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The Quality and Productivity Challenge : AHPs at DH

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Jo Partington, AHP Lead at the Department of Health, Transforming Community Services, addresses AHP Leadership Challenges, Referral to Treatment Project, Service Improvement Project and Transforming Community Services. COT Annual Conference 2010 (22-25 June 2010)

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The Quality and Productivity Challenge : AHPs at DH Jo Partington, AHP Lead, Transforming Community Services. Occupational Therapy Conference. Brighton 2010.

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An acronym that’s here to stay…… Q uality I nnovation P roductivity P revention = > Quality and Productivity Challenge

3

The backdrop….. Services do not have capacity and capability to meet the challenges facing health and social care £10bn annual spend with largely unmeasured outcomes Lack of robust data, tariffs and currencies Large variation in quality, care pathways, productivity, costs and activity Infrastructure outdated - technology, buildings, workforce Confusing referral routes, lack of awareness of what’s available Limited dissemination, adoption and adaption of innovative services Rising demands over the next ten years A 31% increase in people over the age of 65 15 million people with chronic long term conditions, and increasing Rising obesity rates amongst children, storing up longer term chronic health conditions Now – in a financially difficult climate, with hospital and social care systems under pressure and growing consumer expectations.

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What are AHPs at DH doing to help the workforce with this challenge ? AHP Leadership Challenges AHP Referral to Treatment Project Service Improvement Project Transforming Community Services

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AHP Leadership Challenges To develop leadership skills in order to improve the effectiveness of health services and social care Empowerment of AHPs to transform health care and social care delivery;talent spotting & succession planning To expand AHP participant’s comfort zones and broaden horizons To explore future opportunities, career – wise To demonstrate existing skills and future potential of AHPs in positions of leadership, at all levels, to senior leaders

6

AHP Referral to Treatment Project A framework to make clinically sound decisions for clock starts and stops to measure waiting times. Underlying principle that patients should receive excellent care without unnecessary delay ; to recognise bottle-necks, understand why the delays have developed, remove them and so, speed access to service delivery. Enable services to understand their waiting times, and the benefit of their interventions, provided in a timely manner, by a competent staff member.

7

AHP Referral to Treatment 11 pilot sites, initially, involved in the project Voluntary AHP RTT collection from April 2010 No national target attached to RTT pathway Relevant to AHPs delivering NHS funded, non-medical consultant led services

8

Service Improvement Project To deliver sustainable service improvement in a diversity of AHP services. To evidence the maintenance or improvement of quality in relation to effectiveness, safety and the service user experience To develop sustainable methods for managing data (Referral to Treatment) To disseminate learning from the project to support capability of AHP services to deliver service improvement

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Service Improvement Offer 30 AHP services selected To use service improvement techniques to directly reduce waiting times – driving up standards remains a priority (Revised Operating Framework.2010/11) To make strategic alliances to ensure that service improvement delivers transformation – joint planning and commissioning locally, is crucial (R.O.F.11/12) To challenge each AHP service to think innovatively To stretch ambitions to reduce waits and improve quality

10

Transforming Community Services Consistently excellent and personalised services for people High Quality Care Enabled staff to lead transformation Empowered communities that achieve best health outcomes Improving Services Developing People Reforming Systems

11

Ambition: ‘Improving Services and Developing People’ Transformational Guides for Health and Well being Children, Young People and Families Long Term Conditions Acute Care Closer to Home Rehabilitation End of Life Care Measuring Quality of Services, Safety, Evidence and Effectiveness, Service Users Experience Ambition Action Achievement

12

Ambition 1: Getting Basics Right – Every Time Constant themes Information Partnership Equipment Safeguarding Business and commissioning skills Health, well being and reducing inequality Action – What community practitioners and leaders told us needed to be in place to deliver high quality services Get basics right, for example timely provision of equipment. Make the evidence available

13

Ambition 2 & 3: Making Everywhere As Good As the Best Know about local health need and plan services to improve outcomes Create effective health and care partnerships Implement new services/approaches Access and Availability Care Planning/Case Management Information and Technology Education and Training Action: changes where there is research evidence and/or professional consensus that changes are required, has a high impact on improving quality Support innovation and provide information Make all as good as the best including…

14

Health promoting practitioners Clinical innovators Professional partners Entrepreneurial practitioners Leaders of service transformation Champions of clinical quality Ambition 4: Transformational Practitioners and Inspiring Leaders – 6 transformational attributes

15

A Strategy for Quality Framework Improvement Quality is defined across three dimensions The Seven Steps of Quality Bring clarity to quality Measure quality Publish quality performance Recognise and reward quality Provide leadership for quality Safeguard quality Stay ahead SAFETY PATIENT EXPERIENCE EFFECTIVENESS

16

A Strategy for Quality Improvement Taken together, the Seven Steps should: Bring further understanding to the meaning of quality: NICE Standards, assured indicators and evidence. Make it easier to find evidence and to publicise information about the quality of services, improving accountability – what about your services? Support clinicians, practitioners and services to focus on quality improvement, moving from valuing what we measure to measuring what we value. Align business processes with quality outcomes, providing the incentives for continuous improvement .

