Transcript Slide 1
Local Healthcare
Now and in the
Future
(and AGM)
Welcome to The Princess Alexandra
Hospital Local Healthcare Event and
Annual General Meeting
“To deliver the best possible patient care
in a safe, reliable, effective
and respectful environment”
Who We Are and What We Do
2995 people work to provide a range of safe and reliable hospital services
to a local population of 258,000. Responding to local need and accountability
by becoming an NHS Foundation Trust.
DID YOU KNOW?
• Good rating for quality of services
• 86,000 emergency attendances
• 3596 babies were born
• £9.5 million was invested into the Estate
• 80.8% day case rate, compared to national average of
69.5%
Source: 07/08 Annual Report
Promoting Clinical Excellence
Seeing A&E attendance within four hours
C-Diff and MRSA rates
18 Weeks
Delivering Local Healthcare
It is about…..
• Improving Patient Care, Safety and Access
• Providing Care in the Most Appropriate Setting
• Improving the Quality of Facilities and Accommodation
• Being a Model Employer
• Improving Efficiency
• Growing the Trust
Thank You
The Agenda
6:30pm
The Importance of Health in Sport
Bob Winnington, Commercial Manager
Bishops Stortford Rugby Club
6:45pm
Infection Control – We’ve Got It Covered
Dr Jeff Phillips, Consultant Intensivist/Clinical Lead
Infection Control
7:00pm
Investing in the Patient Experience
Sharon Cullen, Associate Director of Nursing
7:15pm
Update on the Year
Chris Pocklington, Chief Executive
7:25pm
Finances of The Trust
Gordon Flack, Executive Director of Finance
7:30pm
Questions to the Trust
The Importance
of Health in
Sport
Bob Winnington,
Commercial Manager
Bishop’s Stortford Rugby Football Club
Bob Winnington, Commercial Manager
Bishop’s Stortford Rugby Football Club
9
Developing a Community Club
• Bishop’s Stortford Rugby Club was formed in 1920 and has
been at its current home at Silver Leys since 1963.
• On a Saturday we are able to field 5 Senior Teams each
playing regular league and cup fixtures whilst on a Sunday
there are over 500 Mini and Youth players either training or
representing the club.
• Our 1st XV will normally contain 8 or more players who have
come through the club from Minis level and our other 4 senior
sides are principally made up of home grown players.
• This makes us all aware of the contribution the club makes to
the local community and to our dependence on the support of
individuals and local businesses.
How the club has grown over the last 88 years!
Physiotherapist’s Role
– Some clubs remain advocates of the “bucket and sponge”
approach but B.S.R.F.C. has taken a strategic decision to employ
a Senior Chartered Physiotherapist for the past 5 years.
– Our present physiotherapist, Julie Wright, has intermediate and
advanced sports aid skills through specialised training.
– Julie’s role covers:• Medical welfare of all players
• First Aider
• Treatment of injuries – on/off pitch
• Return to play
• Prevention of injuries
• Prevention of re-occurrence
• Advice and education
• Legal Responsibility
Rugby Injuries
– 1 in 8 chance at club level
– 1 in 4 at international level
– 72% in CONTACT
– 51% in TACKLE situation
– Average of 18 days absence
– 19% of calendar year absent
– Most occur during final quarter
– Last season, 24% occurred during training at
B.S.R.F.C.! This resulted in 24 days absent
Most Common Injuries
FORWARDS
BACKS
Calf Muscle
Hamstrings
Haematoma thigh
Haematoma thigh
Ankle
Ankle
Hamstring
Calf Muscle
Neck
Concussion
FORWARDS
BACKS
Hamstrings
InjuriesBack
resulting in most lost
time
Knee –
cartilage/degeneration
ACL
Shoulder
Shoulder
Achilles Tendonitis
MCL
Calf Muscle
Knee
Why Injury Prevention is important
– Team Remains intact
– Player Morale
– Continuous season means player and team improve
over season. Injured players may set whole team
strategy back
– Treatment and time costs!
– Players and support staff are less likely to leave the
sport prematurely
– Lifts team morale
KICK INJURIES INTO TOUCH!
How do we prevent injuries?
– Team involvement
– WARM UP and COOL DOWN
– Training
– Position specific drills and conditioning
– Strength and Reaction
– Technique
– Flexibility
– Hydration and nutrition
– Listen to your body!
This is not exclusive to rugby!
It is important for all general and reactive skills.
The fitter people are the less likely they will
be injured!
15
Preparation
Pre-Season Training!
