Towards 7 day working - a whole system change

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Towards 7 day working A whole system change Birju Rana , Colin Doig , Eliot Sykes. Northumbria NHS Foundation Trust Presentation from the 'NHS services open seven days a week: every day counts' event on Saturday 16 November at The Metropole Hotel, Birmingham. This event was hosted by NHS Improving Quality and NHS England to share the views and ideas of public, patients, carers, NHS England and health and social care staff on how to improve access to services for patients across the seven day week. More information at http://www.nhsiq.nhs.uk/improvement-programmes/acute-care/seven-day-services.aspx or #7DayServices

Health & Medicine Business

Birmingham, 16th November 2013

Towards 7 day working
A whole system change
Birju Rana , Colin Doig , Eliot Sykes.
Northumbria NHS Foundation Trust
Birju.rana@northumbria-healthcare.nhs.uk

Northumbria

500,000 pop.
+/- 1,400 beds
8,500 staff
255 Cons.
280 Docs.
9 I/P sites
Turnover > £440 million
Largely Emergency driven
Provincial Medical School

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

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

Identified a need for change….

Key numbers….83

y

84 %
More of the same was not an option….

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
Develop Ambulatory Care
Elderly assessment
Surgical assessment
Direct access to palliative care

KIDD.

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

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

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
MPs can get ‘anxious’

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

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