PROPOSED MONITORING ARRANGEMENTS

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PROPOSED MONITORING ARRANGEMENTS
20th June 2005
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Five key questions

• 1. Is the NHS doing what it said it would do?
• 2. Is the timetable being adhered to?
• 3. Are the changes having the predicted impact?
• 4. What is the public understanding of the
  changes?
• Plus
• 5. What else is going on and to what extent (if
  any) do local plans need to be modified?

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Three general issues

• 1. Difficulty in separating out specific impact
  of IIYH from impact of general changes in health
  and healthcare.
• 2. Balance between hard and soft measures.
• 3. Appropriateness of the level of detail.

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What we said we would do

• More local services
• Expanded primary care and 15 (?) Community DTCs
• Expanded intermediate care facilities
• Expansion of elective care facilities and
  separation from emergency care
• Different approach now between Hertfordshire
  Bedfordshire
• Concentration of hospital based services onto
  fewer sites
• 4 major acute hospitals but 6 AE departments
  remaining
• Development of specialist services
• Cancer centre within Beds and Herts
• Distributed model of supra DGH services
• Development of postgraduate medical school

Proposal Annual report and presentation
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Timetable

• Transitional plan
• Key milestones for
• DTCs
• Development of intermediate care
• Elective treatment centres
• Business case process for 2 major hospitals

Proposal Annual report and presentation Summa
ry Gantt chart
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Predicted impact (1)

• Shift in expenditure
• revenue expenditure in acute, primary and
  other NHS care
• More care locally
• fces delivered within Beds Herts
• fces delivered in non-acute hospitals
• diagnostic tests delivered in non-acute
  hospitals
• emergency bed days (also efficiency measure)
• travel time assessment (emergency care)
• Quality of care
• standardised mortality rates
• readmission rates
• post operative infection rates (MRSA)
• specific services and/or conditions? (e.g.
  cancer, cardiac)
• PCT and Trust surveys on patient satisfaction

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Predicted impact (2)

• Separation of elective from emergency care
• access times
• transfers
• patient satisfaction
• Populations health
• wide range of indicators
• More attractive place to work
• vacancy rates
• staff surveys

Proposal Annual report and presentation Web
based population health
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Public understanding

• Do people know about IIYH and the proposed
  changes?
• Are the changes having a beneficial impact?
• Do behaviour changes reflect changes to model of
  care?
• How are the changes being communicated?

Proposal Three-yearly major survey (MORI) with
annual updates
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External events and comparisons

• Changes in government policy and national
  context, e.g. plurality, payment by results,
  choice, NHS funding
• Changes in local organisations and local context,
  e.g. structural changes, financial performance,
  Harefield
• Legal and procedural issues, e.g. judicial
  reviews, business cases
• Beds Herts compared to England average
• Combined impact on IIYH

Proposal Annual report and presentation