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Chief Operating Officer Lesley McLay, 13th April, 2012 Operational Unit Operational Unit is responsible for delivery of all services across NHS Tayside, which include Acute; Community and Primary Care and Mental Health. NHS Tayside in numbers: • • • • • 400,000 population 74 services 23 main sites 14,000 staff £700 million total revenue budget Breakdown of activities & sites Services Arts Therapy Accident & Emergency Histopathology Blood Borne Virus Managed Care Network Adult Learning Disability Services Homeopathy The Centre for Brain Injury Rehabilitation Adult Mental Health Services Infectious Diseases Community Nursing (HIV) Area Clinical Psychology Service Intensive Care Unit The Corner Breast Screening Maternity Services DARTS Diabetes Audit & Research in Scotland Breast Surgery Medicine for the Elderly Dental Cancer Medicine Neurology and Stroke Dundee Midwifery Unit Cardiovascular & Coronary Care Unit Neurosurgery The East of Scotland Research Ethics Service Child Health Occupational therapy Health Protection Clinical Haematology Ophthalmology Brechin Infirmary Keep Well Clinical Oncology Oral and Maxillofacial Carseview Neurological Sciences Clinical Radiology Orthopaedic Electives Crieff Community Hospital Pre-School Orthoptic Vision Screening (POVS) Community Dental Services Orthopaedic Trauma Dundee Dental Hospital Out of Hours Community Health Services Pharmacy Primary Care Services Dermatology Physiotherapy Public Health Diabetes and Endocrinology Plastic Surgery Respiratory Managed Clinical Network Emergency Medicine Psychiatry of Old Age Services Sexual Health Services Endoscopy Regional Vascular Service Smoking Cessation ENT Renal Unit Perth Royal Infirmary Specialist Palliative Care Family Planning Services Respiratory Royal Dundee Liff Hospital Tayside General Practices Forensic Psychiatry Services Rheumatology Royal Victoria Hospital The Wolfson Hyperbaric Medicine Unit Gastro-intestinal Medicine Speech and language therapy Roxburghe House, Dundee General Adult Psychiatry Services Substance Misuse Services St Margaret's Hospital, Auchterarder General Surgery Tayside Rehabilitation Engineering Services Genetics Theatres and Anaesthetics High Dependency Unit Urology Key Locations Aberfeldy Community Hospital Arbroath Infirmary Armistead Child Development Centre Ashludie Hospital Blairgowrie Community Hospital Dundee Midwifery Unit Pitlochry Community Hospital Little Cairnie Hospital Montrose Royal Infirmary Murray Royal Hospital Ninewells Hospital Stracathro Hospital Strathmartine Hospital Whitehills Health and Community Care Centre Young People's Unit Operational Unit Management & Governance •Integrated Clinical Leadership and General Management model •Devolved Management structure •Fortnightly meetings of Executive Management Team •Bi-monthly Performance Review Meetings Lesley McLay Chief Operating Officer Directorates CHPs Operations Functions Medicine David Johnston AMD Gillian Costello AND Carol Goodman GM Perth & Kinross Bill Nicoll GM Morag Martindale CD Gilliam Costello AMD Workforce George Doherty Director Janice Torbet ADW Surgery John Colvin AMD Evelyn Fleck AND Audrey Warden GM Dundee David Lynch GM David Dorward CD Eileen McKenna AMD Finance Colin Masson Director Access Alan Cook AMD Eileen McKenna AND Lorna Wiggin GM Angus Susan Wilson GM Evelyn Fleck AND vacancy eHealth Ian Fenton Director Operations Ken Armstrong Director Operational Unit Priorities • Productivity and Efficiency • Clinical Quality • Whole System Integration • Performance Management • Facilities Management Operational Unit Priorities Productivity and Efficiency • Sickness Absence Management • Staff eRostering • Service Capacity Review Clinical Quality • Clinical Governance Review • Clinical Strategy Development Whole System Integration • Health & Social Care Integration • Prisoner Healthcare integration • 24/7 day service Performance Management • Complaints Redesign • Business Unit establishment • Performance Dashboards • National and Local Access Targets e.g. 18 weeks RTT Facilities Management • Facilities Optimisation Steps to Better Health Care Programme • • • • • Triple Aim Transformational Change Model- 95:5 Measures for Improvement Aligned to LDP and Strategic Financial Plan Clinically Lead Steps to Better Health Care Triple Aim Health of the Population Experience of Care Best Value for Money Steps to Better Health Care 2010 - 2013 Transition 2011-2013 TACTICAL STRATEGIC PRODUCTIVITY & EFFICIENCY SERVICE OPTIMISATION CRES DEALING WITH THE 5% TRANSFORMATION SPENDING THE 95% BETTER Steps to Better Health Care 2012/2013 Plan TRANSFORMATIONAL PROGRAMMES •Mental Health Integrated Community Services Palliative Care Services PROGRAMMES ALIGNED WITH STRATEGIC FINANCIAL PLAN Clinical Improvement & Productivity Electronic Patient Record Outpatients Clinical Benchmarking