Health, Best Practice Group 4
Date:
12/04/2011
Time:
10.00 - 15.00 Attachments:
Host:
AT Kearney
Venue:
Central Hall Westminster, London
Theme:
The Productive Hospital
Guest Speaker(s):
Kristy Parnell, Lead of Productive Ward Programme, NHS Institute for Innovation and Improvement
Robert Rose, Divisional Director, East Kent Hospitals NHS Foundation Trust
Ira Gaberman, Partner, Health Advisory, AT Kearney
Summary:
Notes from the session will be made available as soon as possible.
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1 year 1 week ago - Primary Power
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1 year 3 weeks ago - Productivity Increase is the Key
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1 year 11 weeks ago - Public-Private Partnership
1 year 12 weeks ago - Acute Trusts Commissioned Into Losses
1 year 13 weeks ago
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Comments
Productivity Increase is the Key
The NHS must reverse its fall in productivity, continuously falling for 10 years now. The NHS budget has grown steadily, receiving a 70% increase in funding, yet productivity has been falling at a rate of 0.2% per year; more resources were poured in, yet each tax-payer pound has been worth less and less.
A report by the King’s Fund estimated the NHS will have to increase productivity by 6% per year till 2014, if it is to achieve the £20bn savings required by the government. The report stated the Department of Health must focus on improving hospital productivity for the ambitious savings to be possible without damaging the quality of healthcare. Pay contracts and tariffs paid by results need urgent revision, as they have failed to deliver the necessary increase of productivity.
“There are risks for the NHS in achieving productivity improvements at the same time as delivering radical reforms”, said Margaret Hodge, public accounts committee chair.
(HSJ, 17 March)
Public-Private Partnership
Though their model would not yet be legal in the UK under current law, Sanitas, Bupa’s Spanish subsidiary, has achieved something worth noting.
At the cost of €600 per person in its care, compared with roughly €850 in the purely public sector, the company provides primary care (at GP surgeries), as well as acute care (at a new state of the art hospital and two specialist hospitals) to 197,000 people in Manises, Valencia .
Care is free, and patients can choose where to go. Sanitas agrees on targets with regional government regarding safety, clinical guidelines, public health programmes and more.
Three main points should be emphasised: Sanitas provides the same care and services that the public sector does elsewhere, but for less money; consumer choice means Sanitas will lose out financially if their services are not perceived as being of high-quality; and integrating primary, intermediate and secondary care makes it extremely worth-while for Sanitas to put great emphasis on preventive care.
Sanitas director was very clear on the point that much of the financial savings are achieved in the salaries they pay – they pay less, and they employ fewer staff.
Importantly, Sanitas has managed to introduce private management principles into public services; for example, the acute hospital has state of the art IT systems that not only maintain the clinical records, but add an economic record. By keeping track of costs, the staff and management can examine ways to streamline care, implement preventive programmes or develop targeted care packages to prevent re-admission in long-term condition patients. Primary and acute care records are integrated electronically, allowing clinicians and managers to standardise care for common conditions – removing unwarranted variation in care.
The director of Sanitas admitted that politically, this had been a tough point to reach – but it seems to have been a success; he declares that the public-private partnership is delivering beyond its targets
Yet, has Sanitas retrieved its investment in the new facilities? The director admits – not yet. But he is confident.
Acute Trusts Commissioned Into Losses
Commissioning targets set by the Department of Health to minimise ‘low priority treatments’ will leave 58 Acute Trusts with whole departments unfunded. This is partially the result of losing economies of scale, when certain treatments become few and far between, but stable costs such as building costs remain the same. Hinchinbrooke Health Care Trust, as an example, is facing a 16% reduction in its tariff income, but only a 9% reduction in costs. Another Healthcare Trust deputy director similarly commented that taking away one patient from a ward does not allow any saving in money or services whatsoever – patients must be removed in groups of 6 to allow closing off a whole ward and thus saving on staff costs. NHS Confederation acting chief executive Nigel Edwards commented that not much can be done to help these trusts, as paying premiums to help smooth over the changes could be seen as anti-competitive by the new NHS economic regulator, Monitor. (HSJ, 17-2-11)
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