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Sustainability Update – November 2017

Pound coinsHow are we doing?
We are now half way through the 2017/18 financial year and our Sustainability Programme continues to perform well. By the end of September, we had planned to save £5m and we have actually saved £7.2m – £2.2m better than originally expected.

All divisions have achieved their savings plan for September 2017:

  • Medicine: saved £302,000 against a plan of £267,000
  • Surgery: saved £364,000 against a plan of £364,000
  • Core Clinical Services: saved £57,000 against a plan of £57,000
  • Women and Children’s: saved £170,000 against a plan of £94,000
  • Estates: saved £76,000 against a plan of £68,000
  • Corporate: saved £126,000 against a plan of £77,000

This is a fantastic achievement and testament to the hard work of all of our staff so thank you. We can’t take our foot off the gas though. The majority of the savings so far have been one off savings and we now need to have a real focus on finding more savings that are recurrent, i.e. bring savings year on year.

We have six months left in this financial year to do all we can to make bigger, faster changes and improvements that most importantly, improve patient safety and quality but also save money. A good example of this is the work to reduce clinical variation across the Trust. If we treat every patient the same way regardless of which hospital of ours they are in, it will improve the outcome for the patient which is our main aim but it will also save money and valuable staff time.

If you have any ideas of areas that will help us achieve this, please let us know.

FOCUS ON…Core Clinical Services Division
Focus
Last month, we told you all about the work that the Estates Division was doing to improve their services and meet their Cost Improvement Programme (CIP) target. This month, we’re focusing on the Core Clinical Services (CCS) Division.

Core Clinical Services is a diverse division that includes many services, such as:

  • Pathology: phlebotomy, haematology, histopathology, biochemistry, microbiology and mortuary
  • Imaging services:  x-ray, CT, MRI, nuclear medicine, ultrasound, fluoroscopy, breast screening and symptomatic mammography, and medical illustration
  • Pharmacy
  • Allied Health Professionals: nutrition and dietetics, occupational therapy, physiotherapy and orthotics
  • Medical engineering
  • Outpatient services
  • Patient access management: Patient Contact Centre (CPCC) and medical records

The teams in CCS delivered £1.8m of savings against a target of £1.5m. This year, their target has increased to £2.522m and some of the things they are working on include: 

Musculoskeletal clinical pathway redesign
This is an Allied Healthcare Professional (AHP) led project that will see the launch of a Physiotherapist-led Musculoskeletal service. After triage, patients referred to an orthopaedic consultant with musculoskeletal issues will be referred directly to an Extended Scope Practitioner in Physiotherapy, who will assess the patient and ensure they received the most appropriate treatment.

It is expected that 50% of these patients triaged will be seen by a MSK physiotherapist for treatment. This will reduce the number of appointments patients have to attend before receiving appropriate treatment by the correct health care professional, which is best for the patient and frees up staff to see more patients. The teams are currently being recruited to and the service is expected to be live from early 2018.

Reducing Pharmacy drug efficiencies
tablets
A number of projects are currently underway to reduce waste, including a new process for ordering drugs and stock control and the continuous monitoring of expired drugs. This allows pharmacy staff to identify themes and patterns and make appropriate changes to clinical practice or the stocked items where necessary. We are also reviewing how patients’ own medications are managed
and how we manage controlled drugs within the Trust.

Oncology medications are often very high cost, with some costing up to £5,000 per treatment. Projects within pharmacy have seen a reduction in waste of these drugs through the way they are prescribed, prepared and dispensed. High cost drugs are also now prescribed in line with NICE guidance to ensure they are being used appropriately.

Sexual health testing
Our Pathology service was successful in winning a tender to deliver sexual health laboratory testing for Sexual Health Services in the south of the country – which went live on 31 October 2017. To ensure this service is provided to a high quality and is safe and efficient, new state of the art sexual health testing analysers and equipment have been purchased, as well as recruiting more staff.

This new service provides the opportunity of additional services, such as bringing back sexual health testing which is currently outsourced. It also will allow us to provide improved testing and the variety of test available which puts us in a great position for providing the service to other areas. This all brings in additional income for the Trust.

Medical equipment
Do you know what happens to medical equipment that is no longer of use within the Trust? Our medical engineering teams resell some of this equipment or materials at auction, which brings in additional income back into the Trust.

You said, we did:
As with previous months, below are some update on suggestions we’ve had from staff in recent months – this time, specifically about procurement:

  • Buying the same brand of tea and coffee: Staff asked why different areas were buying different brands of tea and coffee. As a result, the Procurement Team identified one brand which means we only order that one brand now, saving money.
  • Ordering direct from suppliers: We were asked why we don’t order directly form the suppliers where we can as it is more cost effective. We now do this where possible, for example, we now buy laryngoscopes direct from the supplier.
  • Prices on products in store rooms: Staff suggested we include prices on products in stock rooms so staff become aware of how much things cost. We have now launched the ‘Traffic Light Support System programme’, developed by the Royal College of Nursing, NHS Supply Chain and the Clinical Procurement Specialist Network, which enables nurses to  identify which products are safest and where savings can be made.

 

How can you help?
We really need to continue to work hard in this latter part of the financial year to continue to make the improvements to quality and savings we need to. There are a few ways you can help and get involved:

  • Continue to share your good ideas. No idea is too small! If you have an idea or thoughts, contact the Programme Management Office (PMO) on Mailbox@mbht.nhs.uk.
  • Don’t just think inside the Trust. If there are things we can do differently across the Bay with our Bay Health and Care Partners, let us know.
  • You may be aware that teams across the Trust have started planning for 2018/19 so we need the efforts of everyone at all levels and roles to get involved and help finalise these plans before Christmas
  • Treat our Trust’s money as if it was your own and only order things that bring real to your department and the Trust. Every penny counts!
  • Always look for waste (inefficiencies). Identifying and eliminating waste allows you to provide safer, better quality service and care, which is better for patients and staff, and is also more cost effective. If you need help identifying waste, you can use the below Waste Wheel tool, or contact the PMO who can help you use a number of different tools and techniques for identifying waste

Waste wheel

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