The document summarizes the transformation of University Hospitals of North Midlands following recommendations from a Trust Special Administrator report. Key points include: - The new trust was established in 2015 operating three hospital sites to serve over 700,000 people - The vision is to be a leading healthcare provider driven by excellence in patient experience, research, teaching and education - The Patient Care Improvement Programme aims to deliver excellence in care, clinical professions, and employment through compassionate leadership and a focus on the patient experience - Outcomes have improved including reductions in mortality rates, patient complaints, falls, and pressure ulcers along with improved staff experience

1. May 2016
Liz Rix – Chief Nurse
Ordinary to Predictable Excellence

2. An introduction to
University Hospitals of North Midlands
 In 2013 a new single site hospital
 Transformation programme
 New structures and ways of working
 Service line management
 Clinical leadership
 Staffing management of change

3. Our Professional Identity
Nursing
Assistant
Education
& Quality
Nurse
Staff Nurse Matron Senior
Clinical
Staff Nurse
Senior
Sister
Junior
Sister

4. Our Foundations
 Strong Vision and Values
 Comprehensive education and development for all staff
 Robust support and supervision
 Assurance of Competence
 Learning From Francis

5. The Francis Report
Learning from the past and looking to the future - a new horizon
Trust Special Administrator Model
 The TSA concluded that Mid Staffordshire Foundation Trust
(MSFT), in its current form, was neither clinically nor
financially sustainable.
 The recommendation was that Monitor should dissolve MSFT
and transfer its assets to the Secretary of State.
 The Secretary of State would then be free to exercise powers
available to him to transfer the assets (Stafford Hospital and
Cannock Chase Hospital) and services operated at those
hospitals, to alternative providers to ensure the safe and
sustainable delivery of services within the localities of Stafford
and Cannock.

6. A New Kind Of Trust
 University Hospitals of North Midlands was established on
1st November 2015 following the TSA recommendations.
 The new Trust operates from three sites
 The Royal Stoke University Hospital
 The County Hospital (formally Stafford Hospital)
 1st April 2016 acquired two Community Hospitals
 We serve approximately 700,000 people living in and
around Staffordshire and provide specialised services for
approximately 3 million people from the wider population
 10,480 staff (headcount)
 1522 beds
 £727 million

7. Vision and Values
We will be a leading centre in healthcare driven by excellence
in patient experience, research, teaching and education.
LEARN FROM EXPERIENCE
Giving an receiving feedback
Always improving
Championing learning and education
Innovation and research
WORKING TOGETHER AND EVERYONE
COUNTS
Giving an receiving feedback
Taking personal responsibility
Championing learning and education
Innovation and research
SAFETY IS OUR PRIORITY
Keeping people safe
Taking personal responsibility
Leading with care
Delivering the best outcomes
RESPECT AND DIGNITY
Compassion and kindness
Going the extra mile
Valuing diversity
Protecting dignity

8. Our Patient Care Improvement Programme (PCIP)
The heart of our focus
Our Priorities are to deliver:
 Excellence in Care
 Excellence in our profession
 Excellence in employment
We will achieve this by:
 Being in the top 20% of all NHS hospitals for patient
experience and staff experience by 2018
 Having an HSMR and SHMI of 80 by 2017/18
 Reducing avoidable harm by a further 20% by 2018.

9. Delivering our PCIP
Our Focus is to:
 extend the scope of safety
 develop internal capacity and capability to undertake
improvement
 encourage successful spread of innovation and learning
Our Four Always
 Listen
 Pay attention
 Empathise
 Take intelligent action
= Compassionate Leadership

10. Our Foundation
Strong Leadership
 Created a consistently caring, safe and compassionate culture from
Board to ward.
 Developed the skills of our Middle Managers to strengthen succession
planning with a focus on quality improvement.
 Increased further Doctor involvement in quality improvements
 Expanded further transparency and embed Duty of Candour
 Ensured safe and reliable staffing levels
Develop a culture of patient and family centred care and act on
patient and staff views and experience
 Implemented experience based co design with patients and staff
 Learn further from patient stories and diaries bringing the patient into
every conversation
 Actively listen to our patients and their family and provide support to
make informed choices

11. Our Foundation
Give staff space to support personal growth, develop new
skills and expertise and explore new ideas.
 Facilitated learning when things go wrong
 Rolled out human factors training
 Rolled out models of accreditation
 Recruited a professor of Nursing, and implement a programme of
nursing research
 Enhanced and broadened the role of the Care Coach
 Enhanced the use of benchmarking
 Explored the opportunities for international benchmarking
 Celebrating good practice

12. Our Foundation
Use data more intelligently
 Improved data analysis capacity
 Implemented sustainable improvement from real time
patient feedback
 Increased staff understanding of measurement
Spread and embed sustainable improvement at scale
 Further developed front line dashboards
 Enhanced understanding of variation
 Supported through Quality Academy

13. The Tools, Systems and Processes
 Strong Governance Structure and processes
 Intelligent Information Systems
 A framework for achieving excellence and
giving assurance
 Internal Accreditation

14. • HSMR reduced from 103.99 in 2014/15 to 89.87 in 2015/16
• PROMS scores for Hips and Knees improved
• 17% reduction of complaints received (1061 to 880)
• Complaints rate reduced from 50.54 to 43.25 complaints per 10,000 episodes
of care (15% reduction)
• VTE Risk Assessment compliance improved from 97.7% to 98.2%
• Serious incidents decreased by 40% from 200 in 2014/15 to 120 in 2015/16
• Rate of falls per 1000 bed days decreased from 5.54 to 5.19 (6% decrease)
• Falls Bundle compliance improved from 88.7% to 92.9%
• Patient Safety Incidents rate per 1000 bed days reduced from 32.59 to 30.17
• Harm Free Care improved 2015/16 to 97.9% from 97.3%
Outcomes

15. Outcomes – Staff experience
Improving staff engagement and staff experience
Agency Usage started to reduce and
below target rate

16. Outcomes for Patients
Harm Free Care improving Rate of Patient Falls reducing
C Diff cases reductions across sites
5.48
5.59
5.54
5.19
4.9
5
5.1
5.2
5.3
5.4
5.5
5.6
5.7
2012/13 2013/14 2014/15 2015/16
Patient Falls per 1000 bed days

17. Outcomes for Patients
Improving mortality – better
outcomes for patients
Reductions in Patient
Complaints across both sites
104.18
100.12
99.08
103.99
89.87
80
85
90
95
100
105
110
2011/12 2012/13 2013/14 2014/15 2015/16
UHNM HSMR per Year
UHNM established

18. Outcomes for Patients
Reduction in Grade 3 Pressure
Ulcers
Zero grade 4 for 4 years

19. Thank You
Any questions