1. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow How should NHS services develop over the period of the NHS Plan? Rt Hon Alan Milburn MP Secretary of State for Health

2. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow Key Objectives Improved performance Return on new investment Develop intermediate care Private Sector capacity More Staff More employee commitment Waiting lists Waiting time reductions Positive publicity Sense of urgency Flexibility

3. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow SHIFT Project Salfords Health Investment For Tomorrow – The Salford Model

4. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow The SHIFT Project Salfords Health Investment For Tomorrow Unique approach Whole system project Buildings, services, IM&T Service Redesign Partnership Regeneration Procurement (PFI and LIFT)

5. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow History of the Project Strategic Outline Case Hospital focus Victorian ward blocks Salfords health status Other organisations

6. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow Whole system / Partnership Salford Royal Hospitals Trust Salford Primary Care Trust Salford City Council Salford University Manchester University and Salford population

7. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For TomorrowObjectives Improve health and well-being Improve access Streamline processes Provide effective services Meet capacity targets Regeneration

8. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For TomorrowRegeneration More than just health services Social Care Investment Effect of building Employment opportunities Commerce

9. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow IVE GOT IT, TOO, OMAR… A STRANGE FEELING LIKE WEVE JUST BEEN GOING IN CIRCLES

10. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow Every system is perfectly designed to achieve the results it achieves. Donald Berwick Institute for Healthcare Improvement

11. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow Service redesign Whole system Patient focused Meeting expectations Right time, right place, by right people Best practice standards / Modernisation Agency / targets

12. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow Service Design Groups Emergency ElectiveChronic Disease Management Diagnostic & Therapies Intermediate Care Elderly Primary Care Childrens Interface Group

13. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow Main categories of patients

14. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow How services will change….. Acute Intermediate Primary / community Old = organisational focusNew = Pathway focus 1010 2020

15. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow SELLING THE MESSAGE

16. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow THE CHIEF EXECUTIVES DILEMMA

17. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow

18. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow The whole system – starting in primary care…… Health promotion –Healthy choices –Opportunities –Regeneration Family care –Access –Modern facilities –Flexibility –Scope Case management (Evercare model)

19. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow New intermediate level The new Intermediate tier includes: Improved access to diagnostics and therapies New roles to manage emergency demands Over 100 new beds or equivalent services preventing hospital admission or facilitating transfer of care Provision of minor surgery and other invasive procedures in Health and Social Care Centres

20. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow Unplanned Care Urgent advice: Pharmacist NHS Direct Walk-in 8 til late Receives consistent advice and either self-manages or enters appropriate part of system Urgent care needs assessed and referred to: Rapid Response Team GMAS / Emergency Practitioner assessment Primary Care clinician Intermediate Treatment A&E If admitted to Hope Hospital…. Access to diagnostics to prevent unnecessary admission Emergency Assessment unit for admissions of up to 72 hours, separated from elective activity and managed by Emergency Assessment Physician

21. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow Emergency Admission Unit 772 hour EEarly diagnosis IIntervention / treatment MMedical / surgical response MMulti-disciplinary teams PPlanned transfer of care

22. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow Planned Care……………. Assessment by Primary Care clinician / Tier 2 panel Electronic booking Date of admission agreed with patient Procedure under LA at Health and Social Care Centre Admission to (up to) 72 hour Elective facility at Hope Hospital Intermediate / Primary Care recovery Out patient assessment

23. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow I CANT BE ABSOLUTELY CERTAIN, OF COURSE, BUT YOU DO APPEAR TO BE IN SOME KIND OF TROUBLE, MR HOWARD STATING THE BLEEDING OBVIOUS

24. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow Long-term conditions GGuided self- management PPrimary care management IIntegrated healthcare teams IIncreased complexity

25. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow

26. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow Out Patient activity will change………… The out patient cake will be cut in different ways Different ways of managing conditions, as an integrated team: Self management Call Centres Urgent access support Telemedicine Some clinics will be held in Health and Social Care Centres – with on-line access to health records and diagnostics Some clinics will continue to be provided at hope Hospital, because of the reliance on more complex imaging, etc.

27. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow INVESTMENT + REFORM = NEW SYSTEM 4 Health & Social Care Centres Ambulatory treatment Additional beds Investing in Primary Care New Hospital buildings Weekend and evening sessions 362 w.t.e. new staff Redesign Changes Tier 2 Intermediate care Pathway led Performance improvement 82% occupancy Modernisation Agency Inappropriate admissions Upper quartile LOS IM&T Whole system Supporting clinical practice Consistent with National Strategy Workforce New roles New teams 14 session week Current activity

28. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow and now there goes the Wilsons!… Seems like every ones Evolving except us!

29. Project HIFT alfords Health Investment For Tomorrow Project HIFT alfords Health Investment For Tomorrow REDESIGN YOUR SERVICES PASS IT ON