It is clear that the next few years will be extremely challenging for the NHS. However, Great Ormond Street Hospital plans to continue to grow to meet the increasing demand for our services.
There is a move in the NHS to concentrate many specialist services into fewer centres of excellence, to improve their long term safety and quality. This supports our strategy and is one significant area of increased demand, both as a result of a specific review within London (Healthcare for London) and broader reviews across the NHS.
Scientific advances mean we can do more for very sick patients or those with very complex conditions. This is excellent news for these children and their families but it does increase demand for certain services.
Finally, we anticipate an increase in the number of children, particularly in London and south-east England where a large number of our patients come from.
We will grow our specialist services – particularly in specific clinical areas such as cardiac services, neurosciences and gastroenterology.
We plan to retain as broad a range of specialist services as we can and have no plans to stop providing any specialist services.
We will accommodate this increased demand through:
- The ongoing redevelopment of the hospital site - Phase 2 will allow us to treat up to 20 per cent more children
- Working more effectively
- A carefully planned programme of staff recruitment and training.
Improved financial management and operating efficiency
Like every other service in the NHS, the Trust will need to become more efficient and imaginative in how it works to meet increased needs and make the best use of the funds we receive.
The Trust has been working on a Transformation Programme ("Zero Harm, No Waits, No Waste") that has focused on better ways of working while maintaining our commitment to quality.
For example, we are in partnership with both Cincinnati Children’s Hospital Medical Centre and Children’s Hospital Boston to share experiences and learning. We will learn from leaders in any industry that can help us improve.
Improving quality can both make things better for patients and their families, and also allow us to treat more sick children. For example, reducing infections still further reduces the average time spent in intensive care – which is good in itself but it also allows us to save money to spend on other patients.
Where we can work more efficiently by working jointly with other NHS trusts or other bodies, we will do so, providing it does not compromise our independence.
The Trust currently offers emergency care and inpatient services at all times but planned operations and outpatient appointments are not usually offered at weekends.
Offering more services on a Saturday, for example, might improve convenience for families and it might also allow us to increase the number of children we can see, although there are practical issues around staffing the full range of necessary services.
Working with the rest of the NHS
Children and their families need the best care, in the most appropriate place, with different NHS organisations working well together so that care is seamless and co-ordinated. This is an area we do not always get right and where we are determined to improve.
Local hospitals send us their specialist cases and nearly all those children will go back to local hospitals, or to the care of their GP for further treatment, tests, monitoring or recovery. It seems to us that often much of the child’s care is best delivered locally and conveniently.
We need to improve co-ordination and communication with our colleagues in local services. We have commissioned annual surveys of our referring clinicians to help us better understand what we do well and less well for them and our patients.
We already run clinics jointly with local expert clinicians on other sites, agree care plans with local services, provide clinical advice where needed and, of course, train specialists and undertake research. In some trusts we make joint appointments of staff, so that when a child moves to adult services, they are familiar with the key clinicians involved.
Great Ormond Street Hospital cannot run children’s services in every trust. (In just one service, bone marrow transplant, for example we work with 58 local hospitals and 62 community health teams).
We are, however, exploring providing formal support to some trusts in the form of professional advice, education and training, and support around child protection/safeguarding. We expect to be asked to do more of this sort of work in future.
We also need to work well with schools, community health services, social services and, in some cases, charities such as hospices or rehabilitation centres.
More information about Great Ormond Street Hospital
- We already ask patients and their parents about our service. In our last independent survey, 96 per cent were ‘very’ or ‘fairly’ satisfied with their last visit and 97 per cent were ‘very likely’ or ‘fairly likely’ to recommend us for treatment. (The headline figures for children and their families were very close.)
- The Trust aims to produce outcomes for treatment that are among the best in the world.
- The Trust meets all waiting time targets. Children are now seen much more quickly across a whole range of services.
- Our new redevelopment is thought to be one of the greenest hospital developments in the UK.
- Many of the paediatric cardiac surgeons in the United States have been trained at Great Ormond Street Hospital.
- Infection Control - the hospital test every inpatient for MRSA, and treats them as infected until we have proof they are not, one of several systems which contributes to a relatively low cross-infection rate. This year, to date, we have had a relatively low two cases of MRSA blood infection (and that doesn’t necessarily mean any of them caught it here).
- Independent assessment of our safety and quality by the NHS Litigation Authority (NHSLA) rates us as level two and we plan to attain level three, the highest.