1. Our Passion, Your Care. The Ipswich Improvement Journey Suffolk Care Conference Neill Moloney Chief Operating Officer Ipswich Hospital

2. Our Passion, Your Care. Context – From April 2013 Increased levels of activity in ED Continued to utilise winter capacity right through the summer Escalation of impending breaches was uncontrolled with no clear process, and occurred only when individual patients were approaching 4 hours The trustwide response was erratic, limited and ultimately did little to prevent breaches occurring – too little, too late! Seen as an ED ‘problem’ and left to their own devices to resolve. Senior managers and executives were often reactively called upon to ‘troubleshoot’ Seemingly poor relationships with community partners A&E Performance in Q2<95% and 40 out of 92 days below the standard. Patient experience deteriorating External interest in performance from Trust Development Authority and local CCG

3. Our Passion, Your Care. Theory of constraints

4. Our Passion, Your Care. Theory of constraints

5. Our Passion, Your Care. Projects that had the biggest impact Response to ED pressures too little too late: ED Trigger Tool & Escalation Insufficient beds during the day: Demand and Capacity Delayed pathway of care: Red & Green days

6. Our Passion, Your Care. Our continuing Journey Complex Discharge Trigger Tool Frailty Unit and Crisis Action Team Community Services contract Red to Green: Community hospitals, Theatres, A&E, recruitment! Engagement with all community partners – We need your help!

7. Our Passion, Your Care. Delayed Transfers of Care

8. Our Passion, Your Care. What’s the challenge? Why is winter special?