Lynne Sheridan presents Maidstone and Tunbridge Wells NHS Trust's approach to engaging stakeholders and delivering 7-day services. The trust conducted an organizational assessment, established a steering group led by the Medical Director, and presented to various staff groups to increase awareness and engagement. A challenge day was held with national experts to assess compliance and identify gaps. Directorates developed action plans and were categorized based on compliance. Ongoing engagement of clinical and managerial leads aims to monitor progress and make 7-day services part of standard operations. The goal is to improve services and reduce unwarranted variation in patient outcomes based on the day of admission or treatment.

1. Seven Day Services
Our approach to
7DS delivery and
stakeholder engagement
Lynne Sheridan
Head of Delivery Development
Maidstone and Tunbridge Wells NHS Trust
Webinar hosted by:
Sustainable Improvement
NHS England South
August 2017

2. Objectives
During this session you will hear about:
• Reducing unwarranted 7DS variation: How to engage your internal
stakeholders for clinical leadership and planning
• How to engage your wider system partners: The commissioner,
clinician and patient perspective
• ‘Spreading the word’ – Resources to help clinicians on how to deliver
the 7DS standards
7 Day Hospitals – Session objectives

3. Guest Speaker is
Lynne Sheridan,
Head of Delivery Development, Maidstone and
Tunbridge Wells NHS Trust
7 Day Hospitals – Guest Speakers

4. 7 Day Services
Reducing Unwarranted Variation
Getting It Right From The Start:
Engaging Internal Stakeholders for Clinical Leadership
and Planning
July 17

5. Getting It Right From The Start:
Engaging Internal Stakeholders for clinical leadership and
planning
Organisational Stocktake - Commenced November 2016
Key questions:
* Who is currently (or has been) involved in this programme?
* What is the current level of organisational understanding/awareness/engagement?
* What stage is our programme plan documentation at?
* Who are our key players?
* What are our gaps against the standards?
* What data do we have on variation
* What have the previous National surveys shown us?
* What organisational importance does the Programme have?
Creation of a critical path (see next slide)
Establishment of a Steering Group (Medical Director Led)
(Internal: Medical Director, Lead Manager, PMO Lead, Clinical Audit Lead, Business Intelligence Lead)
(External: NHS Improvement Lead, CCG Lead)

6. Getting It Right From The Start:
Challenge Day with National Team
(Revisited this step in May 2017 – see
slides 8 & 9)

7. Getting It Right From The Start:
Engagement Process:
Generation of a presentation to key staff groups to bring the
programme to life and get it on the agenda:
• Demystify programme, remove the ‘fear’ barrier and present compelling data
that means something locally to engage clinicians and managers
• Presentation content:
* Overview of National Programme’s requirements
* Simplify the standards and explain them
* National findings and statistics (mortality and variation)
* Local data (Dr Foster mortality) and variation data by day of week
* ED attendances, NE admissions, discharges, conversion rates, readmissions
relative risk of death by day of admission and discharge
* Summary of National survey results from last 2 surveys
* List out the ‘to do’ list and requirements of the key clinical and managerial staff
* Review the requirements of the forthcoming National survey

8. Getting It Right From The Start:
Engaging Internal Stakeholders for clinical leadership and
planning
Staff and Groups presented to:
• Trust Medical Executive
• All General Managers
• Clinical Directors’ meeting
• All Divisional Boards
• Clinical Commissioning Group

9. Getting It Right From The Start:
Engaging Internal Stakeholders for clinical leadership and
planning
What Were Our Key Next Steps?
 Clinical Lead to be nominated for each Directorate
 Appointment of a Trust-wide Clinical Lead
 Baseline assessment tool completion – for stocktake against standards
 Production of detailed template for each service, measuring current service model and gaps
 Challenge Day (with National Leads present) – templates presented and discussed
 Directorate level action plans and categorisation - produced after Challenge Day
 Programme plan and trajectory updated with action plan detail
 Steering Group Participation for key Leads (with National Team involvement)
 National Survey requirements & learning (ongoing)

