Choice Sub-Group of the Council of Governors Presentation By Raj Jain, Director of Workforce & Service Development 2nd February 2007

Introducing more Choice is integral to health reform Money following the patients, rewarding the best and most efficient providers, giving others the incentive to improve (transactional reforms) Better care Better patient experience Better value for money More diverse providers, with more freedom to innovate and improve services (supply-side reforms) More choice and a much stronger voice for patients (demand-side reforms) A framework of system management, regulation and decision making which guarantees safety and quality, fairness, equity and value for money (system management reforms)

Why Choice? Meeting patients expectation Lever to modernise the NHS by: - Improving efficiency - Reducing waiting times - Strengthening local accountability - Strives to create a more personalised, responsive & efficient health service The Labour 2001 manifesto promised ‘to give patients more choice’ (The Labour Party, 2005). The extension of choice in health care is seen as a way of meeting patients expectations, improving efficiency, reducing waiting times and strengthening local accountability. Choice is not a new phenomenon in the NHS. Patients could choose which hospital they wanted to go to until the 1990s and the right to choose between GPs has always existed in theory –albeit limited by under provision in many areas.. Nevertheless, extending patient choice is one of several levels in the government’s programme to modernise the NHS as it strives to create a more personalised, responsive and efficient health service.

Why Choice? Rising expectations of public services- taxpayers want more choice and control over the health care and services offered, in particular about where, when and how they are treated and what treatment they receive. 65% of people want more choice of treatment, 63% choice of hospital and 53%- choice of appointment date and time (British Social Attitudes, 2005) Improving the patient experience: giving people the opportunity to choose the services which best meet their needs and preferences

Why Choice? With financial incentives aligned, Choice introduces a new incentive for providers to develop more responsive services 74% of people expect that choice of hospital will drive up standards for all within the NHS (BBC/MORI 2004) Empowering people: increasing evidence to suggest that if people are more involved in decisions about their care they are likely to experience better health outcomes, for example compliance with medicines.

What is Choice? Choice of Provider in Elective Care January 2006 2006 2008 Choice of at least 4 providers Extended Choice Choice at 6 Months- from August 2004, patients who would otherwise wait more than 6 months for surgery were able to choose another hospital commissioned by their PCT for faster treatment. Choice at Referral- from January 2006, eligible patients referred for planned elective care are being offered clinically appropriate choices from a list of 4 or more providers commissioned by their PCT Extended Choice- From May 2006, in addition to the locally commissioned providers, patients have the opportunity to choose from a national menu of NHS Foundation Trusts. New NHS FTs and Independent Sector Treatment Centres will shortly be added to the menu. Other nationally procured independent sector providers will be included later this year. ‘Free Choice’: ‘By 2008, a patient who is referred for planned hospital care will have the right to choose any healthcare provider which meets the Healthcare Commission’s standards, which can provide the care within the price that the NHS will pay.’ NEXT SETPS FOR CHOICE AGENDA: for treatment in primary care for diagnostics (‘choice of scan’ model offering choice to long waiters and at referral) from consultant to consultant, including into a specialised service to aftercare Free Choice

Percentage of people who are offered choice Aug-06 Sep-06 Oct-06 Nov-06 Dec-06 25% 32% 28% 44% 6 Months Maximum Wait – Patient Choice Project – patients do exercise choice when it means they will be seen sooner. The GMSC has a lot to over in terms of patient expectation and decisions that influence choice (i.e. private sector image). In terms of choice at the point of referral, we have seen some slight shift in referral where patients have been unable to gain access to the services at SRFT, but we are unable to quantify how many have chosen for other reason. But, we have also seen a slight shift in referrals to SRFT where patients have chosen SRFT out of choice i.e. patient from Preston.

Why is it important to SRFT? Maintaining local services for local people To be able to continue to be a thriving organisation - Growth is a sign of success Reliant on average 2% growth every year to fund hospital build and development plan Financial impact of choice could put services at risk Reputation

How does it happen? Informal information: - GP influence/recommendation - Word of mouth - Family & Friends recommend/experience - Staff - Patient past experience/knowledge Formal Information – internet - media - published performance data

Factors Influencing Choice National Patient Survey – July 2006

What is Choose & Book? DEMO: nww.ebs.ncrs.nhs.uk http://www.nhs.uk/England/Hospitals/Services.aspx?id=RM301 http://www.nhs.uk/england/choice/pct/TrustMainsite.aspx?id=5F5 What is Choose and Book? What does it mean to the patient? Current state/future?

What is the Trust doing about it? Safe, Clean & personal Patient Survey Staff Survey Local GP engagement Modernisation/redesign of service delivery Marketing Communication Strategy

Getting the product right

Corporate brand/ identity

Marketing communications strategy Sets out promotional objectives, messages and tools for the Trust’s key audiences: GPs patients staff Considers how the Trust brands and positions itself to inform, persuade and differentiate its services from competitors How can we use Choose and Book to our advantage?

Marketing communications strategy

Emergency Care Currently, outside of ‘Choice’ agenda But, patients already make choices on which A&E to attend: - Clinical reputation - Speed of service - Past experience How can use this influence choice for elective care?

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