the pressures of sustainability in the nhs · the pressures of sustainability in the nhs paul holt...
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The Pressures The Pressures of Sustainability of Sustainability
in the NHSin the NHSPaul Holt Paul Holt Director of Estates Director of Estates
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‘The management of an organisation’s total impact upon both its immediate stakeholders and upon the society within which it operates………..accounting for a wide range of criteria relating to the financial, environmental and social implications of business operations.’
DTI/CRG Report – Changing Manager Mind-sets (2003)
Defining Sustainability Defining Sustainability
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Pressure or PleasurePressure or Pleasure
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Pressure or PleasurePressure or Pleasure
THE DAY JOB
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Provide high quality, accessible and responsive services by putting the patient at the heart of everything we do
The Trust’s values & missionThe Trust’s values & mission
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COMMUNITYFINANCESERVICESTAFF
Corporate ObjectivesCorporate Objectives
Department / team objectives1 year timeframe
Corporate objectives1 year timeframe
Strategic objectives3-5 year timeframe
Individual objectives1 year timeframe
PATIENTS
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Strategic objectivesStrategic objectives
Avoid needless deaths by providing effective, evidence-based care, reducing HSMR to 80 by 2012
Continually improve patient and family experience: achieve top 10% in national patient satisfaction survey
Be in the top 5% of Trusts nationally by April 2013
Ensure financial security: achieve a Monitor risk rating of 4 or better every year in the medium term plan
Develop and sustain a valued, motivated and skilled workforce to deliver excellent patient care
Leaders use lean techniques to inspire, drive and sustain a culture of continuous improvement
Avoid needless harm by providing safe and clean care to all patients
Business Groups and Directorates proactively contribute to corporate social responsibility (CSR)
Ensure national targets are met, achieving NHS Operating Framework requirements each year
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Provide high quality, accessible and responsive services by putting the patient at the heart of everything we doProvide high quality, accessible and responsive services by putting the patient at the heart of everything we do
Trust Business Plan by Strategic ObjectiveTrust Business Plan by Strategic Objective
Improve minimum ward standardsImprove minimum ward standards
Efficient and effective utilisation of beds and theatres
Efficient and effective utilisation of beds and theatres
Improvement embedded in business groups’agendas
Improvement embedded in business groups’agendas
Deliver clinical income targets Deliver clinical income targets
Include CSR objectives in bg business plans
Include CSR objectives in bg business plans
Comprehensive workforce plans created and implemented
Comprehensive workforce plans created and implemented
Reduce MRSA to zeroReduce MRSA to zero
Meet mixed sex accommodation standards
Meet mixed sex accommodation standards
Reduce ALoS for Medical patients from 8.5 to 8.0 days
Reduce ALoS for Medical patients from 8.5 to 8.0 days
First class leaders undertaken by 75% per cent of clinical managers
First class leaders undertaken by 75% per cent of clinical managers
Deliver planned activity and performance within expenditure budget
Deliver planned activity and performance within expenditure budget
Extend VLS to more departments and increase placements
Extend VLS to more departments and increase placements
80% of Trust staff have an annual appraisal
80% of Trust staff have an annual appraisal
Screen 100% of elective patients for MRSA
Screen 100% of elective patients for MRSA
Address reasons for patient complaints reliably
Address reasons for patient complaints reliably
Deliver 4% improvement in efficiency and productivity
Deliver 4% improvement in efficiency and productivity
Deliver 4% improvement in efficiency and productivity
Deliver 4% improvement in efficiency and productivity
Achieve CMIP target reductions Achieve CMIP target reductions
96% of staff demonstrate commitment by reliable attendance
96% of staff demonstrate commitment by reliable attendance
Reduce hospital acquired C.diff.Reduce hospital acquired C.diff.
Reduce MRSA to zeroReduce MRSA to zero
Reduce hospital acquired C.diff.Reduce hospital acquired C.diff.
