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4.3 productivity & efficiency framework nhs tayside & scottish government
1. NHS Efficiency and Productivity Framework
Stephen Gallagher
Deputy Director for Health Performance
Gerry Marr
Chief Executive, NHS Tayside
Changing the World
Improvement Conference
24 November 2011
5. Prescribing – Variation in per
capita FHS drug expenditure
250
£ spend per head adjusted for
200
150
need
Series1
100
50
0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
NHS Board
6. How?
• A Single Portfolio
• Leadership and buy-in from NHS Chief
Executives
• Efficiency Portfolio Board
• 6 Work-streams supported by a
transformational narrative 20/20
7.
8. Linked to Performance
• Agreement that EPB identifies, tests and
champions priorities
• Actions enabled by Quality & Efficiency
Support Team (QuEST)
• Boards challenged to adopt or justify
• Annual Plans set out in Local Delivery
Plans
• Tailored Performance Support available
9. Tailored Performance Support
• Leadership, Governance, Grip
• Productive Opportunities identified through
Whole Systems Data Analysis
• Support for specific local schemes
10. The 3-step Improvement Framework for
Scotland’s public services
Macro system –
1) Change Vision, aim and context.
the
world
Meso system –
Culture, capacity
And challenge.
How much and by
2) Create the conditions
when?
Micro system –
Implementation, measur
3) Make the improvement ement and improvement
11. 2009 - 2011
TACTICAL STRATEGIC
PRODUCTIVITY & SERVICE
EFFICIENCY OPTIMISATION
CRES TRANSFORMATION
DEALING WITH SPENDING THE 95%
THE 5% BETTER
12. 2010 - 2013
TACTICAL STRATEGIC
PRODUCTIVITY & SERVICE
EFFICIENCY OPTIMISATION
CRES TRANSFORMATION
DEALING WITH SPENDING THE 95%
THE 5% BETTER
13. Steps to Better Healthcare
Mental Out Theatre Workforce Integrated Child Optimisation Prescribing Other
Health Patients Capacity / care health of Health and
Planned communities Facilities Medicines Labs
Care across Maternity
Tayside
Scenario Planning, Financial Baselines, Benefits Tracking, Business Finance Support
Cases
Workforce Modelling, Engagement & Communications with staff Workforce Support
Communications with public and staff Comms Support
Organisational Effectiveness support OE Support
14. 2010 - 2012
TACTICAL STRATEGIC
Case management –
Prevention of admission improved pathways
Improved Day care Intermediate care
Improved service liason and Care home interface
discharge Medications reviews
Reduced hospital stays and Housing/home care support
bed days Technologies
Maximise Community
hospitals
Virtual wards
Workforce redesign
Cost minimisation Self care and enablement
Workforce efficiencies New models of care in
Teleheath/telecare dementia, falls, end of life
care
DEALING WITH SPENDING THE 95%
Working with communities -
THE 5% coproduction
BETTER