16
Nutrition
– Readily available energy for quicker recovery and
protection of joints and muscles from injury
– Ensures body performs at best
– Avoid high fat pre and post exercise
– ½ food intake should come from carbohydrates –
potatoes, pasta, bananas etc
– Increase intake of carbohydrate foods 2-3 days before
game
– Ensure 15% of diet is protein – eggs, fish, meat etc
– Manage alcohol intake and timing!
All our 1st Team players are given advice and
guidance on their diets and are actively
encouraged to maintain a strict personal
programme to reach peak fitness.
17
Water
Did you know?
– Your body is 60% water
– If you are thirsty you are dehydrated
– Performance decreases if by 25% when you dehydrate
– You lose 1-2 litres of water every hour in a light training session!!
Remaining Hydrated is essential for high performance and prevention
of injuries. So we ensure our players …….
– Drink plenty of water each + every day & make it a habit
– Start hydrated
– Keep water levels up all week
– Have a sports drink 2-3 hours pre game + 10-20mins post game
Get water On Board Quickly + as often as possible during a game
or training session.
Only you can ensure you are hydrated properly!!
Conclusions
– The health of players is important for 7 days a week not just
a Saturday or Sunday!
– Notwithstanding the fact we are not a professional club, we
put the health and safety of our players top of our priority
list.
– This is relevant to not just the 1st team but throughout the
club to our newest Under 7 recruits!
– Awareness of injuries and injury prevention is key.
– Nutrition and the importance of water are paramount.
– However, the club cannot monitor every player across its
senior, youth and mini sides; it is the Individuals’
responsibility!
The fitter people are the less likely they will be
injured!
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ENJOY YOUR SPORT AND STAY INJURY
FREE!
Thank you
Infection
Control –
We’ve Got It
Covered
Dr Jeff Phillips
Consultant Intensivist and
Clinical Lead for Infection
Control
Reducing Healthcare Acquired
Infections
Jeff Phillips
Consultant, Intensive Care
National Clinical Champion for Infection Control
Infection is an insult
to our patients!
What will make the biggest
difference?
•
•
•
•
Individual and Team ownership
Screening and decolonisation
Utilise the Care Bundles/HIIs
Act on compliance data to improve
reliability
• Agreed antibiotic prescribing policy
• Monitoring of cleaning standards
MRSA bacteraemias April 04-Sept 08
8
7
6
5
4
3
2
1
0
CYH
1
4
7
10
13
DH
16
19
22
25
28
Month
31
34
37
40
43
46
49
52
Bacteraemias
Cumulative MRSA Bacteraemias - Actuals Vts Trajectory 2008/09
14
13
12
11
10
9
8
7
6
5
4
3
2
1
0
Apr
08
May
08
Jun Jul 08 Aug
08
08
Sep
08
Oct
08
Nov
08
Pre 48 Hr
Post 48 Hr
SHA target trajectory Cumulative
Dec
08
Jan
09
Feb
09
Mar
09
Cases of Clostridium difficile : April 2007-Sept 2008
50
40
30
20
10
0
1
2
3
4
5
6
7
8
9 10 11 12 13 14 15 16 17 18
Month
Cumulative C -DIF - Actuals Vts Trajectory 2008/09
120
110
100
90
C -DIF
80
70
60
50
40
30
20
10
0
Apr
08
May
08
Jun
08
Jul
08
Aug Sep
08
08
Oct
08
Nov
08
Dec
08
Actuals Cumulative
SHA target trajectory Cumulative
Jan
09
Feb
09
Mar
09
Ever tried? Ever failed?
No matter. Try again.
Fail again. Fail better.
Samuel Beckett
Playwright
Pray for the dead and fight
like hell for the living.
Mary Harris (Mother) Jones,
Social and political activist
Investing in the
Patient
Experience
Sharon Cullen,
Associate Director - Nursing
The Patient Experience
• The patient is at the centre of
everything we do
• Our aim is to deliver effective
services in partnership with the
people that need to use the hospital
• We want to be the hospital that the
local community choose to use for
healthcare.
