NHS – Enabling Change Improving processes and adding value 5th February 2015 Ian Quinnell Associate Director for Programme Management and Service Improvement

Join the discussion at Call us on +44 (0) Challenging Times “The next 5 years are going to be extremely challenging for the NHS” NHS England, 2014 “We have an innovative group of health care professionals who are up for change” NHS England, 2014 “We’re in quality improvement for the long haul, but real success will be when Quality Improvement is business as usual” The Health Foundation

Join the discussion at Call us on +44 (0) Gloucestershire NHS Foundation Trust - GHNHSFT One of the largest hospital trusts in the UK Provides care for 612,000 people Split over two sites – Cheltenham General and Gloucestershire Royal Employs over 7500 staff

Join the discussion at Call us on +44 (0) Trust challenges Increase in demand for all services, limited resources Need to align services across the 2 sites Growing population – in 10 years the Trust will need to provide care for 850,000 An ageing population – Gloucestershire has a greater than the national average rise in those aged over 65 Chronic disease increase – over the next 20 years those with diabetes and strokes are projected to increase by over 30% and coronary heart disease by 50%

Join the discussion at Call us on +44 (0) Trust challenges: Productivity and Efficiency NHS is expected to deliver savings of £20bn by 2015 Every Trust has Cost Improvement Plans (CIPs) in place GHNHSFT needs to save in the region of £24m p.a

Join the discussion at Call us on +44 (0) Trust challenges: Cost Improvement Plan The Cost Improvement Plan (CIP) includes reducing costs and generating additional income. There are a combination of initiatives and projects running to achieve this:  Trust initiatives - technology systems, getting the basics right, process improvements  Local Improvement Events – within the local area, joint ventures with other NHS partner organisations  Community wide projects – across counties and regional networks

Join the discussion at Call us on +44 (0) Time for Transformation Transformational change is required now

Join the discussion at Call us on +44 (0) Time for transformation: Trust projects Vision for Healthcare Technology for GHNHSFT Current situation: End of life patient administrative system (PAS) & other aging systems Individual clinical systems with no integration Government directive for an Electronic Patient Record (EPR)

Join the discussion at Call us on +44 (0) Time for transformation: Trust projects SmartCare solution: Fully integrated clinical system Patient centric electronic record Provision of Order Comms and ePrescribing Real time data entry providing up to date information Harnessing the benefits of information technology to improve the quality of care

Join the discussion at Call us on +44 (0) Enabling the Change What are we doing now? Needed to know what current processes we had in the trust to support change management for SmartCare Visited the ‘hands on’ operational staff, from Porters to Intensive Care, covering various activities Mapped using Microsoft Visio, using swimlanes to identify the person/group responsible for the task

Join the discussion at Call us on +44 (0) Enabling the Change Managing the cultural change Identified over 300 key processes that needed to be mapped Lack of actual process in some areas but the visit was used as an information session and staff engagement Useful exercise for identifying inconsistent working practices across sites Obtained sign off and ownership from general managers or senior supervisors

Join the discussion at Call us on +44 (0) Mapping in action: Rapid Improvement Event

Join the discussion at Call us on +44 (0) Process Map in Visio Swimlanes used to identify the person or group of people responsible for the task Subject Matter Expert and the date the process was collected Person responsible for sign off / process map owner Colour & a code used to identify the system currently used File reference and version

Join the discussion at Call us on +44 (0) Quite complex processes Quote Goes here Some maps are too large to fit on one page and therefore cannot be displayed end to end

Join the discussion at Call us on +44 (0) Making things simpler Visio maps were quite hard to read and required Visio to view/edit them To encourage alignment in working processes needed to be made more transparent and accessible Lack of version control for processes and supporting documentation Data was captured but could not be searched or retrieved to use effectively Information needed to be easy to get to and All in one place

Join the discussion at Call us on +44 (0) Introducing a central source of Truth Quote Goes here

Join the discussion at Call us on +44 (0) Triaster Process Mapping Quote Goes here Use of a Keyword to speed up the search for appropriate map/s Accessed using a web browser, so it can be viewed by everyone Gateway to the sub specialties and all the maps related to a division

Join the discussion at Call us on +44 (0) Triaster Process Mapping Quote Goes here

Join the discussion at Call us on +44 (0) Local Improvement Event – clear concise mapping style Quote Goes here Links to supporting information e.g. forms, procedure notes etc

Join the discussion at Call us on +44 (0) Supporting the system transformation Quote Goes here Staff can access the GHNHSFT Process Library from the hospital intranet All SmartCare training materials will only be placed on the Process Library Staff will be required to use the Process Library and processes to support the implementation of SmartCare Process Mapping is also supporting lots of local & community wide Improvement Projects The Process Library drives the management and continuous improvement of processes

Join the discussion at Call us on +44 (0) The Future Quote Goes here The Process Library will be the One Stop Shop for all information GHNHSFT will utilise SmartCare as the enabler to introduce Triaster to the organisation

Join the discussion at Call us on +44 (0) Sources of funding Quote Goes here We have £1.5m available for up to 20 teams to test and develop innovative ideas and approaches to improving health care delivery in the UK. A Regional innovation Fund (RIF) of £5million was launched by NHS England in November 2013, to support and promote the adoption of innovation and the spread of best practice across the NHS. In collaboration with NHS England Innovation Exchange is the central point for anyone interested in innovation in healthcare in the NHS.

Join the discussion at Call us on +44 (0) Thank you Any Questions?