1. Stakeholder Reference Group
Annual Plan 2018/19
Stakeholder Reference Group

2. Our Plan on a Page

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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