1. Malnutrition Prevention Programme Chris Bryant - Project Director Lisa Godfrey – Project Manager Julia Wood – Project Manager

2. Plan for Today NHS Elect and AQuA –Who we are and what we do IHI Model for improvement and engagement The Five Principles Collaborative Working Group Work – Exploring the Challenges

3. NHS Elect An NHS members’ network –founded in 2002 and working directly with 50 + sites as members Provide support to members in the following areas: –Service improvement –Business of healthcare –Marketing, branding and patient experience Led major national improvement programmes e.g. –18 Weeks Programme –Ambulatory Emergency Care Programme

4. Better Care Better Value Indicators Provider Indicators – Acute Trusts –Managing variation in length of stay –Day case rate for procedures –Reduction in wasted bed days as a result of admission prior to operation –Reducing DNA rates –Reducing New to Follow Up rates –Reducing Emergency Re-admissions at 14 days Commissioner Indicators - PCTs –Admission rates for selected procedures where surgery is recognised as unnecessary –Reduction of avoidable emergency admissions against 19 recognised diagnoses –Managing variation in Outpatient Attendances GP Practice Indicators –Admission rates for selected procedures where surgery is recognised as unnecessary –Reduction of avoidable emergency admissions against 19 recognised diagnoses –Managing variation in Outpatient Attendances

5. What are we trying to accomplish? How will we know that a change is an improvement? What changes can we make that will result in the improvements that we seek ? Model for improvement ActPlan StudyDo aims measurements change ideas * Copyright IHI 2000 testing ideas before implementing changes

6. MTF - The Five Principles

7. Collaborative Working

8. Benefits of Collaborative Working –Sharing resources can accelerate action and improve response times across the programme –Sharing expertise and knowledge supports early identification of the ‘real’ issues that need to be prioritised –Engaging and involving key stakeholders from the outset helps to build a broader understanding of the big picture - ‘A problem shared is a problem halved’. –Improvements can be achieved quite quickly –Shared improvement solutions are much more likely to be sustainable.

9. Challenges of Collaborative Working Not everyone has the same issues, so the ‘starting point’ for each organisation may be different Some may feel their position is unique and may find it difficult to think beyond their own position/organisation Working across organisations can make decision making complex and lengthy Sometimes it may be difficult to ‘see’ the improvements

10. Your first challenge this afternoon: In your groups discuss how your organisation/s feel right now at the start of this journey and then draw an image or images that capture that feeling. –Elect a spokesperson to explain your artwork! –8 Minutes for your Artwork and 2 Minutes to feedback

11. Your second challenge this afternoon: In your groups discuss how you might encourage partner organisations to engage with you in a really positive way –Elect a spokesperson and feedback your ‘top tips’ on a flip chart - no more than five bullet points –8 Minutes to brainstorm and 2 minutes to feedback

12. Your final challenge: In your groups discuss how you will know when you have made an improvement and how you will share success –Prepare an illustration that best describes your collective thoughts! –8 Minutes to brainstorm and 2 minutes to feedback

13. Top Tip Create a compelling ‘Vision’, which can easily be understood by all stakeholders Describe a positive future state, not how to get there Make it compelling to motivate all stakeholders – must engage hearts as well as minds! Demonstrates the benefits/deliverables that will be derived from the process (Use examples) Avoid too much focus on target dates and performance

14. Guiding Principles to Achieve Success Alignment with organisational vision & corporate objectives – easier with organisational support Leadership and on-going support from the top Robust Governance – Roles and responsibilities Communication – Share a vision of the future state Leadership and management of both the programme and projects Infrastructure to support the programme (Admin support) Learning from doing to continually add value!

15. Christine@nhselect.nhs.org.uk Any questions?