getting transformational change through collaboration: moving from plan to action

Getting transformational change through collaboration – moving from plan to actionRachel Hinde – Sustainable Improvement Team NHS EnglandSheinaz Stansfield - Practice Manager Oxford Terrace and Rawling Road Medical Group & Self Care Lead: NHS NGCCG (Gateshead Locality)

Stepping-up the pace

#bigrealchange

• Development for Commissioners (2011-13) - 70% Clinical Commissioning Groups took-up our support to help them become ‘authorised’

• Transforming Care / CCG capability programme (2013-15) – over half the country’s CCGs and local partners took this up

• Improvement partner to Prime Minister’s Challenge Fund sites – 20 pilots (2014/15) and 37 schemes (2015/16)

• General practice development programme support 2016-19 – available to all practices

“Investment in building capacity and capability for change is the most consistent characteristic in high-performing systems globally ……Evidence from high-performing health systems indicates the need to invest significantly in leadership-level skills for large-scale change; [skills] to mobilise for improvement, strategically align goals and create measures and implementation initiatives; to work explicitly with models and theories of large-scale change; and to balance short-term operational results with longer term transformation”

‘The next leg of the journey: how do we make high quality care for all a reality?’

Helen Bevan, Chris Ham, Paul Plsek (2009)

Our role

• Helping to frame the challenge - the burning platform and burning ambition*

• Creating ‘transformational space’ – distinct from business as usual meetings

• Using evidence-based tools and approaches – tested at an unprecedented scale and creating a resource for NHS and its partners

• Flexibly supporting local systems to deliver their change

*Peter Fuda: Leadership Transformed www.peterfuda.com

GP Forward View “Making Time to Care Through Collaboration”

Sheinaz Stansfield: Practice Manager Oxford Terrace and Rawling Road Medical GroupSelf Care Lead: NHS NGCCG (Gateshead Locality) Twitter: @SheinazsEmail: Sheinaz.stansfield1@nhs.net

• Merger/Two sites• 15.200 Patients• 2500 high admission

risk• All long term

conditions• Hospital stay longer• Deaths earlier etc etc• High Dementia

Prevalence• PMS• 8 Care Homes

Oxford Terrace & Rawling Road Medical Group

“Passionate about Complex care”Culture of Continuous Quality

Improvement

“Needs are becoming more complex, demand is

increasing, we don’t have time to listen!”

Making Time In General Practice• Look at the skill mix• Join forces• Extend the practice

team• Manage demand• Support patients to

help themselves• Social prescribing• Health and housing

10 High Impact Actions

Extending the Practice TeamWorkforce

Transformation of Nurse team

Frailty NursePrimary Care Navigators

Practice Based Occupational Therapist

Practice based Community Matron

Older Peoples Specialist Nurses

Emergency Health Care

Plan

Managing Demand- Through Care Navigation & Social Prescribing

• Dementia Screening + 117• Assessment for Dementia +38• Carers Register + 43• Veterans Register + 20• Care Plans +396• NHS Health Checks + 95• Post discharge + 86 none of whom needed a physician as PCN

sorted• Reduction in discharge letters suggesting avoided admissions –

from 7 to 8 a day to 2-3 a week, within first six months• more effective in ringing patients following emergency admission• less fragmentation• reception managing better• improved communication• less prescription errors• more co-ordinated personalised care

Supported Self Help Year of Care; Practice Health Champions;

Long term conditions strategy launch tea dance; Voluntary organisations providing self-help support; 250 people attended & introduced to community based

organisations to support them with their long term conditions; An opportunity to meet with health care professionals in an

informal setting to discuss health and wellbeing needs; Flu fair, to enable supported self-help, 150 people

attended; Several self-help groups, befriending, knit ‘n’ Natter,

walking, games groups & link with existing groups in our community.

Questions?

“Whoooooooo hooooooooo ,:) :) :) This is the bestest work place in the world and proud to be a part of it ..... such a good team !”Julie Bray – PCN

Our core tools

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Consecutive patients

Days

waiting timemeanupper process limitlower process limit

Models for large scale change

Further information

• ‘Stepping up the pace…’ – free copy featuring case studies, insights and tools

• youtube.com/c/transformingcare – our YouTube channel packed with online webinars (driver diagrams, measurement, capacity & demand etc), team videos/case studies and Productive General Practice resources

• Twitter @rachelhinde @sheinazs