The Nursing
Directorate
Matron
Infection
Control
Nurses
Practice
Development
Nursing Team
Estates
Patient
Facilities
(Cleanliness
Standards)
Transformation
Team
Nursing,
Midwifery
& Operating
Department
Practitioners
The Patient
•
Patient experience tracker provides immediate
feedback on five key areas raised in the annual
patient survey
Feedback from Patient Council
Patient involvement across all areas
of our work including:
•
•
–
–
–
Environmental assessments
Service improvement projects
Self assessment audits against
national standards
Matron
• Role reviewed (November - March)
• Trust has invested in an additional 8 matrons
• Increased visibility in wards & departments 7 days
a week
• Four main areas of responsibility. Their
duties include:
–
–
–
–
–
–
Environmental checks
Infection control audits
Challenging standards of practice
HR issues
Patient experience tracker
Privacy and dignity audit
Infection Control Nurses
Our Aims
• Achieve transparency in our communication
• Share information with openness and honesty
• Make infection prevention and control everyone’s
business
Infection Control Nurses
• Enhanced communication with matrons and nursing workforce
• Influencing best practice and providing advice
• Promoting a clear message to all concerned about healthcare
associated infections and how to prevent cross infection
• Development of ward information boards to
share progress against minimising the risk of
infection
• Changes to clinical practices to enhance
patient safety in line with national
directives
• Enhanced screening for MRSA to
enable early treatment
Practice Development Nursing Team
• Provide training for nursing staff to enhance and
sustain standards of care
• The team ensure that national and professional
guidance is embedded in clinical practice
• All newly appointed healthcare
assistants are trained and assessed
in essential care delivery
Facilities
• Additional £500,000 spending on additional cleaning staff
• Standards monitored using the national cleanliness
standards
• Investment in cleaning equipment at ward level
• Increased training for supervisors
• Annual deep cleaning for clinical areas
• Working on greater integration of
domestic team into clinical areas
Estates
• Very close links with domestic and nursing staff to
address environmental issues
• Executive director of nursing influencing trust
expenditure on the patient’s environment to meet
privacy, dignity and safety
standards
Nursing, Midwifery &
ODP Workforce
Our strategy
• Staff fitness for purpose
• Clear understanding of professional responsibilities
Themes
• Essential care
• Infection prevention & control
• Leadership
• Communication & record keeping
Transformation
Service improvement including:
•
•
•
•
•
•
•
Ward standardisation
Environment
Equipment
Common patient processes
Releasing time to care
Patient medication
Patient assessment & observation
Assurance Framework
Sharing our progress in an open and transparent way
with:
Patients, Staff, Trust Board members, Commissioners,
Strategic Health Authority and up to the Department of
Health
Key Performance Indicators:
• Infection prevention and control
• Patient Feedback
• Privacy and Dignity
• Quality of Care and Treatment
Thank you
Now and in the
Future
Chris Pocklington Chief Executive
The Here and Now…
2008/09
“To become the best general hospital in the
East of England”
Continuing to Deliver Innovation in
Healthcare
Our clinical achievements place us amongst some of the
best Trusts in the Country
The work of our support staff is recognised
by many
Journey to Foundation Trust Status
FT status is about giving individual hospitals the opportunity
to develop forward looking services in response to the
needs for the local population
6,900 people have signed up at FT members
Visit www.pah.nhs.uk for more
information or speak to one of the
Executive team
Thank you
Finances of
The Trust
Gordon Flack Executive Director of Finance
Headline Results
Steady delivery of surpluses since deficit in 2005/06:
Income & Expenditure
Surplus/-Deficit
6000
4000
2000
£m
0
2005/06
-2000
-4000
-6000
2006/07
2007/08
Continued growth of the Trust which is
expected to remain a feature of the
future:
Turnover
150000
100000
£m
50000
0
2005/06
2006/07
2007/08
Continued investment in infrastructure
over and above the “wearing” out of our
assets:
Capital Cashflow
& Depreciation
10000
8000
£000 6000
4000
2000
0
2005/06
2006/07
Depreciation
2007/08
How we spent your money:
2007/08 Costs
3.7% 1.8%
6.0%
0.7%
4.6%
0.7%
0.8%
17.4%
64.3%
Services from the NHS
Purchase of healthcare from non NHS bodies
Directors' costs
Staff costs
Supplies & services
Consultancy
Premises, transport & establishment
Depreciation
Clinical negligence & Other
Staff Resources remain at the heart of
our business and account for the largest
proportion of our costs:
Staff
3000
2000
WTE
1000
0
2005/06
Medical
Nursing
2006/07
Healthcare assistants & support
2007/08
Scientific, therapeutic
Admin & Estates
The Auditors Local Evaluation (ALE) assesses how
well NHS organisations manage and use their financial
resources.
The Trust can show strong and steady progress over the last three years
and aspires to excellent ratings.
Auditors Local Evaluation
"Use of Resources"
Excellent (4)
4
Good (3)
3
2005/06
Adequate (2)
2
Inadequate (1)
1
2006/07
2007/08
0
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Thank you
Open forum for questions to the
Executive Team.
Please join us for refreshments