East Kent Hospitals NHS Trust 18 Week Early Achievers

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East Kent Hospitals NHS Trust18 Week Early
Achievers

• Matthew Kershaw, Chief Operating Officer
• Tracy Rouse, 18 Week Project Manager
• East Kent Hospitals NHS Trust

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East Kent Locality Pioneer

• To develop short term solution to enable the
  capture and measurement of referral to treatment
  (RTT) data
• Collecting data retrospectively and prospectively
  since last April
• Working towards early achievement

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Advantages of our data collection RTT

• Have a very good idea of our current RTT waits,
  across the whole of pathway, not segments
• Beginning to understand the data and utilising it
  to inform local delivery plans (LDPs)
• The pathway data gives us focus for significant
  service change and capacity planning
• Enable commissioning by service specifications or
  pathways

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The challenge..
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The challenge..
Admitted January 2007
Source East Kent Hospitals RTT January Report
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Other Learning

• Clinical leadership is critical
• Only the clinician treating can determine the
  treatment status and relevant pathway
• Admitted clock stops easier to capture and easier
  to define
• Non admitted clock stops difficult to capture and
  are more difficult to define

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Achieving the 18 Week Target

• Development of clinical pathways and new service
  models including
• early triage and primary care and self management
• diagnostics earlier in the patient pathway
• Improved productivity
• waiting list management
• hours of operation
• booking systems and management
• Workforce redesign
• Patient and public awareness
• IT

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Early Achiever Planning

• Emphasis on speed and momentum
• Need to see early wins and rapid improvement
• Project needs to gain early credibility and build
  confidence across our locality

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Early Achiever Planning

• Business Planning
• 18 week activity planning integral to the current
  LDP and business planning process
• There is a recognition that new pathways will
  require us to plan activity differently but no
  model to support this process as yet
• Setting local trajectories by directorate
• Backlog / waiting list initiatives to maximise
  theatre capacity and minimise the constraints of
  theatres
• Clock stop - first treatment not always end of
  pathway

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Early Achiever Planning

• Clinical Pathways
• Challenge existing practice
• Maximise opportunities for transformational
  change across the health economy
• Deliver 18 weeks
• Need to be clinically led
• Clinical pathways to be developed and agreed and
  implemented across our locality
• Development of service models to support pathways
• Agreement with commissioners via contract
• Audit of agreed pathways

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Early Achiever Planning

• Communications
• Initial awareness utilizing existing locality
  communications systems
• Email, trust magazine, chief executive forum
• Long term communications to continue through
  traditional methods. Monthly communication forum
  to be agreed
• PPI patient representatives will continue to be
  invited to the steering group, supported by
  regular briefings and consultation requirements
• Staff drop in sessions to be set up across the
  locality

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Early Achiever Planning

• RTT
• To continue with development of referral to
  treatment data collection.
• Specific work streams include
• Inter-organisation data collection and data
  pathway implementation
• PTL development and SUS
• Begin to work with Fujitsu re RTT solution

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Early Achiever Planning

• Translating the rules into practice
• Review of current administrative rules to reflect
  18 week
• principles and definitions
• Reduction in suspension and tolerances
• Reasonableness needs to be defined and its impact
  qualified on outpatients, diagnostics, inpatient
• Reasonableness and outpatient timescales to be
  defined and planned within choose and book
• PCT and GP support to sustain implementation
• Need to quantify impact on our lower waits and
  demand from other localities
• Patient perception of a no waits system

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Early Achiever Planning

• Governance
• Nominated Executive, Managerial and Clinical
  leads across locality
• 18 Week Steering Board. Membership includes
  managerial and clinical leads from PCT and Acute
  Trust, PPI members. Chaired by Executive Lead
• Project groups will be accountable to the
  steering board

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Summary

• We are clear on the challenges that we face
• We need to win hearts and minds early in the
  process
• Can only achieve as a health community
• We are confident that it can be done

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• The NHS Plan cannot be delivered unless staff
  start breaking the rules. We need a second order
  approach to change getting rid of the old rule
  book and experimenting with new ways of doing
  things, redesigning the whole system
• Bevan H, Plsek P (2001) NHS Confederation