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

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HEALTH GROUP REPORT

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Health group report

HEALTH GROUP REPORT

Russell Patmore

Medical Director, Clinical Support


Structure

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


  • Challenges

    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?


    Health groups united

    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?


    Enhancing patient safety

    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


    Enhancing patient experience

    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


    Enhancing patient experience1

    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


    Innovation and efficiency

    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


    Innovation and efficiency1

    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


    Innovation and efficiency2

    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


    Partnerships

    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


    Partnership

    Partnership

    • York

      • Pathology

      • Head and Neck Cancer

      • Renal

      • Cardiology

      • Opthalmology

      • Paediatric Surgery

      • Urology

      • Orthodontics


    Can we see the future

    Can we see the future?


    Can we see the future1

    Can we see the future?

    • There will be less money around


    Can we see the future2

    Can we see the future?

    • There will be less money around

    • Everyone is getting older


    What pyramid

    What Pyramid?


    Can we see the future3

    Can we see the future?

    • There will be less money around

    • Everyone is getting older

    • All roads lead to the emergency department


    Increase in over 80s

    Increase in over 80s

    11.6%

    17.5%


    Increase in majors attendances

    Increase in ‘Majors’ attendances

    1.8%

    5.8%


    Can we see the future4

    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


    Aau admissions 2006

    AAU Admissions (2006-)


    Can we see the future5

    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


    Can we see the future6

    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


    Can we see the future7

    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


    It can be different

    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


    It can be different1

    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


    Hgu summary

    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


    We need your help

    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


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