deployed system will not fulfil

service requirements without additional unplanned resource or service remodelling.

• Unexpected system critical changes within new software.

• Pathology staff resources are inadequate to support implementation at pace required.

Target9

M1 12

M2 12

M3 12

M4 12

M5 12

M6 12

M7 15

Pathology LIMS

Corporate Projects

Pati

ent

Mitigations: • Enhanced project governance

and mobilisation package currently being negotiated

• Completion of full user acceptance testing of new version of software.

• Staff capacity around project milestones supplemented with bank and agency support.

Documents

Patient First Board Report November 2016 · Development Plan being developed M3 • Focus groups exploring areas for improvement • Staff care and engagement groups (replacing WOW)