Achieving transformational change through integrated service improvement

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Achieving transformational change through
integrated service improvement

• David Waller

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ISIP Helping the NHS

• deliver better patient care, more efficiently
• maximise and capture benefits for patients of
  local/national service and system reforms
• realise expected Gershon efficiencies
• demonstrate quality and value
• thrive in a patient-led NHS

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By

• reducing the burden of separate initiatives and
  policies by aligning into a coherent approach
• exploiting people, process and technology
  enablers to achieve transformational change
• evidencing practice that demonstrates time
  releasing and quality benefits
• building confidence in a self improving NHS
• influencing future policy development

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An Integrated Approach
How do we as a Local Health Community...
best exploit and co
-
ordinate
to make health delivery
in the context of local strategy...
national
and
local solutions?...
demonstrably...
10 High Impact Changes
faster
NHS Improvement Plan
Agenda for change, MMC
more efficient
Choice
PbR
A Patient
-
led NHS
better patient experience
ISTCs
Local service
happier staff
reconfiguration
Care Record Service
safer
PACS
FT migration
better clinical outcomes
Estates
Local Delivery Plans
National Service
within financial balance
Frameworks
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What is a Benefit?

• An advantageous change realised from the
  transformation of resources to deliver new or
  improved value adding activity
• Cranfield University
• A benefit is a result that a stakeholder
  perceives to be of value.

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Features, Outcomes, Benefits

• Feature - my car is painted Police Car white
• Outcome - people move over for me on the motorway
  so I get home for 6 pm
• Benefit - I get to watch The Simpsons on TV

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What is Benefits Management?

• A process of organising and managing such that
  potential benefits are actually realised.
• Aims to maximise the benefits from business
  change

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What is Benefits Management?

• Lots of projects become unglued from the business
  need, processes and people that created them.
  Benefits Management puts the glue back. It is a
  structured approach that
• makes the link between a project and the
  organisations strategic objectives
• builds the case for investment
• gains buy-in to the project from all participants
• maximises the benefit from the original
  investment

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Whats the point?

• Programmes
• Projects
• Plans
• are questionable activities if they do not
  support the declared strategies and objectives of
  the organisation

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Whats the point?

• A Programme
• A Project
• A Plan
• are questionable activities if they cannot
  demonstrate benefits to one or more groups of
  stakeholders

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Whats the point?

• Programmes
• Projects
• Plans
• will be of no value if they cant be shown to
  have made a difference

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Change Programme focus across England
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Yorks Humber Programmes

• See spreadsheet

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So far

• LHC planners learning as they go
• LHC governance vs NHS re-structuring
• It takes time and effort
• The Benefits Dependency Networks are proving
  valuable
• The proof of the pudding

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We are using the ISIP approach to build 12
million of whole system benefits by 2008 to
achieve an integrated care network and to afford
our new PFI hospital in 2012-13
The ISIP approach helped us rationalise over 70
disconnected plans into a coherent service
transformation plan, focussing scarce resource to
get on and deliver
South Devon Local Health Community
North Derbyshire Local Health Community
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Its all about integration

• Discussion

ISIP Adding value for patients a must have,
not a must do Nick Relph, Top Team Sponsor
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OHOCOS Themes

• More patient choice and louder voice
• Better prevention and early intervention
• Care closer to home
• Better access,less inequality in
• primary community care
• New expanded Services,esp. LTC
• Partnership working with supporting
  Infrastructure
• System in surplus by 2007

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ISIPs Fit with OHOCOS Policy

• Service shift themes mirror CDS
• enabling health, prevention/early
  intervention, care in right setting, provider
  choice, rapid convenient access
• Scale of change is transformational
• Working on LTC Model of Care
• ISIP landed as recommended delivery tool
• ISIP emphasis on LHC fits with health,social care
  axis
• Enabler alignment strongly referenced

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The So What for ISIP

• Urgent join up- ISIP Strategic Plan LAA
• Collaborate with national PBC dev support
• Leverage for LA engagement
• Joint DPH role- strong clinical leadership
• Community ownership of strategic plans
  reconciled with urgency for reconfig inc.
  productivity
• Unbundling tariff enables benefit sharing
• ISIPs 4 priority models of care fit primary,
  community and care closer to home implicit
• unscheduled, planned, LTC and diagnostics