1. NHS Efficiency and Productivity Framework
Stephen Gallagher
Deputy Director for Health Performance
Gerry Marr
Chief Executive, NHS Tayside
Changing the World
Improvement Conference
24 November 2011

2. Quality & Efficiency = Value

3. Identify Priority Areas

4. Waste, Unwarranted Variation &
Harm

5. Prescribing – Variation in per
capita FHS drug expenditure
250
£ spend per head adjusted for
200
150
need
Series1
100
50
0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
NHS Board

6. How?
• A Single Portfolio
• Leadership and buy-in from NHS Chief
Executives
• Efficiency Portfolio Board
• 6 Work-streams supported by a
transformational narrative 20/20

8. Linked to Performance
• Agreement that EPB identifies, tests and
champions priorities
• Actions enabled by Quality & Efficiency
Support Team (QuEST)
• Boards challenged to adopt or justify
• Annual Plans set out in Local Delivery
Plans
• Tailored Performance Support available

9. Tailored Performance Support
• Leadership, Governance, Grip
• Productive Opportunities identified through
Whole Systems Data Analysis
• Support for specific local schemes

10. The 3-step Improvement Framework for
Scotland’s public services
Macro system –
1) Change Vision, aim and context.
the
world
Meso system –
Culture, capacity
And challenge.
How much and by
2) Create the conditions
when?
Micro system –
Implementation, measur
3) Make the improvement ement and improvement

11. 2009 - 2011
TACTICAL STRATEGIC
PRODUCTIVITY & SERVICE
EFFICIENCY OPTIMISATION
CRES TRANSFORMATION
DEALING WITH SPENDING THE 95%
THE 5% BETTER

12. 2010 - 2013
TACTICAL STRATEGIC
PRODUCTIVITY & SERVICE
EFFICIENCY OPTIMISATION
CRES TRANSFORMATION
DEALING WITH SPENDING THE 95%
THE 5% BETTER

13. Steps to Better Healthcare
Mental Out Theatre Workforce Integrated Child Optimisation Prescribing Other
Health Patients Capacity / care health of Health and
Planned communities Facilities Medicines Labs
Care across Maternity
Tayside
Scenario Planning, Financial Baselines, Benefits Tracking, Business Finance Support
Cases
Workforce Modelling, Engagement & Communications with staff Workforce Support
Communications with public and staff Comms Support
Organisational Effectiveness support OE Support

14. 2010 - 2012
TACTICAL STRATEGIC
Case management –
Prevention of admission improved pathways
Improved Day care Intermediate care
Improved service liason and Care home interface
discharge Medications reviews
Reduced hospital stays and Housing/home care support
bed days Technologies
Maximise Community
hospitals
Virtual wards
Workforce redesign
Cost minimisation Self care and enablement
Workforce efficiencies New models of care in
Teleheath/telecare dementia, falls, end of life
care
DEALING WITH SPENDING THE 95%
Working with communities -
THE 5% coproduction
BETTER