Towards 7 day working - A whole system change David Evans, Medical Director Northumbria NHS Foundation Trust Presentation from seven day services event held on 20 August 2013

1. London, 20th August 2013
Towards 7 day working
A whole system change
David Evans
Medical Director
Northumbria NHS Foundation Trust
Dave.evans@northumbria-healthcare.nhs.uk

4. Northumbria
500,000 pop.
+/- 1,200 beds
8,500 staff
255 Cons.
280 Docs.
9 I/P sites
Turnover > £440 million
Largely Emergency driven
Provincial Medical School

5. We are a bit odd…..
Mobile workforce
Trust wide contracts
30% off site
Flat…
Stability
Flexibility
Willingness to try…
Rural pressures
Lots of Hub & Spoke
Ageing population

6. Beginnings
3 Trusts into 1
Very low baseline
££££ difficulties
Inefficient clinical model
Unsustainable services
Recruitment difficulties
Staff unsettled
Political pressures
12 years

7. A Need for Change….
Key numbers….83
84
More of the same was not an option….

8. Why not be radical?….
A whole system change…..
Create a Specialist Emergency Care Centre
Split Elective / Emergency work
24/7 resident Consultant in Emergency Care
Extended working day 7/7 , 9 clinical teams
Change DGH s for elective / community care KIDD.
Develop Ambulatory Care
Elderly assessment
Surgical assessment
Direct access to palliative care

9. • ECC location map to do….
*

14. Front line….
Emergency Care Consultants
Acute Care Physicians
Surgery x 2
Orthopaedics x 2
Cardiology
Respiratory
ITU / Anaesthetics
O & G.
Paediatrics
+ Nurse practitioners
+ Pharmacists

15. Clinical engagement
Build in Safety & Quality
Make this the right thing to do
It is better for patients
Collectivism
Business Units
Harness the competitiveness
No deals , no surprises
Use patient feedback
Job planning & appraisal
All core activity within PA’s

16. Clinicians
Compact of Behaviours
Escalation plan
Clear policies & Governance systems work….CNST
Clearly understood expectations
“No surprises please…”
Competency & values framework
Revised recruitment process
New Consultant programme
Leadership development programme
Well established & valued appraisal programme
Clear and robust job planning

17. Culture
Stability , Consistency & Honesty
Collectiveness
Respectful
Clinically led
Multi-disciplinary
Value driven
Patient centred
Safety & quality are key

18. Lessons learned
Whole system change can be good
People enjoy a challenge
Splitting elective / emergency is life changing
Public consultations can be good
Local councils like local solutions
MP’s can get ‘anxious’

19. For the last 5 years…
Every service development is NECC proofed
Large work stream reconfiguration programme
We will not be moving current ways of working
Everyone will change