Stakeholder Reference Group Annual Plan 2018/19 Stakeholder Reference Group

Our Plan on a Page

Strategic Development Clinical Strategy – Summer 2018 Followed by Organisational Strategy Underpinned by other work: MH and LD Strategic Frameworks Primary and Community Services Strategy Children and Young People’s Strategy Non-Surgical Oncology Strategy Digital Strategy Workforce Strategies

Priorities Quality and Safety is our top priority – informs all our plans Targeted Intervention Priorities remain remain Unscheduled Care, Stroke, Planned Care, Cancer and Healthcare Acquired Infections and Finance Annual Plan is based around 5 Operational Plans for each of the service areas All plans assume we achieve our agreed efficiency targets No major investment schemes – based on incremental gains within resources and with limited capital investment Within a financial plan to significantly reduce our deficit of £36m Financial plan includes procurement efficiencies, capacity redesign and workforce improvement targets

Unscheduled Care Living Well – prevention actions re smoking, vacs and imms Timely access to Urgent Care – maximise 111, rebalance care to the community through CRTs & intermediate care Reduction in Hospital Attendance – maximise Ambulatory Emergency Care (AEC), reduce conveyances of falls Patient Flow – operational improvement in Emergency Departments improve frailty services, AEC, change hospital models of care and focus on reducing numbers of medically fit for discharge patients Capacity Redesign – reduce Length of Stay to Welsh average to underpin rebalance care from inpatient to community model - acute hospitals & community hospitals & older adult Mental Health

Stroke Living Well – prevention actions on smoking, anti-coagulants Provision of FAST care – linked to Unscheduled Care plans, confirm arrangements for thrombectomy through WHSSC, continue to develop Transischaemic Attack service Rehabilitation - explore providing Early Supported Discharge through Value Based Healthcare approach (disinvest to reinvest) End of Life – maximise use of End of Life pathway Workforce – workforce redesign within resources to expand 7-day cover Hyper- acute Stroke Unit planning on a regional basis

Planned Care Detailed planning is still ongoing with national support Service redesign ongoing at pace in ophthalmology in line with national best practice (maximising use of other staff groups eg optometrists) Also redesigning orthopaedics, ENT Maximising outpatients and theatre efficiency Likely to achieve targets for outpatients, diagnostics and therapies Challenge is inpatient waiters Will be dependent on financial support agreed – this is still being worked through

Cancer HB refreshed performance management approach with new Service Lead Prevention – smoking, healthy eating, obesity Detecting Cancer Earlier – improve endoscopy, outpatient capacity for cancer, centralise breast outpatients Delivery of care – breast, Gynae, urology, performance management, improvement of process, implement Strategy Meeting People’s Needs – appoint Lead Nurse, patient engagement Improving Information – system development

Infection Control Plan based on best practice and audit Prevention – reduction in Urinary Tract Infections, unnecessary use of catheters, reduce antibiotic usage, hand hygiene C. difficile – antibiotic actions, audit, cleaning protocols Staph. Aureus bacteraemias – catheter actions, audit, decolonisation practice E. coli – catheter actions, hand hygiene, cleaning Workforce – training