1. Safe at all Times Delivery Proposal

2. ‘Normal’ Working Day Handover Medical ‘H@Night Nursing Team Medical Rota Team Handover Surgical The ‘Alder Hey Clock’ – Current State

3. ‘Normal’ Working Day Safe at All Times Team Medical Rota Team Handover Medical Site Coordination Incorporating MET Handover Surgical The Future View

4. Work Streams & Teams Key Deliverables: Deliverables: 1.Implementation of the Medical Rotas Quality Assurance Report, to be owned at CD level within CBUs 2.Review options for sustainable delivery of service by the Junior Dr workforce 3.Introduction of Modular (hot/cold block) working for acute paediatric on call work patterns and cross cover working at Junior Surgeon level 4.Guide the Trust in developing sustainable working policy to govern working patterns Measureable Benefits: Savings in line with avoidance of non-compliance penalties Reduction in OOHs incidents Reduction in rota gaps and locum spend Predictable access to training Centralised approach to medical workforce management Timescales for delivery: 1.Delivery of options analysis in acute on call rotas for paeds and surgery – December 2013 2.Delivery of ‘on-ground’ assessment of working patterns for ALL specialties and rotas – January 2014 3.Implementation of new ways of working – February 2014 Medical Rotas Led by Dr Margaret OConnor

5. Work Streams & Teams Key Deliverables: Deliverables: 1.Develop & agree roles of PACE team, CSP, bed management & 304 bleep 2.Assessment of how specialist teams may support PACE/CSP 3.Development of implementation plan with any cost implications/savings Measureable Benefits: Equity of care 24/7 Predictable first line response to deteriorating patients Timescales for delivery: 1.Building response team model with defined roles, costs and business case – February 2014 2.Implementation – March – September 2014 MDT Working & 1 st Response Led by Michelle Milner/Pauline Brown

6. Work Streams & Teams Key Deliverables: Deliverables: 1.Development of a handover structure which ensures patient visibility across the hospital 24/7, with specific teams being aware of sick patients and tasks for completion 2.Development of a coordinator role 3.Educational programme to equip staff with handover skills and embed the importance of handover into the hospital culture 4.Consider options for multidisciplinary handover and work with the SAAT e-Solutions group to develop supporting IT Measureable Benefits: Safer service- timely review of patients & completion of tasks Better understanding of patients across the hospital Reduced cardiac arrest calls, unexpected ICU admissions, preventable deteriorations & critical incidents Timescales for delivery: 1.Development of training package – April 2014 2.Subsequent rollout working with medical & surgical teams, nursing staff & support services – October 2014 Handover Led by Theresa Cole

7. Work Streams & Teams Key Deliverables: Deliverables: 1.Identify e-solutions to support site coordination (1st response, eHandover, Observations, Team & Task Management) 2.Determine information flows & reporting requirements (provide clarity, support decision making & visibility of important events such as traffic light system for overdue handover) 3.Ascertain existing functionality or that available in future development (Meditech nursing module, handover module in M6 & re-working rotas to support SAAT in Excel) 4.Establish technical requirements to support e-solutions (devices, interfacing and wireless etc) Measureable Benefits: Safe management of patient information Appropriate management & prioritisation of tasks Timescales for delivery: 1.Options appraisal RE different e-solutions – February 2014 2.Business case approval – March 2014 3.Implementation – March – October 2014 SAAT e-Solutions Led by Heather Swanston