10. Getting It Right From The Start:
Engaging Internal Stakeholders for clinical leadership and
planning
Further refinement of engagement plan:
• Communications plan including internal 7DS intranet resource site
• Linking of 7DS to all relevant internal groups and processes
(Clinical Groups inc Mortality, LOS etc, and managerial groups Divisional and Directorate Boards,
Trust Medical Executive, Clinical Directors Meeting, Executive Performance Review Meetings)
• Engagement with all leads for internal processes and publications
(STP and Strategy Lead, Operational Plan Lead, Quality Account Lead etc)
• Induction of all Clinical Leads by Medical Director and Lead Manager, and
development of our Trust-wide Clinical Lead
• Inclusion of Divisional Directors in Steering Group to report on progress
• Making 7DS part of ‘Business as Usual’

11. Getting It Right From The Start:
Trust Wide Challenge Day
• Whole Day Event
• 4 Priority Standards were focus
• Panel: Medical Director (Chair), 4 x National Leads, Trust 7DS Clinical Lead, Lead Manager, PMO Lead
• Delegates: CDs, 7DS Clinical Leads, DOPs, ADNs, Matrons, GMs, AGMs
• Programme: Split into 3 Divisions
Presentation of service position template by CD
2 way challenge – panel and delegates
Confirmation of compliance status and identification of gaps and actions required
• Outputs: Report on compliance status and actions required
Classification of Directorates into 3 groups (compliant, small confirmation actions, non-compliant)
Production of ‘at a glance’ compliance table
Detailed action plans for non-compliant group
Some small audits for confirmation group
Evidence production for compliant group
Ongoing monitoring at Steering Group

12. Getting It Right From The Start:
Trust Wide Challenge Day
7 DAY SERVICES PROGRAMME
AT A GLANCE COMPLIANCE TABLE @ 19.05.17
(Please see individual Directorate templates for detail)
14 hrs 1 hrs 6 hrs NEWS
Twice
Daily
Once
Daily
Medically
Active
1 hr
Critical
12 hrs
Urgent
24 hr /
Routine
Critical
Care
IR Int. Endo
Emerg
Surg
Emerg
Renal
Urg
Radiother
Stroke
Thromb.
PPCI
Pacing
Temp/
Perm
Urgent Care (A)  X X  X X X  N/A  N/A N/A N/A   
Urology (A) X X X 

(via ICU)  X  *X N/A  N/A N/A N/A N/A N/A
Surgery (A) X X X 

(via ICU) X   N/A N/A  N/A N/A N/A N/A N/A
T&O (A) X X X 

(via ICU) X X   N/A N/A N/A N/A N/A N/A N/A
Women's (C) X  X 

(via ICU)    N/A N/A N/A N/A N/A N/A N/A N/A
Paeds (B)    

(via ICU)    N/A N/A N/A N/A N/A N/A N/A N/A
ICU (C)   *X      N/A N/A N/A N/A N/A N/A N/A N/A
Head & Neck ( C) X N/A N/A 

(via ICU) X X  N/A N/A N/A N/A N/A N/A N/A N/A
Haem/Onc ( C) X X X 

(via ICU)    N/A N/A N/A N/A  N/A N/A N/A
CT (B)   
Ultrasound (B)   
MRI (B)   
Microbiology (B)   
Endoscopy (A) X X X
Echocardiogram(B)   
Note: * 6pm -
8pm only
- to audit
un-
planned
adms
*Audit
hrs for
OOH
Only
KEY TO INPUT INTENSITY REQUIRED
Category Position Statement
A High intensity actions with 7DS Team support to action plans
B Compliant - No actions required - evidence only (some additional notes to read from Panel)
C Low intensity actions or small confirmation audits required
Standard 6
Division/
Service/ Category
Standard 2 Standard 8 Standard 5

13. Getting It Right From The Start:
Engaging Internal Stakeholders for clinical leadership and
planning
• Aim to move to BAU monitoring (eventually via monthly Exec Performance Review process)
• Steering Group to move into a ‘monitoring’ role, with emphasis on
Divisions to drive delivery of action plans via Divisional Boards
• Monthly reports to:
Trust Management Executive
CCG Performance and Quality Review
• Quarterly Steering Group Meetings with our National Lead members

14. www.england.nhs.uk
For further information
Speaker contact: Lynne Sheridan, Tel: 01622 227540
To request webinar recording email: vivrichards@nhs.net
More case studies can be viewed at:
https://www.england.nhs.uk/seven-day-hospital-services/resources/
https://improvement.nhs.uk/resources/seven-day-services/#resources