17

QIPP challenges & opportunities for AHPs from the Coalition Agreement and the Revised Operating Framework 2010 - 2011 Reduce duplication and un-necessary management costs and ensure resources diverted to front-line care Strengthen power of GPs as patients’ expert guides, by enabling them to commission care on their behalf – joint working crucial. Develop a 24/7 urgent care service in every area of England, including GP out-of-hours services. Make NHS work better by extending best practice on improving discharge from hospital, and where possible, enabling community access to care and treatments Help elderly people live at home for longer

18

Transforming Community Services – Coalition Agreement (cont) Give front-line staff more control of their working environment so that the workforce can use their professional judgement in their patients’ best interests Publish data about the performance of healthcare providers online, to help patients make informed choices Put patients in charge of making decisions about their care, including control of their health records Continuous improvement of the quality of services to patients, involving independent and voluntary providers Focus on services to military veterans Local implementation of the National Dementia strategy Commissioning pack development – cardiac rehabilitation, then possibly dementia, diabetes, chronic obstructive pulmonary disease, end of life care, stroke rehabilitation

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Allied Health Professional’s (AHP’s) involvement is important , OTs as integrators of care are vital, because… AHPs, - OTs – YOU - increasingly, have the confidence and competence to lead the re-design, transformation and delivery of services, supported & enabled by the 4 projects described. AHPs are well placed to use the enablers of innovation and prevention in order to deliver the answers to the Quality and Productivity challenge. We have the opportunity to provide clinical leadership, advice and relevant expertise to the future delivery of health & well-being services

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Thank you for listening… Useful web - sites www.dh.gov.uk/tcs www.dh.gov.uk/chpo www.evidence.nhs.uk http://www.cot.co.uk/Homepage/Library_and_Publications/Occupational_Therapy_News_(OTnews)/Latest_features_from_OTnews/ E-mail [email_address]

