We are currently operating in a climate where making savings is a priority and we are forced to look at our services and contracts to ensure they are operating as efficiently as possible. The NHS is facing some of the hardest financial times over the next few years and we must ensure we can provide the best services within the tightest of budgets.
A number of new and visionary ways of working have been developed to ensure effective use of funding and health care commissioning.
QIPP - Quality, Innovation, Productivity and Prevention
This is the way in which the NHS is trying to drive up quality, improve productivity, prevent illness and be innovative in the delivery of healthcare.
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Quality - focus on improving poor outcomes
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Innovation - deliver healthcare in the most appropriate setting, with minimal intervention
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Productivity - improving value for money
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Prevention - keep people healthy.
QIPP is the way in which we can improve patient care, whilst increasing value for money and delivering our financial responsibilities. NHS Southampton City has four long-term work programmes:
- planned care
- urgent care
- mental health/learning difficutlies/continuing care
- maternity and child health.
Clinical Pathways Project
This project aims to provide a series of guidelines for GPs to be used when considering referring patients to hospital departments. A series of workgroups (including GPs and consultants and supported by the PCT) have been set up to review current services and recommend changes based on quality and efficiency. This pathway will be used by GPs when referring patients.
System Reform programme
A System Reform programme was introduced in 2009/10 to ensure the best possible value whilst commissioning high quality healthcare services. The 2009/10 System Reform programme included five areas of work:
1. Timely Discharge
The Timely Discharge programme aimed to improve the commissioning of services for patients at the point of discharge from secondary care, and for patients with long-term health needs.
Projects within the programme included Delayed Discharge Management, improving the use of Excess Bed Days and Continuing Healthcare. The project delivered savings of approximately £500,000 and saw the reduction in adult excess bed days by around 20 per cent and the development of an integrated discharge service with Southampton University Hospitals NHS Trust (SUHT) and social care.
2. Admissions Avoidance
The Admissions Avoidance programme focused on caring for patients in the community through the effective commissioning of services as alternatives to hospital admission. The programme also supported patients to choose the most appropriate alternative to emergency hospital services.
Successes included the development of a seven day a week older people’s outreach service in the Emergency Department, a children’s asthma service in localities which resulted in a 20% reduction in hospital admissions and improved case management services within GP practices. Savings of approximately £1m were made through this work.
3. Elective Care and Capacity
The Elective Care and Capacity programme included work on capacity management, the GP referrals process and the development of community-based elective services.
The aim was to improve the commissioning of elective care, to ensure the appropriate use of services and to support patients in making the right choices, whilst maximising usage of the Southampton NHS Treatment Centre. This programme succeeded in making savings of approximately £2m.
4. Non-hospital Urgent Care
The Non-hospital Urgent Care programme improved the commissioning of services and supported patients in making the most appropriate choice for their needs.
Duplication in the system was reduced and resulted in the closure of Shirley NHS Walk-in Centre and the establishment of an ambulance non-conveyance service set up in partnership with all GP practices.
5. Corporate Changes
Savings of around £4.7m were achieved through the improved use of internal resources and the better use of our estate, in addition to the successful delivery of primary care and prescribing savings.
The 2010/11 System Reform programme will build upon the successes of the 2009/10 and continue to improve the patient experience and the cost effectiveness of the services we offer to the people of Southampton.
