Staff Meetings

May 2012

Agenda

1. How we did in 2011/12

2. The Financial Challenge this year

3. BEH Clinical Strategy

How did we do? 2011/12 in Summary1. Targets

• A&E 96% for the year• Infection control: 1 above target in MRSA, CDiff 23/60• 18 weeks: achieved• 62 day cancer treatment waits (80% rather than 85%).

2. Of 4,000 patients who have provided feedback since January 2011 97% rate their care as good or excellent.

3. Statutory and Mandatory Training and Appraisal- we need to improve

4. Staff survey- this year’s results similar to last year

5. Patient survey- one improved area, mixed sex accommodation, rest same as 2010

6. Ended year with £2.2m surplus, £800k behind plan.

2012-13 Will be Difficult Financially

Contract income this year is £10m less than last year because of a combination of national tariff price reductions, acute demand management and efficiency requirements from commissioners.

Commissioners wanted to reduce our contract further- the final figure reflects the outcome of arbitration which largely went in our favour.

200

250

300

350

400

2003-04 2010-11 2011-12 2012-13

2003-04

2010-11

2011-12

2012-13

BCF Trust Income

What Does This Mean for You as a Member of Staff and How Can You Help?

1. We believe you have ideas to improve our efficiency and reduce waste. We shall be establishing some focus groups to capture staff ideas and you can also raise things with your manager or email feedbackbcf@nhs.net

2. A major issues we need to tackle is reducing our use of bank and agency staff. Last year we spent £32m on short term staff. We need to bring this down by:

• Recruiting permanent staff• Making sure we roster staff efficiently using e-rostering• Follow the staff sickness and absence policies

3. Think about how you can do more with less: do you really need to order that test, place that order. Would you do it this way with your money?

4. This is not about reducing quality or safety. We have to maintain standards while cutting waste and inefficiency.

BEH creates two sites with complimentary roles

Chase FarmPlanned Care

• Outpatients• Elective surgery• Cancer services• Day surgery• Rehabilitation• UCC

– Paediatric Assessment Unit– Elderly Assessment Unit

• Enhanced Recovery

BarnetEmergency Care, Maternity &

Paediatrics

• A&E• Emergency surgery• Day surgery• Maternity (inc. Midwife Led

Unit)• Paediatrics• Outpatients• ITU & HDU

BEH Activity Shifts – Post Transfer 

Barnet Hospital Chase FarmBCF Activity @

other sites

 

NMH Transfer

  2010/11 Post BEH Change 2010/11 Post BEH Change 2010/11 Post BEH

In Patient

Medicine 26,341 28,667 2,326 14,999 5,804 -9,195 0

 

4,888

Surgery 22,566 22,039 -527 22,734 19,176 -3,558 0 2,855

Maternity 4,930 8,606 3,676 4,966 0 -4,966 421 2,889

Paediatrics 5,026 7,891 2,865 4,924 1,783 -3,141 60 2,002

Total 58,863 67,203 8,340 47,623 26,763 -20,860 481 12,634

 

Out Patient

First Attendance 82,444 82,444 0 77,268 77,268 0 21,624

 

0

Follow up Attendance 151,334 151,334 0 149,274 149,274 0 32,954 0

 

A&E

 

 

Attendances - Major 31,262 39,754 8492 29,351 1619 -27,732 0 14,572

Attendances - Minor + Walk in

46,894 50,863 3969 44,027 30,868 -13,159 0 6,993

 Total 78,156    90,617 12,461  73,378    32,487 -40,891  0 21,565 

Event

OBC Approval by NHS London April 2012

OBC approval of NMUH Business case by Treasury July 2012

FBC Approval by NHS London August 2012

FBC approval of NMUH Business case by Treasury November 2012

Works to increase capacity at BH begin September 2012

Works to expand capacity of BH for additional activity,

complete

October 2013

Transfer activity from CFH to BH and NMUH November 2013

EAU and UCC services at CFH begin November 2013

All CFH works complete and new OPD configuration begins

operation

October 2014

BEH Timeline

OBC Barnet Capital Works to support BEH ~ £18m

• Barnet Hospital– Relocation of Genito Urinary Medicine to allow conversion of template

for ward use – Works to A&E to include sufficient resus. and paediatric facilities; – Expansion of ITU/HDU capacity– Increase in single room accommodation – CT scanner – Changes to paediatric in- and out-patient areas – Remodelling of Women’s outpatients – New and remodelled maternity and neonatal facilities

But What About Car Parking at Barnet?

Car Parking proposals have been submitted to Barnet Council

• there are now 375 marked spaces for use by patients and visitors, and 570 marked spaces for use by staff (945 in total) in practice around 980 parking spaces are currently available

• Following BEH visitor numbers are expected to increase by 6%, and staff by 3% • Temporary parking areas will be provided for contractor staff within a compound

proposed north of the access road on fallow land• total of around 40 additional spaces for visitors would appropriate to ensure

equivalent parking provision in the future.• About 28 further spaces can be created by better organisation of space.• Can make improvements via encouraging care sharing, public transport

improvements and green travel.

Awaiting Barnet Council Response

OBC CFH Investment ~ £12m

• Refurbish the Maternity Block to create Modern Out Patient facilities

• Refurbish Highlands Wing to include new Elderly Assessment Unit

• Refurbish A&E to include UCC and PAU

OBC Loan Funding

• Funded through Interest Bearing Loan– Standard 5% interest– 24 year term

Further CFH Investment- Stage 2

• Follow on Business case– Further modernisation of Highlands Wing– Relocation of Pathology and Pharmacy – Modernisation of infrastructure to significantly improve

site energy efficiency– Relocation of Admin and Support Services– Clearing of land for sale

• Plan to fully/partially fund through land sales

Chase Farm Final Configuration

BEH Workforce Changes Workforce changes: Strategy implementation will require some staff to relocate

from the Chase Farm Hospital site to Barnet Hospital and North Middlesex Hospital sites. The Trust aims to retain affected staff by redeploying into suitable vacancies where possible. Workforce plans are being developed to determine exact numbers and staff affected.

Financial implications: The strategy has around £30m of workforce reductions post BEH in 2013/14. We currently have 574 vacancies and 12% turnover.

Change management: The Trust will adopt robust change management principles in accordance with the Trust’s Policy, legislation and best practice including: – Timely and meaningful communication and consultation– Regular meetings with union representatives– Mechanisms to support staff through the change

Timeline for Workforce Changes

Action Timescales

Internal communication to all staff and union representatives on the implementation of the BEH Strategy via FAQs, staff bulletins, intranet and letters reflecting timelines and the impact on staff and services.

Ongoing

Identification of future staffing numbers at specialty, staff group and grade levels to meet BEH requirements

By Jul 2012

Development of detailed workforce change plans and proposed changes and staff consultation processes to be discussed with union representatives

By Dec 2012

Hold suitable vacancies From Feb 2013

Consultation papers to be issued. From Apr 2013

Commencement of redeployment of displaced staff From Jul 2013

Transfer of staff . By Nov 2013

Finally, on the Secretary of State’s Feasibility Study

• The SoS asked NHS London to undertake a feasibility study, on the creation of “Enfield Hospitals” that is merger of North Middlesex Hospital and Chase Farm Hospital

• A report was submitted in December

• SoS has accepted conclusion of NHS London that “there is little merit in pursuing this option”

• NHS London has said it will continue to support BCF and NM to develop further options for ensuring clinically and financially viable hospitals for this part of London

Questions?