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Sustainability update – September 2017

How are we doing?

The hard work and dedication of our teams across the Trust meant that at the end of July 2017, we over achieved our planned savings for this point in the year by an impressive £1.6m! Some of this over achievement was through one-off benefits which don’t give us long-term savings but they do make an impact so thank you!

Although this is positive, we still have a long way to go if we are going to deliver our Cost Improvement Plan (CIP) target of £17.4m by the end of this financial year. Therefore, we still need your help in identifying opportunities where we can make savings and thinking twice before committing to spending money where possible.

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Focus on…

Women and Children’s Division

Staff from across our hospitals are working together to turn their ideas into action so to help give you an idea of what kind of schemes are being worked on, we are going to focus on different areas in each monthly update. This month, we’re focusing on the Women and Children’s (WACS) division and examples of what they are working on.

As with all our Divisions, WACS understands that reducing costs does not need to mean reducing the quality of care we offer. They have seen opportunities to use advanced clinical technology, the reduction of clinical variation, increased efficiency by streamlining processes and just good general housekeeping as ways they can reduce costs, offer better care to women and families and make it easier for staff to work effectively. WACS delivered their

target of £12m last year, and this year, their target has increased to £1.757m. Some of the things they are working on to achieve that include:

Hysteroscopic outpatient procedures

outpatient.jpgCurrently, women who have symptoms due to uterine polyps attend for an outpatient diagnostic hysteroscopy and are likely be listed for surgery with a general anaesthetic. This requires the woman to return for pre-operative assessment and a day case procedure. A new service is being led by the consultant team at FGH, which will enable them to diagnose the polyps and immediately remove them in clinic using a maceration technique. The woman will attend for only one appointment and will recover more quickly.

Clinical testing and training in the new equipment is underway and the service will be operational at FGH from January 2018. The project will then be launched at the RLI. This project is a great example of how we can deliver better patient care at lower cost, and most importantly, the new equipment makes the procedure safer and more effective. It also reduces the costs to the Surgery and Critical Care Division as there will be a reduced need for theatre sessions and anaesthetic time.

Children and Young People’s Outpatient Services

childrens.jpgIn Children and Young People’s services, a review of outpatient clinics has made it clear that new approaches need to be taken to manage patients closer to home and more effectively. Nationally, high DNA (Do Not Attend) rates are a common feature of hospital Paediatric outpatient clinics.

The team has introduced a new electronic booking system that allows easier and faster booking of outpatient’s appointments in hospital and in the community. Not only will the new system bring us in line with national standards, it will also save time for clinical staff that can be redirected into direct clinical care.

Changes to the induction of labour procedure

For women who are late in delivering their first baby and are fit and well, it is possible to use a pessary instead of intravenous medication to induce labour. This option is being looked at for appropriate women using our maternity services. The benefits of this approach are that the woman requires less intimate examinations to be conducted, the labour is less painful and labour can progress more quickly. The financial savings in this project are small but any project that improves the care we offer, frees up staff time and reduces the amount of time a patient is in our hospital can have a cumulative effect on the efficiency of the care we deliver and therefore, cost less.

You said, we did

Thank you to those that took the time to feedback to us after the last update and via Team Talk. There were some really good suggestions on how we could save money or valuable staff time, and we wanted to update you on where we are with a couple of them:

  • Scan / MRI forms with yellow dots: We received feedback that sometimes, there are delays in CT scans and MRI scans being carried outbecause the yellow stickers which highlight it is an urgent test, are not being placed on the test request forms. This wastes time for patients and staff and can have a financial impact due to diagnostic wait time targets. Since the feedback, the Radiology team is working with other colleagues to determine what can be done to make it mandatory when electronically requesting a scan to mark whether it is urgent or not.
  • Oncology drugs: Staff fed back that some bespoke oncology drugs that may no longer be needed by the patient cannot be returned to Pharmacy as there is no guarantee it has been stored in a fridge. Instead, they are disposed of. Since the feedback, the Pharmacy team is working with Oncology to understand the reasons why bespoke treatments prepared were no longer required so that they can explore what system would be required to ensure the safety and cold chain integrity for any products not used.

How can you help?

The simplest thing you can do to help is to treat our Trust’s money as if it was your own. Ask yourself and your team before committing to spend – “What benefit will this bring to the department and the Trust?” If the answer is none, don’t order it!

We are also still on the lookout for ideas on how we can make further savings and improve services for patients. No idea is too small! If you have an idea or thoughts, contact the Programme Management Office (PMO) on PMO.Mailbox@mbht.nhs.uk.

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