Presented by Cheryl Coppell
Minutes:
Cheryl Coppell gave a presentation which provided the Board with an overview of the current BHRUT health economy.
The overriding message was that BHRUT was making positive strides forward. A new team at BHR had been implementing plans for productivity improvements with a focus on ensuring that such plans were consistent, complimentary, measured and performance managed across the system and that financial targets were reconciled.
The presentation identified specific pressures in the system. Whilst improvements had brought in additional monies (£87.4) this also brought additional burdens. For instance, it was critical that some of the short term initiatives in the winter resilience programme did not impact upon more long term plans which BHRUT was operating.
Similarly, there was a significant pressure in the system based on demand, with acute pressure experienced in A&E attendance rates which were up 4.4% from the previous year. This was however within commissioned activity levels which allowed a 4% rise for demography. In addition, more work would be required to reduce the average length of stay in hospital despite BHR having one of the best DTOC performances in London.
Leadership and clinical resources were also identified as a current pressure. BHRUT had only recently fully recruited its leadership team and as such it would require time before it became fully functional. The Trust was also experiencing a shortage in A&E consultants. And finally, citizen satisfaction remained low across the system despite high satisfaction in the new care in the community initiatives.
There were however significant opportunities across the system, these included:
· A strong high level buy-in of local system leaders
· A new management team at BHRUT which had identified real productivity and management issues and increased communication with stakeholders
· Non-recurrent funding approved to test initiatives
· All Better Care Fund plans had been approved in the second highest category
· An opportunity to accelerate and prioritise demand management activity in order to tackle the financial deficit
Moving forward, a number of key recommendations were made. Critically, BHRUT delivery needed to be focused around one overarching programme plan. This would enable individual initiatives to be linked together to focus on whole system demand, dependencies to be understood, resources prioritised and the planned source of efficiency and transformational savings made much clearer and transparent.
In addition, clinical ownership of change needed to be strengthened as delivery intensified with the attraction of a mass of clinicians central to this. Also, there needed to be continued strengthening of the relationships between primary, secondary and community care clinicians.
Such key recommendations had been encapsulated into a 5 year delivery strategy. This would enable the reprioritisation of resources, the reconfiguration of services and the commissioning / decommissioning of services to ensure that overall objectives were met.
In the short term, it was explained that the focus was on reviewing critical areas for system delivery through plan alignment. It was suggested that this could be best delivered through a series of strategic workshops.
Mrs Coppell was thanked for delivering a useful and informative presentation.