Patient Pathways Low Impact Interventions eRostering Releasing Time to Care Workforce Review Supplementary Pay Review Absence Drugs & Prescribing Medicines Leadership Estates & Facilities Realignment of Services Optimising Healthcare Facilities Appendix 1. Strategic Aims Steps to Better Healthcare underpins all NHS Tayside Strategic Aims, which are as follows: • Contribute to closing the health inequalities gap within a generation • Improve healthy life expectancy by supporting people to look after themselves • Ensure that services meet agreed quality standards, especially patient experience • Be cost effective in all decisions, actions and services Appendix 2. Operational Unit Directorate – Key Parameters Operational Unit Surgical Directorate Directorate Surgical Leadership team Audrey Warden General Manager John Colvin Associate Medical Director Gillian Costello Associate Nurse Director Scope The Directorate provides OP, IP, DC and emergency services for the following: General Surgery Breast surgery Paediatric Surgery Urology Orthopaedics & Trauma (TRES) Anaesthetic Services & Assessment (APA) Critical Care Services (ICU & HDU) Pain Services Theatres Nephrology Services Oncology and Acute Palliative Care Haematology Pathology Regional Plastics Service Oral Maxillofacial Surgery Neurosciences Genetics Ophthalmology ENT Surgery Audiology Dermatology & Photobiology Regional clinical networks: East of Scotland Breast Screening Service East of Scotland Vascular Network East of Scotland Upper GI Network Staff numbers Budget Key activities Key outputs 2300 WTE £131M. To provide a robust model for Clinical Governance, Quality and Clinical Effectiveness Optimise Productivity and Efficiency promoting transformational change Co-ordinate and manage the functions within the allocated resources Provision of integrated care pathways for patients in NHS Tayside with clear lines of joint working arrangements ; Establishing strong clinical structures to support integrated way of working and shift the balance of care and resources National performance indicators & Waiting Times and Cancer guarantees. Improved patient outcomes. Genetics. Services that consistently meet recognised quality standards Improved patient experience of services Efficient & effective use of allocated funding and resources within the Surgical Directorate Optimise Productivity and Efficiency 18-week RTT targets as per HEAT Cancer targets 62 day and 31 day Establish Day Surgery as the ‘norm’ Infection control reducing infection. Promote care in local communities and people’s homes Clinical Strategy for Genetics, in line with the National Genetics vision Operational Unit Medicine Directorate Directorate Medicine Leadership team Scope Staff numbers Budget Key activities Carol Goodman GM David Johnston AMD Evelyn Fleck AND All adult in patient and outpatient medicine services:Acute Medicine/General medicine Medicine for the elderly Diabetes Cardiology (including intervention) Rheumatology Gastroenterology/Endoscopy Acute Stroke Respiratory medicine Infectious diseases Investigations unit - pan Tayside Emergency Department services- pan Tayside Out of Hours GP Service – pan Tayside All maternity services including hospital and community based provision- pan Tayside All Gynaecology services including surgery – pan Tayside Children's services including community paediatrics, child and adolescent mental health, children with complex needs, AHP services and Neonatal intensive care services– pan Tayside 2124 WTE £101M. Provision of inpatient care for all medical specialties for adults and children Antenatal, perinatal and post natal care and gynaecological sugical and medical care of women Provision of inpatient and outpatient care for all surgical and mental health specialties for all children Provision of Emergency dept services including Trauma team response service Key outputs Safe, effective high quality care for all patients Achieving HEAT targets and standards Providing a responsive service to meet need within the resource envelope available Operational Unit Access Directorate Directorate Access Leadership team Lorna Wiggin GM Alan Cook AMD Eileen McKenna AND Scope Diagnostic Services – labs, radiology and medical physics. Integrated Dental Services – CDS & Dental School SRTC & OP Perth / Angus Medical Records Business Unit Corporate portfolio – cancer, waiting times performance Staff numbers Budget 1476 WTE £59M Key activities Key outputs Provision. Of direct patient care services. High quality patient experience & care Provision of services which support the delivery of patient care. Fair /equitable / timely access to services Provision of information for improvement, performance & assurance Monitor and report on progress cancer, waiting times, data quality Governance assurance & performance management to CE /COO Staff engagement Data validation, analysis and