1. Impact of Dynamic DTCs Transformation of Kidderminster Hospital 1st September 2003 David Evans Project Director Worcs Acute Hospitals NHS Trust

2. Worcestershire n 3 PCTs u South Worcestershire pop 280,000 u Redditch and Bromsgrove pop 150,000 u Wyre Forest pop 110,000 n 1 Acute Trust u WRH 450 bed PFI u Alexandra 340 bed DGH u Kidderminster DTC and other services

3. Electives v Emergencies n Which is the priority? n Conflict between medicine and surgery n Cancellations through lack of beds n Patients cared for in inappropriate areas n Waste of time and resources - day to day crisis management n Stressful for patients and staff

4. Services at Kidderminster n DTC - short stay elective surgery n Diagnostics n Clinics n Midwifery led maternity unit n Minor Injuries Unit/Primary Care Centre n Cancer services n Renal Dialysis Unit n Intermediate care beds n Therapy services n Education Centre

5. Activity Strands at Kidderminster Local Primary Care Elective Wyre Forest Elective Worcs Elective Patient Choice Kidderminster Hospital IS-DTC

6. The Design - Ground Floor n Main Entrance n Atrium n Café n MIU/PCC n Oral/Maxillofacial Department

7. The Design - First Floor Outpatient Functions n Consulting rooms n Radiology n Cancer Services n Ophthalmology n Renal Dialysis n Rehabilitation and therapy services n Clinical Measurement

8. The Design - Second Floor Treatment and Intervention n Operating Theatres n Intervention Rooms n Short stay elective beds n Other inpatient facilities n Staff rooms and changing facilities

9. The Design - Third Floor Support Services n Office accommodation n Pathology Laboratories n Education Centre n Midwifery led Maternity Unit

10. Project Status n Nov 24th - Phase 1 handover n Dec 15th - Outpatients, Radiology and MIU/PCC open n Dec 22nd - 1st operating and endoscopy lists n Jan 5th - Phase 2 starts n Aug 2004 - Phase 2 handover n Oct 2004 - Phase 2 opens

11. DTC aims n Separation of emergencies and electives n High quality health care facility n Quick access to treatment and diagnostics n Flexible facilities n Patient centred - one stop approach n Patient flows and navigation n Wow factor n Wellness model n Focusing on the predictable n Transforming the patient experience

12. Changing the culture n Patient centred care n Reduced waiting times n Partnership working n Breaking down the barriers n Flexible/multiskilled working n Smarter not harder n Process and systems n Individual responsibility n Healthcare is not rocket science

14. Changing roles n Scheduler u understands whole journey, books patients, compiles lists, close links with clinical staff, strong customer care aspect n Nursing u Multi-skilled, competency based, nurse discharge n PSP project u case management, assess, diagnose and initiate treatment n Surgeon u customer?, credentials?, audit, little involvement in post op care n Anaesthetist u increased blocks, recovery care, clinical responsibility for DTC? n Radiographer Assistant

15. Process not Function Rehabilitation Low Dependency Respite Shared Care Home Care Social Care Patient Hotel A&E Diagnostic Investigation Critical Care Acute Inpatient Care Intermediate Care Facilities Hospital at Home Ambulatory - 23 hr investigations & surgery Outpatients - Generalised - Specialised - One Stop Secondary Care Community Primary Care Community + Primary Care Primary Care Community Chest Pain Elderly Assessment Medical Surgical areas Peri Acute Care Hospital at Home

16. DTC Business n Managed as a business unit of Trust u Activity targets u Income targets and generate surplus n Patient Choice n Order book n High quality care, facility and behaviour n Market services and facilities n Evening and weekend working n Flexible staff