Chief Operating Officer Lesley McLay, 13 th April, 2012.

Chief Operating Officer

Lesley McLay, 13th April, 2012

Operational UnitOperational Unit is responsible for delivery of all services across NHS Tayside, which include Acute; Community and Primary Care and Mental Health.

NHS Tayside in numbers:

• 400,000 population• 74 services• 23 main sites • 14,000 staff• £700 million total revenue budget

Services

Arts Therapy Accident & Emergency Histopathology

Blood Borne Virus Managed Care Network Adult Learning Disability Services Homeopathy

The Centre for Brain Injury Rehabilitation Adult Mental Health Services Infectious Diseases

Community Nursing (HIV) Area Clinical Psychology Service Intensive Care Unit

The Corner  Breast Screening Maternity Services

DARTS Diabetes Audit & Research in Scotland

Breast Surgery Medicine for the Elderly

Dental  Cancer Medicine Neurology and Stroke

Dundee Midwifery Unit Cardiovascular & Coronary Care Unit Neurosurgery

The East of Scotland Research Ethics Service Child Health Occupational therapy

Health Protection Clinical Haematology Ophthalmology

Keep Well Clinical Oncology Oral and Maxillofacial

Neurological Sciences Clinical Radiology Orthopaedic Electives

Pre-School Orthoptic Vision Screening (POVS) Community Dental Services Orthopaedic Trauma

Out of Hours Community Health Services Pharmacy

Primary Care Services Dermatology Physiotherapy

Public Health Diabetes and Endocrinology Plastic Surgery

Respiratory Managed Clinical Network Emergency Medicine Psychiatry of Old Age Services

Sexual Health Services Endoscopy Regional Vascular Service

Smoking Cessation ENT Renal Unit

Specialist Palliative Care Family Planning Services Respiratory

Tayside General Practices Forensic Psychiatry Services Rheumatology

The Wolfson Hyperbaric Medicine Unit Gastro-intestinal Medicine Speech and language therapy

General Adult Psychiatry Services Substance Misuse Services

General Surgery Tayside Rehabilitation Engineering Services

Genetics Theatres and Anaesthetics

High Dependency Unit Urology

Key Locations

Aberfeldy Community Hospital

Arbroath Infirmary

Armistead Child Development Centre

Ashludie Hospital

Blairgowrie Community Hospital

Brechin Infirmary

Carseview

Crieff Community Hospital

Dundee Dental Hospital

Dundee Midwifery Unit

Pitlochry Community Hospital

Little Cairnie Hospital

Montrose Royal Infirmary

Murray Royal Hospital

Ninewells Hospital

Perth Royal Infirmary

Royal Dundee Liff Hospital

Royal Victoria Hospital

Roxburghe House, Dundee

St Margaret's Hospital, Auchterarder

Stracathro Hospital

Strathmartine Hospital

Whitehills Health and Community Care Centre

Young People's Unit

Breakdown of activities & sites

Operational Unit Management & Governance

Lesley McLay Chief Operating Officer

Directorates CHPs Operations Functions

Medicine David Johnston AMD Gillian Costello ANDCarol Goodman GM

Perth & KinrossBill Nicoll GMMorag Martindale CDGilliam Costello AMD

WorkforceGeorge Doherty Director Janice Torbet ADW

SurgeryJohn Colvin AMDEvelyn Fleck AND Audrey Warden GM

Dundee David Lynch GMDavid Dorward CDEileen McKenna AMD

Finance Colin Masson Director

eHealth Ian Fenton Director

AccessAlan Cook AMDEileen McKenna AND Lorna Wiggin GM

AngusSusan Wilson GMEvelyn Fleck AND

vacancy

Operations Ken Armstrong Director

•Integrated Clinical Leadership and General Management model•Devolved Management structure•Fortnightly meetings of Executive Management Team •Bi-monthly Performance Review Meetings

Operational Unit Priorities

• Productivity and Efficiency

• Clinical Quality

• Whole System Integration

• Performance Management

• Facilities Management

Operational Unit Priorities

Productivity and Efficiency• Sickness Absence Management• Staff eRostering • Service Capacity Review

Clinical Quality• Clinical Governance Review• Clinical Strategy Development

Whole System Integration• Health & Social Care Integration • Prisoner Healthcare integration • 24/7 day service

Performance Management• Complaints Redesign • Business Unit establishment• Performance Dashboards • National and Local Access Targets e.g. 18 weeks RTT

Facilities Management• Facilities Optimisation

Steps to Better Health Care Programme

• Triple Aim• Transformational Change Model- 95:5• Measures for Improvement• Aligned to LDP and Strategic Financial

