Enclosure A3 - PP_TEG_Winter Story FinalBoard PaperER

Winter Evaluation 2013/14
Board of Directors
Wednesday 16 July 2014
Kirsten Major, Ellen Ryabov & Lisa Needham
Slide 1
A Winter Story…
Outline
• The beginning - description of Winter
2013/14 compared to 2012/13.
• The middle – what did we do? What worked
well?
• The end – planning for next winter.
Slide 3
IN THE BEGINNING…
Slide 4
Winter 2012/13…
Slide 5
Slide 6
Last Winter….
We’re running out of
ideas…
Never seen so much
pressure for such a
long time
Slide 7
Relentless
Considerable staff
pressure
WHAT ABOUT 2013/14 THEN?
Slide 8
Slide 9
National Picture – 2013/14
• Emergency admissions highest level ever
during the last 10 years
• Total of 3.8m admissions in 2013/14 versus
2.8m in 2004/05 - +38%
• 2% increase between 2012/13 and 2013/14
• Reduced A&E attendances by 0.3%
Slide 10
STH’S EXPERIENCE…
Slide 11
4062 more admissions
Slide 12
Slide 13
Slide 14
Slide 15
WAS IT EASIER WORK?
Slide 16
No real change in ambulance arrivals 12/13 & 13/14 - Overall Acuity Same
Slide 17
THE MIDDLE…
Slide 18
WHAT THINGS DID WE DO
DIFFERENTLY?
Slide 19
Expansion of Clinical Decisions Unit (CDU) increased throughput +27%
Slide 20
Slide 21
Extended weekday opening hours to 8pm and w/e opening improved usage
Slide 22
The Trust has an internal mechanism for recharging medical outliers to the responsible
speciality
The recharge value for 2012/13 was £3,574m as compared with £1,334m for 2013/14
An overall reduction of 6042 bed nights equating to £2,240m fines reduction of 63%
Slide 23
A SUMMARY OF FLOW IN NGH…
Slide 24
Performance in Q3/4 2012/13 = 91.1% whereas Q3/4 in 13/14 = 95.48%
Slide 25
Summary of Winter Story
2012/13 compared with 2013/14
Period 12/13
A&E 4-Hour Average Performance in period
91.10%
95.48%
4.38%
4.81%
All admissions - Total in period
107398
111460
4062
3.78%
Elective IP Admissions – Total in period
14618
15302
684
4.68%
Non Elective IP Admissions - Total in period
41872
42474
602
1.44%
All Day Case admission – Total in period
50908
53684
2776
5.45%
Hospital Cancelled Operations
6719
5851
-868
-12.92%
Outlier bed nights by Week
36522
30480
-6042
-16.54%
All Discharges - Total in period
107349
111512
4163
3.88%
Month 12
Actual
Improved
Position
Comparison on Month 8 versus Month 12
Financial Improvement – Total in period
Slide 26
Period 13/14 Difference % Improved
Variance from Pro-Rata to
Mth 8 Target
Month 12
£2,253,000
£3,528,000 £6,890,000 £3,362,000
THE END…
Slide 27
More & ongoing
• System change –
working with partners
internally and externally
• Cultural change – wide
ownership from the
outset
• Discharging and
discharge processes
• More systematic
processes and
escalation
Slide 28
New & next…
• Admissions avoidance
and admissions process
• Managing sickness
absence
• Profiling work across
week and days and
responding
• Managing elective flow
• Planning for bank
holidays
AN EPILOGUE…
Slide 29
•
•
•
•
We did more work
We performed better
We performed better than many others
We did a lot and what we did made a
difference
• Winter is coming…
Slide 30