David Radbourne Director of Organisational

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David RadbourneDirector of Organisational
Service Development
Showcase Milton Keynes Hospital
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EWTD Pilot
The hospital of choice. Committed to treating you
well.
3
Scope of Presentation

• Scope of pilot
• How we approached it (management perspective)
• What has worked
• What didnt go so well
• Remaining areas requiring attention
• Hints and tips
• Q A

The hospital of choice. Committed to treating you
well.
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Milton Keynes
The hospital of choice. Committed to treating you
well.
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Scope of Pilot

• Approved 15 months ago as a rural site NWP EWTD
  pilot
• Part of a plan to get ahead, plan relatively
  early, learn from others
• Key components to test in our plan were
• Rota design
• Cross cover
• New roles and role clarification
• Refresh of hospital at night
• Improved team working and communication
• Part of a wider piece on urgent care redesign

The hospital of choice. Committed to treating you
well.
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How we approached it

• An organisational priority
• Clinically led
• Clear programme management arrangements with
  dedicated
• Project management
• Medical staffing (HR) capacity
• Clinical leadership time
• Executive leadership from Service Development,
  Medical Director and HR Director
• Initially rotas and new ways of working but
  brought streams together quite quickly

The hospital of choice. Committed to treating you
well.
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What worked

• Up front, active, clinical leadership made a real
  difference especially on new ways of working
• Not being able to always get additional staff
  forced new ways of working also
• Focussed, determined hard work on rotas
• Rota software and support package
• Taking expert advice
• Focus on staging what can become compliant,
  when, and through what actions

The hospital of choice. Committed to treating you
well.
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What worked contd

• Persistence
• Clinical director sign off, Medical Director
  leadership
• Solid project management effort
• Learning from those who have cracked elements and
  packaging it together
• Some clinical teams have really embraced it as an
  opportunity
• Better night time differentiation of role, task
  and cover

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What didnt go so well

• Impact on training?
• Are the people there anaesthetics
• Cultural change takes time we are different!
• Seeing the bigger picture challenge to fit EWTD
  requirements and Service Strategy together in a
  meaningful way
• Technology I bleep
• Business case v transitional costs
• Still a general reluctance to cross cover
• New roles take time

The hospital of choice. Committed to treating you
well.
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Achievements / Attention

• Compliant except anaesthetics, T O, Paeds due
  Feb
• Keep a close eye as easy to stray over as set
  tight
• Some teams have genuinely embraced the
  opportunity and the results have been very
  positive
• Continued attention to whether the teams are
  making the changes and are sticking to them

The hospital of choice. Committed to treating you
well.
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Contd

• Are we seeing a continued move and progress
  towards greater cross cover and exemplar H_at_N
  operation?
• Will we ever get the IT to work? (I bleep)
• Clinical networks
• What happens if the staff arent out there?

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Hints and Tips

• Strong clinical leadership
• It cant just be about more of the same
• It should be part of a wider workforce strategy
  linked to Service Strategy but this is a
  challenge
• Maybe a staged process of practical actions and
  more medium term changes and developments rather
  than a one off
• Dedicated resourcing

The hospital of choice. Committed to treating you
well.
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Any Questions?