Plan• Clinically Lead

Health of the Population

Experience of Care

Best Value for Money

Steps to Better Health Care Triple Aim

2010 - 2013

TACTICAL STRATEGIC

DEALING WITH THE 5%

SPENDING THE 95% BETTER

PRODUCTIVITY & EFFICIENCY

CRES

SERVICE OPTIMISATION

TRANSFORMATION

Steps to Better Health Care Transition 2011-2013

TRANSFORMATIONAL PROGRAMMES

•Mental HealthIntegrated Community ServicesPalliative Care Services

PROGRAMMES ALIGNED WITH STRATEGIC FINANCIAL PLAN

Clinical Improvement & ProductivityElectronic Patient RecordOutpatientsClinical Benchmarking Patient PathwaysLow Impact InterventionseRosteringReleasing Time to Care

WorkforceReview Supplementary PayReview Absence

Drugs & PrescribingMedicines Leadership

Estates & FacilitiesRealignment of ServicesOptimising Healthcare Facilities

Steps to Better Health Care 2012/2013 Plan

Appendix 1. Strategic Aims

Steps to Better Healthcare underpins all NHS Tayside Strategic Aims, which are as follows:

• Contribute to closing the health inequalities gap within a generation

• Improve healthy life expectancy by supporting people to look after themselves

• Ensure that services meet agreed quality standards, especially patient experience

• Be cost effective in all decisions, actions and services

Appendix 2. Operational UnitDirectorate – Key Parameters

Operational Unit Surgical Directorate

Directorate

Leadership team

Scope Staff number

s

Budget Key activities

Key outputs

Surgical Audrey Warden General ManagerJohn Colvin Associate Medical DirectorGillian Costello Associate Nurse Director

The Directorate provides OP, IP, DC and emergency services for the following:General SurgeryBreast surgeryPaediatric SurgeryUrologyOrthopaedics & Trauma(TRES) Anaesthetic Services & Assessment (APA)Critical Care Services (ICU & HDU) Pain Services TheatresNephrology ServicesOncology and Acute Palliative CareHaematology PathologyRegional Plastics Service Oral Maxillofacial SurgeryNeurosciencesGeneticsOphthalmologyENT SurgeryAudiologyDermatology & PhotobiologyRegional clinical networks: East of Scotland Breast Screening ServiceEast of Scotland Vascular NetworkEast of Scotland Upper GI Network

2300 WTE

£131M.

To provide a robust model for Clinical Governance, Quality and Clinical Effectiveness Optimise Productivity and Efficiency promoting transformational changeCo-ordinate and manage the functions within the allocated resources Provision of integrated care pathways for patients in NHS Tayside with clear lines of joint working arrangements ;Establishing strong clinical structures to support integrated way of working and shift the balance of care and resourcesNational performance indicators & Waiting Times and Cancer guarantees.Improved patient outcomes.Genetics.

Services that consistently meet recognised quality standardsImproved patient experience of servicesEfficient & effective use of allocated funding and resources within the Surgical DirectorateOptimise Productivity and Efficiency18-week RTT targets as per HEAT Cancer targets 62 day and 31 day Establish Day Surgery as the ‘norm’ Infection control reducing infection.Promote care in local communities and people’s homes Clinical Strategy for Genetics, in line with the National Genetics vision

Operational Unit Medicine Directorate

Directorate Leadership team Scope Staff number

s

Budget Key activities

Key outputs

Medicine Carol Goodman GMDavid Johnston AMD Evelyn Fleck AND

All adult in patient and outpatient medicine services:-Acute Medicine/General medicineMedicine for the elderlyDiabetesCardiology (including intervention)RheumatologyGastroenterology/EndoscopyAcute StrokeRespiratory medicineInfectious diseasesInvestigations unit- pan Tayside Emergency Department services- pan TaysideOut of Hours GP Service – pan TaysideAll maternity services including hospital and community based provision- pan TaysideAll Gynaecology services including surgery – pan TaysideChildren's services including community paediatrics, child and adolescent mental health, children with complex needs, AHP services and Neonatal intensive care services– pan Tayside

2124 WTE

£101M.

Provision of inpatient care for all medical specialties for adults and children

Antenatal, perinatal and post natal care and gynaecological sugical and medical care of women

Provision of inpatient and outpatient care for all surgical and mental health specialties for all children

Provision of Emergency dept services including Trauma team response service

Safe, effective high quality care for all patients

Achieving HEAT targets and standards

Providing a responsive service to meet need within the resource envelope available

Operational Unit Access Directorate

Directorate Leadership team Scope Staff number

s

Budget Key activities

Key outputs

Access Lorna Wiggin GMAlan Cook AMDEileen McKenna AND

Diagnostic Services – labs, radiology and medical physics.

Integrated Dental Services – CDS & Dental School

SRTC & OP Perth / Angus

Medical Records

Business Unit Corporate portfolio – cancer, waiting times performance

1476 WTE

£59M Provision. Of direct patient care services.

Provision of services which support the delivery of patient care.

Provision of information for improvement, performance & assurance

Monitor and report on progress cancer, waiting times, data quality

Governanceassurance &performance management to CE /COO

Staff engagement

High quality patient experience & care

Fair /equitable / timely access to services

Data validation, analysis and reporting.