improve recognition of the acutely unwell patient
improve recognition of the acutely unwell patient
Reduce harm from patient fallsReduce harm from patient falls
Improve efficiency and reliability of patient identification
Improve efficiency and reliability of patient identification
Engage with patients & service users to obtain feedback
Engage with patients & service users to obtain feedback
CQC rates Stockport FT as ‘excellent’ for use of resources
CQC rates Stockport FT as ‘excellent’ for use of resources
Implement and use service line reporting system for bg monitoring
Implement and use service line reporting system for bg monitoring
Reduce staff travel to work in single occupant cars by 0.5%
Reduce staff travel to work in single occupant cars by 0.5%
Deliver minimum standards for all cancer patients
Deliver minimum standards for all cancer patients
Act on all areas for development identified in patient surveys
Act on all areas for development identified in patient surveys
Deliver capital programme within budget
Deliver capital programme within budget
Reduce non-clinical landfill and increase recycling
Reduce non-clinical landfill and increase recycling
Deliver minimum referral to treatment pathway standards (18 wks)
Deliver minimum referral to treatment pathway standards (18 wks)
Ensure all services and policies are impact assessed for E&D
Ensure all services and policies are impact assessed for E&D
Standardise existing and new Service Level Agreements
Standardise existing and new Service Level Agreements
Increase local purchasing Increase local purchasing
Consistently deliver ED waiting times performance standards
Consistently deliver ED waiting times performance standards
Increase membership involvement and activity
Increase membership involvement and activity
Deliver performance standard for thrombolysis
Deliver performance standard for thrombolysis
improve outcomes for patients with #NoF
improve outcomes for patients with #NoF
Improve care through Advancing Quality
Improve care through Advancing Quality
Increase survival through additional, effective evidence-based practices
Increase survival through additional, effective evidence-based practices
Create efficient & effective complaint response and resolution process
Create efficient & effective complaint response and resolution process
StockportNHSFT2011-12
StockportNHSFT2011-12
Patientexperience
Patientexperience
WorkforcedevelopmentWorkforce
developmentImprovement
cultureImprovement
cultureTop 5% of
TrustsTop 5% of
TrustsFinancialsecurity
Financialsecurity CSRCSRNational
targetsNationaltargets
Avoid needless harm
Avoid needless harm
Avoid needless deaths
Avoid needless deaths
Productive ward objectives metProductive ward objectives met
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Medicine W & C D&CS ElectiveServices
Ensure CSR objectives in Business Group by March 2012
Ensure CSR objectives in Business Group by March 2012
Continue to develop relationships with 3rd sector providers
Reduce staff travel costs
Continue to develop links with Children’s Trust and sub-groups to improve links with other orgs
Increase number of volunteers
Business Group DeliveryBusiness Group Delivery
Organise open days for local community
Encourage staff to use public transport, car sharing & cycling
Offer work experience placements
Provide school talks about careers in the NHS
Ensure all new equipment is energy efficient
Encourage staff to use public transport, car sharing & cycling
Identify areas with all depts to extend and increase placement for VLS
Identify key areas and materials for which recycling can be increased by raising awareness
Ensure all new equipment is energy efficient to contribute towards carbon footprint
Reduce amount of paper usage & maximise opportunities within digital dictation
Estates Facilities
Source equipment & materials locally where possible by communications with procurement
Sustainable CapitalProgram
SustainableAgenda
Facilities LiaisonSustainable
Agenda
CMIP Agenda
Deliver CSR
EnergyManagement
WaterManagement
Reduce dependence on
landfill
WaterManagement
Deliver a workable solution
to encourage car share
Continue involvement and
Commitmentto VLS
Extend use of electric vehicles
Deliver recycling plan
Identify local purchasing
opportunities
Improve education for clinical waste
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Progress against the Strategic ObjectiveProgress against the Strategic Objective
Include CSR objectives in bg business plans
Include CSR objectives in bg business plans
Extend VLS to more departments and increase placements
Extend VLS to more departments and increase placements
Achieve CMIP target reductions
Achieve CMIP target reductions
Reduce staff travel to work in single occupant cars by 0.5%
Reduce staff travel to work in single occupant cars by 0.5%
Reduce non-clinical landfill and increase recycling
Reduce non-clinical landfill and increase recycling
Increase local purchas/ing
Increase local purchas/ing
Increase member’sinvolve/ment and activity
Increase member’sinvolve/ment and activity
RAG rating RAG rating
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�Increased our performance by 13%
�Achieved 60 % score of the – Good Corporate Citizenship score card
CSR – Current PerformanceCSR – Current Performance
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• Environment– 1st Impressions � Regular Inspection agenda &
scoring mechanism� Focussed investment in those
areas of most need� Reducing clutter & improving
storage� Brightening up clinical areas � Developing plans to create a
‘Ward charter standard’ that we all aspire to maintain
� Strong/positive PEAT scores
Estates & Facilities - Specific HighlightsEstates & Facilities - Specific Highlights
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Estates - Specific HighlightsEstates - Specific Highlights• Carbon Management
Implementation Plan� Exemplar document – Carbon Trust� Mitie – Energy Partners preparing a
strategic plan� Capital Investment of £ 300k per
annum� Seeking external Salix funding to
complete the ‘Big Bang’� Influencing the development of the
site through advice and guidance� Appointment of energy champions� Helps deliver the CRP
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Facilities - Specific HighlightsFacilities - Specific Highlights• Transport
– Travel Plan
� Ratified by the Board & the Local Authority
� Regular TRICS survey� Roll out of bike facilities� Improved walking access across
the site for people wheelchair users
� Promoted through the Team Brief
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• Waste– Recycling
� Commercial plastic bottles
� Waste Cardboard � Waste paper � Majority of construction
waste� Procurement methods
reduce waste at source� Recycling of computers� Food waste is reduced
to a liquid and put down the drain
Facilities - Specific HighlightsFacilities - Specific Highlights
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Finance Specific HighlightsFinance Specific Highlights• Procurement
– How to guide is allowing greater access to local contractors to tender
– Involved in ‘Meet the Buyer’ events– Probably 80% of companies we
use are Manchester based – Design development considerate of
the BREEAM standard– Southern Sector main supplier –
MTX– Expect P 21+ partners to procure
through the local economy
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Summary Summary
Despite the increasing economic pressure� A good start � Demonstrated through the values being
embedded within the Corporate Objectives� Delivered through Divisional objectives� Evidenced with a growing list of real outcomes� Saving Money & the environment
We can keep our ethical principles whilst facing the economic challenges remembering………….
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The Trust’s values & missionThe Trust’s values & mission
Provide high quality, accessible and responsive services by putting the patient & Sustainability at the heart of everything we do