More Related Content

The Quality and Productivity Challenge : AHPs at DH

  • 1. The Quality and Productivity Challenge : AHPs at DH Jo Partington, AHP Lead, Transforming Community Services. Occupational Therapy Conference. Brighton 2010.
  • 2. An acronym that’s here to stay…… Q uality I nnovation P roductivity P revention = > Quality and Productivity Challenge
  • 3. The backdrop….. Services do not have capacity and capability to meet the challenges facing health and social care £10bn annual spend with largely unmeasured outcomes Lack of robust data, tariffs and currencies Large variation in quality, care pathways, productivity, costs and activity Infrastructure outdated - technology, buildings, workforce Confusing referral routes, lack of awareness of what’s available Limited dissemination, adoption and adaption of innovative services Rising demands over the next ten years A 31% increase in people over the age of 65 15 million people with chronic long term conditions, and increasing Rising obesity rates amongst children, storing up longer term chronic health conditions Now – in a financially difficult climate, with hospital and social care systems under pressure and growing consumer expectations.
  • 4. What are AHPs at DH doing to help the workforce with this challenge ? AHP Leadership Challenges AHP Referral to Treatment Project Service Improvement Project Transforming Community Services
  • 5. AHP Leadership Challenges To develop leadership skills in order to improve the effectiveness of health services and social care Empowerment of AHPs to transform health care and social care delivery;talent spotting & succession planning To expand AHP participant’s comfort zones and broaden horizons To explore future opportunities, career – wise To demonstrate existing skills and future potential of AHPs in positions of leadership, at all levels, to senior leaders
  • 6. AHP Referral to Treatment Project A framework to make clinically sound decisions for clock starts and stops to measure waiting times. Underlying principle that patients should receive excellent care without unnecessary delay ; to recognise bottle-necks, understand why the delays have developed, remove them and so, speed access to service delivery. Enable services to understand their waiting times, and the benefit of their interventions, provided in a timely manner, by a competent staff member.
  • 7. AHP Referral to Treatment 11 pilot sites, initially, involved in the project Voluntary AHP RTT collection from April 2010 No national target attached to RTT pathway Relevant to AHPs delivering NHS funded, non-medical consultant led services
  • 8. Service Improvement Project To deliver sustainable service improvement in a diversity of AHP services. To evidence the maintenance or improvement of quality in relation to effectiveness, safety and the service user experience To develop sustainable methods for managing data (Referral to Treatment) To disseminate learning from the project to support capability of AHP services to deliver service improvement
  • 9. Service Improvement Offer 30 AHP services selected To use service improvement techniques to directly reduce waiting times – driving up standards remains a priority (Revised Operating Framework.2010/11) To make strategic alliances to ensure that service improvement delivers transformation – joint planning and commissioning locally, is crucial (R.O.F.11/12) To challenge each AHP service to think innovatively To stretch ambitions to reduce waits and improve quality
  • 10. Transforming Community Services Consistently excellent and personalised services for people High Quality Care Enabled staff to lead transformation Empowered communities that achieve best health outcomes Improving Services Developing People Reforming Systems
  • 11. Ambition: ‘Improving Services and Developing People’ Transformational Guides for Health and Well being Children, Young People and Families Long Term Conditions Acute Care Closer to Home Rehabilitation End of Life Care Measuring Quality of Services, Safety, Evidence and Effectiveness, Service Users Experience Ambition Action Achievement
  • 12. Ambition 1: Getting Basics Right – Every Time Constant themes Information Partnership Equipment Safeguarding Business and commissioning skills Health, well being and reducing inequality Action – What community practitioners and leaders told us needed to be in place to deliver high quality services Get basics right, for example timely provision of equipment. Make the evidence available
  • 13. Ambition 2 & 3: Making Everywhere As Good As the Best Know about local health need and plan services to improve outcomes Create effective health and care partnerships Implement new services/approaches Access and Availability Care Planning/Case Management Information and Technology Education and Training Action: changes where there is research evidence and/or professional consensus that changes are required, has a high impact on improving quality Support innovation and provide information Make all as good as the best including…
  • 14. Health promoting practitioners Clinical innovators Professional partners Entrepreneurial practitioners Leaders of service transformation Champions of clinical quality Ambition 4: Transformational Practitioners and Inspiring Leaders – 6 transformational attributes
  • 15. A Strategy for Quality Framework Improvement Quality is defined across three dimensions The Seven Steps of Quality Bring clarity to quality Measure quality Publish quality performance Recognise and reward quality Provide leadership for quality Safeguard quality Stay ahead SAFETY PATIENT EXPERIENCE EFFECTIVENESS
  • 16. A Strategy for Quality Improvement Taken together, the Seven Steps should: Bring further understanding to the meaning of quality: NICE Standards, assured indicators and evidence. Make it easier to find evidence and to publicise information about the quality of services, improving accountability – what about your services? Support clinicians, practitioners and services to focus on quality improvement, moving from valuing what we measure to measuring what we value. Align business processes with quality outcomes, providing the incentives for continuous improvement .
  • 17. QIPP challenges & opportunities for AHPs from the Coalition Agreement and the Revised Operating Framework 2010 - 2011 Reduce duplication and un-necessary management costs and ensure resources diverted to front-line care Strengthen power of GPs as patients’ expert guides, by enabling them to commission care on their behalf – joint working crucial. Develop a 24/7 urgent care service in every area of England, including GP out-of-hours services. Make NHS work better by extending best practice on improving discharge from hospital, and where possible, enabling community access to care and treatments Help elderly people live at home for longer
  • 18. Transforming Community Services – Coalition Agreement (cont) Give front-line staff more control of their working environment so that the workforce can use their professional judgement in their patients’ best interests Publish data about the performance of healthcare providers online, to help patients make informed choices Put patients in charge of making decisions about their care, including control of their health records Continuous improvement of the quality of services to patients, involving independent and voluntary providers Focus on services to military veterans Local implementation of the National Dementia strategy Commissioning pack development – cardiac rehabilitation, then possibly dementia, diabetes, chronic obstructive pulmonary disease, end of life care, stroke rehabilitation
  • 19. Allied Health Professional’s (AHP’s) involvement is important , OTs as integrators of care are vital, because… AHPs, - OTs – YOU - increasingly, have the confidence and competence to lead the re-design, transformation and delivery of services, supported & enabled by the 4 projects described. AHPs are well placed to use the enablers of innovation and prevention in order to deliver the answers to the Quality and Productivity challenge. We have the opportunity to provide clinical leadership, advice and relevant expertise to the future delivery of health & well-being services
  • 20. Thank you for listening… Useful web - sites www.dh.gov.uk/tcs www.dh.gov.uk/chpo www.evidence.nhs.uk http://www.cot.co.uk/Homepage/Library_and_Publications/Occupational_Therapy_News_(OTnews)/Latest_features_from_OTnews/ E-mail [email_address]

Editor's Notes

  1. I