This document discusses the challenges of implementing 7-day services in the East Midlands region from the perspective of the Chief Executive of Chesterfield Royal NHS Foundation Trust. It provides details of Chesterfield's experience with 7-day services initiatives through their work with HFMA, the East Midlands Senate, and collaborative programs. It also summarizes the results of HFMA costing analysis which found that meeting all 7-day standards would require a gross investment of £3.8 million but could result in £1.7 million in savings from reduced lengths of stay. Local schemes at Chesterfield focusing on areas like acute re-ablement and transitional care wards have already achieved over half a day per medical admission.

1. Understanding the Challenge for the
East Midlands
Gavin Boyle
Chief Executive
Chesterfield Royal
NHS FT

2. A Chief Executive’s Perspective
• It’s the right thing to do
• Hard wired into the ‘system’ e.g. regulators,
contracts etc.
• Not just hospitals

3. The Chesterfield Experience
• Early HFMA work
• NHS IQ National Pilot
• EM SCN & Senate
• Working Together – S. Yorks.

4. HFMA - Costing Workstream
• 1 of 8 trusts involved in Finance workstream of 7 Day
Service Forum – HFMA
• Fieldwork Summer 2013 (Emergency and Urgent Services +
Supporting Diagnostics)
• Not currently meeting all standards Mon-Fri e.g. time to first
consultant review.
• Main cost driving standards
• Standard 2 - Consultant Time to Review
• Standard 3 – MDT Review
• Standard 5 – Diagnostics
• Standard 8 – On-going Review (daily consultant ward rounds)

5. HFMA - Potential Costs
• Pilots – £1.4m investment =
£1.7m Saving (reduced
LOS)
• Gross Investment of £3.8m (
to meet all standards)
• This is equivalent to 2.9%
of Pay bill
• Or 2.0% of patient care
income
0
10
20
30
40
50
60
70
wte's
Other
Therapies
Nursing
Radiology

6. Our Local Schemes
• Successful pilots made recurrent with 7 day services
as a key theme:
• Acute Re-ablement Unit (Frailty Unit)
• Transitional Care Ward – including Social Care
Workers
• Senior Clinical Decision Makers – increased
presence
• Therapy and Diagnostic Services
• Primary Care support co-located with ED
• Over half a day per General Medicine NEL spell
already achieved >9000 bed days circa £1.7m

7. 7 Day Collaboration
• North Derbyshire – NHSIQ National Pilot
• East Midlands SCN & Senate (10 Acute Trusts)
• NHS IQ self–assessment tool
• Data Collection
• Case note audit
• Service level interviews
• South Yorkshire – Working Together Programme
• Smaller specialities e.g. Ophthalmology,
ENT, OMFS
• Radiology