Ensure best value

Staff well being

Operational Unit Community Health Partnerships

Directorate Leadership team

Scope Staff numbers

Budget Key activities

Key outputs

Perth & Kinross

Bill Nicoll GMMorag Martindale Clinical Director Gillian Costello AND

All primary and community healthcare, mental health, drug and alcohol support for P&K population and prisoner healthcare

1047 WTE £106M. Integrated care deliveryPartnership workingCommunity Planning

Early Years,Child development and protection,Health & well-being & equity, Anticipatory care, long term conditions, care at home, prevention of admission, care of the elderly, improving discharge, dementia care and palliative care

Dundee CHP

David Lynch GMEileen McKenna ANDDavid Dorward Clinical Director

All primary and community healthcare, mental health, drug and alcohol support for Dundee population

1350 WTE £144M. Integrated care deliveryPartnership workingCommunity Planning

Early Years,Child development and protection,Health & well-being & equity, Anticipatory care, long term conditions, care at home, prevention of admission, care of the elderly, improving discharge, dementia care & palliative care.

Angus CHP Susan Wilson GMEvelyn Fleck AND

3 patient pathways: Adult Services, Child & Family Health; Mental Health. Services include Community Hospitals, Community Nursing Services, Psychiatry of Old Age, AHPs, Medicine for the Elderly, Palliative Care, Minor Illness & Injuries Units, Integrated Mental Health Services, and hosting of Tayside Substance Misuse Service

1400 WTE £50M. Partnership & Integrated Working; Community Medicine & Rehabilitation Service Redesign;Substance Misuse Service Redesign; Introduction of C2 Approach;

Introduction & development of See & Treat Service; Poly-Pharmacy Reductions;Dementia Liaison Team;Generic AHP workers; Programmes to support Long Term Conditions/Self Management

Operational Unit Operations Directorate

Directorate Leadership team

Scope Staff numbers

Budget Key activities

Key outputs

Operations Ken Armstrong Director

To provide a wide range of Site/Support Services and key infrastructure in delivering ongoing improvement re patient care

2000 WTE £60M.

Procurement spend £120M.

Site/Support Services

Production Unit

Procurement & Logistics

Property

Environmental Management

H & S/Fire Safety

Unlicensed Medicines

Provision of high quality catering, cleaning and portering services together with rapid and intelligent response to site “issues”

Clean equipment and linen as and when required

The right product at the right time in the right place

Sustainable/fit for purpose accommodation

“A greener environment”

“A safer environment”

Provision of niche medicines internal and external

Appendix 3. Operational UnitBreakdown of activities & sites

Services

Arts Therapy Accident & Emergency Histopathology

Blood Borne Virus Managed Care Network Adult Learning Disability Services Homeopathy

The Centre for Brain Injury Rehabilitation Adult Mental Health Services Infectious Diseases

Community Nursing (HIV) Area Clinical Psychology Service Intensive Care Unit

The Corner  Breast Screening Maternity Services

DARTS Diabetes Audit & Research in Scotland

Breast Surgery Medicine for the Elderly

Dental  Cancer Medicine Neurology and Stroke

Dundee Midwifery Unit Cardiovascular & Coronary Care Unit Neurosurgery

The East of Scotland Research Ethics Service Child Health Occupational therapy

Health Protection Clinical Haematology Ophthalmology

Keep Well Clinical Oncology Oral and Maxillofacial

Neurological Sciences Clinical Radiology Orthopaedic Electives

Pre-School Orthoptic Vision Screening (POVS) Community Dental Services Orthopaedic Trauma

Out of Hours Community Health Services Pharmacy

Primary Care Services Dermatology Physiotherapy

Public Health Diabetes and Endocrinology Plastic Surgery

Respiratory Managed Clinical Network Emergency Medicine Psychiatry of Old Age Services

Sexual Health Services Endoscopy Regional Vascular Service

Smoking Cessation ENT Renal Unit

Specialist Palliative Care Family Planning Services Respiratory

Tayside General Practices Forensic Psychiatry Services Rheumatology

The Wolfson Hyperbaric Medicine Unit Gastro-intestinal Medicine Speech and language therapy

General Adult Psychiatry Services Substance Misuse Services

General Surgery Tayside Rehabilitation Engineering Services

Genetics Theatres and Anaesthetics

High Dependency Unit Urology

Key Locations

Aberfeldy Community Hospital

Arbroath Infirmary

Armistead Child Development Centre

Ashludie Hospital

Blairgowrie Community Hospital

Brechin Infirmary

Carseview

Crieff Community Hospital

Dundee Dental Hospital

Dundee Midwifery Unit

Pitlochry Community Hospital

Little Cairnie Hospital

Montrose Royal Infirmary

Murray Royal Hospital

Ninewells Hospital

Perth Royal Infirmary

Royal Dundee Liff Hospital

Royal Victoria Hospital

Roxburghe House, Dundee

St Margaret's Hospital, Auchterarder

Stracathro Hospital

Strathmartine Hospital

Whitehills Health and Community Care Centre

Young People's Unit

Breakdown of activities & sites