Our Annual plan and its delivery is part of a rolling three year programme that is subject to regular strategic review. We have formally set out to support our planning process with a performance management framework designed to ensure that it encompasses:
- Clinical quality and safety indicators, benchmarked where appropriate, focussed on improved performance
- Emphasis on identification of risks
- Identification of breaches to standards or targets
- Identification of appropriate management action
Details of our 2011/12 Annual Plan
High quality and effective careWe also firmly believe that providing high quality care provided in a timely manner delivers cost effective care. We aim to give every patient the right high quality treatment first time every time.
We have been working with Dr Foster Intelligence to benchmark the efficiency of our services in four of our priority specialties against our English peers. We analysed the percentage of spells of care with excess bed days, length of stay and readmission rates in our cardiac, neurosurgery, general and spinal surgery services.
The following table is a summary of the results:
|Indicator||Cardiac Surgery||General Surgery||Neurosurgery||Spinal Surgery|
|Excess bed days||Better Than Average (0.56)||Better Than Average (0.73)||Best (0.57)||NA|
|Length of stay||Best (0.61)||Better Than Average (0.83)||Best (0.67)||Best (0.79)|
|Readmission rates||Average (1.01)||Best (0.74)||Best (0.72)||Worse Than Average (1.09)|
For the 11 indicators shown above, GOSH is the best performing in six, better than average in three, average in one and below average in one.
As an example, if all cardiac surgery providers delivered the same length of stay as GOSH then England would need approx 50 less beds for this specialty, given that centres generally have less than 15 beds allocated to paediatric cardiac surgery this would remove the need for at least three centres in the NHS (if other resources were available – such as theatres).
Over the next few years we intend to improve our efficiency throughout the organisation by moving patients’ treatments to their appropriate least acute environment and ensuring that patients do not experience delays and flow in a timely manner. We have started to model a modest amount of this improvement but we aim to achieve a considerable amount more. Below are some examples of what we have modelled, many of which represent savings for commissioners.
We undertake numerous follow up outpatients by telephone and is continuously transferring more follow ups from clinic to telephone. The table below shows our year on year plans to expand this service;
|No. telephone outpatients||7,725||8,408||8,909||9,416||9,977||10,612|
|New to follow up ratio||4.48||4.39||4.35||4.34||4.34||4.34|
We have an established programme to undertaken a greater proportion of inpatient gastroenterology activity as day cases. The changing proportions are shown in the table below:
|Day Case Spells||614||799|
|Non Day Case Elective Spells||897||1,079|
|% Day Case||68%||74%|
|Bed days saved||563||1,120||1,624||2,209||2,883|
Find out more about how we comply.