Seven day services in Microbiology. Mark Cioni. Directorate Service Manager (Bacteriology) and Laboratory Manager. Path Links. North Lincolnshire and Goole NHS Foundation Trust.

Lincolnshire wide pathology service hosted by North Lincolnshire and Goole NHS Foundation Trust, but also providing United Lincolnshire Hospital Trusts. Exemplars in National Improvement Programmes. Provider in the ‘North East Lincolnshire out of hospital providers’ early adopter community. Lord Carter of Coles Pathology services review- endorsed as a model of centralised service provision.

Current Service Provision Boston Blood Sciences: Working time directive (WTD) compliant shift rota (approx. 41hrs) with band payments. Microbiology: Non WTD compliant on call system with band payments Grantham Blood Sciences: Working time directive (WTD) compliant shift rota (37.5hrs) with shift payments Grimsby Blood Sciences: Working time directive (WTD) compliant shift rota (37.5hrs) with band payments Lincoln Blood Sciences: Working time directive (WTD) compliant shift rota (37.5hrs) with band payments Scunthorpe Blood Sciences: Non WTD compliant on-call system with band payments Microbiology:Non WTD compliant on-call system with band payments

‘RESHAPING PATHOLOGY’ THE PATH LINKS INNOVATION & IMPROVEMENT PLAN 2010 – 2014 Path Links management endorse recommendations of the Operational Managers Group to: 1.Defer implementation of Agenda for Change Terms & Conditions, Section 2 (2.8 – 2.30),for Out of Hours payments for BMS staff pending the outcome of national agreement scheduled for 31st March Pending Trust agreement, support the option to progress with full implementation of Agenda for Change Terms & Conditions for Out of Hours payments for BMS staff post 31 st March 2011 in the absence of a national agreement. 3.Restrict OOH working of laboratory duties to Band 6 grades and below cross all Clinical Directorates.

Path Links Microbiology Path Links strategy to provide 24/7 services. Northern Lincolnshire and Goole NHS Trust strategy to provide 7 day services. Technological advances in rapid testing in microbiology. Whole pathway approach to service provision.

Patient Impact Earlier diagnosis. Responsive and appropriate treatment. Faster recovery. Reduced risk and suffering from inappropriate care and treatments. Less need for critical care and isolation

Staff Impact On - call to shift. Negotiation. Service need. Work-life balance. Less stress from managing backlogs. More time to focus and activities that add value instead of managing problems associated with backlogs.

Impact on the Overall System. Improved management of capacity and demand and patient flow. Supports earlier clinical decision making when teams work 7 days across the whole system including transport. Reduces the risks and costs of inappropriate treatment and delayed patient management. Bed utilisation is improved and less requirement for expensive critical care and isolation management which reduces costs overall. Can help admission avoidance. Improved Infection prevention and control. Reduction in staff costs and increased capacity from running services as a network instead of at every hospital. Better value for money for commissioners of services. Improved patient safety and patient experience.

Challenges: Inflexible working patterns. Changes to staff terms and conditions. Balancing the flow of work across the care delivery system. Key challenges and solutions to delivering 7 day services Solutions: Involve staff in redesign. Well planned negotiation and communication with staff. Engage with teams across the whole pathway when redesigning services.

Top Tips Strategic leadership is very important. A real understanding of demand and capacity is a helpful key step when making changes. Measurement and tracking of benefits can help to motivate staff and demonstrate added value to stakeholders. A team that has an embedded improvement culture is easier to work with and they can have the ideas of how best to make changes.

Thank You.