reporting. Ensure best value Staff well being Operational Unit Community Health Partnerships Directorate Leadership team Scope Staff numbers Budget Key activities Key outputs Perth & Kinross Bill Nicoll GM Morag Martindale Clinical Director Gillian Costello AND All primary and community healthcare, mental health, drug and alcohol support for P&K population and prisoner healthcare 1047 WTE £106M. Integrated care delivery Partnership working Community Planning Early Years, Child development and protection, Health & well-being & equity, Anticipatory care, long term conditions, care at home, prevention of admission, care of the elderly, improving discharge, dementia care and palliative care Dundee CHP David Lynch GM Eileen McKenna AND David Dorward Clinical Director All primary and community healthcare, mental health, drug and alcohol support for Dundee population 1350 WTE £144M. Integrated care delivery Partnership working Community Planning Early Years, Child development and protection, Health & well-being & equity, Anticipatory care, long term conditions, care at home, prevention of admission, care of the elderly, improving discharge, dementia care & palliative care. Angus CHP Susan Wilson GM Evelyn Fleck AND 3 patient pathways: Adult Services, Child & Family Health; Mental Health. Services include Community Hospitals, Community Nursing Services, Psychiatry of Old Age, AHPs, Medicine for the Elderly, Palliative Care, Minor Illness & Injuries Units, 1400 WTE £50M. Partnership & Integrated Working; Community Medicine & Rehabilitation Service Redesign; Substance Introduction & development of See & Treat Service; PolyPharmacy Reductions; Dementia Liaison Team; Generic AHP workers; Programmes to support Long Term Conditions/Self Management Operational Unit Operations Directorate Directorate Operations Leadership team Ken Armstrong Director Scope To provide a wide range of Site/Support Services and key infrastructure in delivering ongoing improvement re patient care Staff numbers Budget 2000 WTE £60M. Key activities Site/Support Services Procurement spend £120M. Key outputs Provision of high quality catering, cleaning and portering services together with rapid and intelligent response to site “issues” Production Unit Clean equipment and linen as and when required Procurement & Logistics The right product at the right time in the right place Property Sustainable/fit for purpose accommodation Environmental Management “A greener environment” H & S/Fire Safety “A safer environment” Unlicensed Medicines Provision of niche medicines internal and external Appendix 3. Operational Unit Breakdown of activities & sites Breakdown of activities & sites Services Arts Therapy Accident & Emergency Histopathology Blood Borne Virus Managed Care Network Adult Learning Disability Services Homeopathy The Centre for Brain Injury Rehabilitation Adult Mental Health Services Infectious Diseases Community Nursing (HIV) Area Clinical Psychology Service Intensive Care Unit The Corner Breast Screening Maternity Services DARTS Diabetes Audit & Research in Scotland Breast Surgery Medicine for the Elderly Dental Cancer Medicine Neurology and Stroke Dundee Midwifery Unit Cardiovascular & Coronary Care Unit Neurosurgery The East of Scotland Research Ethics Service Child Health Occupational therapy Health Protection Clinical Haematology Ophthalmology Brechin Infirmary Keep Well Clinical Oncology Oral and Maxillofacial Carseview Neurological Sciences Clinical Radiology Orthopaedic Electives Crieff Community Hospital Pre-School Orthoptic Vision Screening (POVS) Community Dental Services Orthopaedic Trauma Dundee Dental Hospital Out of Hours Community Health Services Pharmacy Primary Care Services Dermatology Physiotherapy Public Health Diabetes and Endocrinology Plastic Surgery Respiratory Managed Clinical Network Emergency Medicine Psychiatry of Old Age Services Sexual Health Services Endoscopy Regional Vascular Service Smoking Cessation ENT Renal Unit Perth Royal Infirmary Specialist Palliative Care Family Planning Services Respiratory Royal Dundee Liff Hospital Tayside General Practices Forensic Psychiatry Services Rheumatology Royal Victoria Hospital The Wolfson Hyperbaric Medicine Unit Gastro-intestinal Medicine Speech and language therapy Roxburghe House, Dundee General Adult Psychiatry Services Substance Misuse Services St Margaret's Hospital, Auchterarder General Surgery Tayside Rehabilitation Engineering Services Genetics Theatres and Anaesthetics High Dependency Unit Urology Key Locations Aberfeldy Community Hospital Arbroath Infirmary Armistead Child Development Centre Ashludie Hospital Blairgowrie Community Hospital Dundee Midwifery Unit Pitlochry Community Hospital Little Cairnie Hospital Montrose Royal Infirmary Murray Royal Hospital Ninewells Hospital Stracathro Hospital Strathmartine Hospital Whitehills Health and Community Care Centre Young People's Unit