Stockport Model
Presented by: Donald Menzies
2010 - 2011Every patient
mattersEvery pound counts
Occupational HealthMultidisciplinary team
Talk
• The Stockport Way• Working with partner regional OH Providers• The way ahead
PATIENTSTo Be Caring, Clean and Safe
FINANCETo Deliver Security
SERVICE21st Century Care
STAFFTo Develop Our Workforce
COMMUNITYCorporate Citizenship
Our Top 5 PrioritiesOur Top 5 Priorities
Every Patient Matters
OH Services Provided 2009
• Stockport Foundation Trust• Stockport PCT• Pennine Care Trust• Greater Manchester Ambulance Trust• Private Care organisations• Hospices• Voluntary organisations• Colleges of HFE• Transport companies• Private companies
OH SHH Clinical Team
2009• 1 Consultant Occupational Physician• 4 Occupational Physicians• 1 Clinical Nurse Manager• 4 Occupational Health Nurses• Counsellors• Management Team
• Business Manager• Secretarial and administration staff
• Website
OH Tender Coverage Merseyside, Greater Manchester, Lancashire & Cumbria
Process
Initial Discussions
(OHS services with geographical coverage)
Audit of current facilities• Data collection• Equipment• IT facilities• Counselling• Physio• KPI’s• Opening times• Costs• Use of post, email etc
Website development
NWAS partition • Password protected• Manager access• Employee access• Referral Forms• Physio• Counselling list
OH Services partition• Forms• Policies• Procedures
in-house website developer
Records - sharing: Scanning
Central Unit & Regional Units
Wigan
Carlisle
Barrow
Kendal
Lancaster
Preston
Chester
Aintree
Stockport
Our Regional Clinical Team
• 5 Consultant Occupational Physicians• 10 Occupational Physicians• 5 Clinical Nurse Managers• 25 Occupational Health Nurses• 15 Counsellors• Dedicated 1 WTE contract administrator• Management Team
• Business Manager• Secretarial and administration staff
Understanding your Priorities
• Comprehensive range of clinical services• Flexibility to meet changing requirements• Skilled professionals• Quality service• Value-for-money • Accessible to employees and managers• Prompt feedback
Services we can offer
Comprehensive Occupational Health Service• Pre-employment Health Assessment • Advice on Sickness Absence • Rehabilitation and Re-deployment Advice• Immunisations • Counselling • Health Promotion • Advice on practice legislation i.e. DDA• Periodic / Specialised Health Surveillance• Access to specialist services
Added Value We Offer quality focused
• Investors in People stamp of approval • Commitment to on-going training and
development of staff. • Committed to clinical excellence, audit,
clinical governance and quality assurance procedures.
Added Value Offervalue for money
• No hidden costs• Not profit motivated • Income spent directly on service to you • Cost conscious public sector organisation
Added Value We OfferNHS focused
• Proud to be part of NHS• Provider of choice to large number of NHS
organisations• Committed to supporting patient care by
supporting NHS organisations• Healthy and motivated workforce• We adhere to NHS policies and
governance requirements
Added Value We OfferNHS focused
• One lead provider – Stockport Foundation • Hospital based• Managed through local spokes• One on-line administration system • Local physio and counselling provided • Agreed timescales for appointments
How to run a Hub & Spoke OH programme(or a fictional railway)
• You need:• A Fat Controller (a Director to get the resources
& commitment and support the Engine Driver)• An Engine Driver (a “fired-up” person to do the
day-to day management work, liaison etc). • Red engine, blue engine, green engine etc
Conclusion 1
• Seemed a ‘brave’ project at inception• Supportive cooperative colleagues• Has required a lot of negotiating and influencing skills• IT has proved the most difficult to integrate• SLA’s a problem• BUT - we have found very few real service barriers in
practice
Conclusion 2
• Get to know their organisation• Projections of workload allows resource planning• Service specs – what not how• Comprehensive but few performance measures• Share information generously• Briefings of relevant information
Lessons learned
• IT biggest challenge– Encryption– Records– ESR OH
• Recruitment of counsellors• Regional Physio• Online forms works well• Regular contract meetings• Regular OH meetings• Communication
Relationship management
• Honesty
• Integrity
• Collaboration
• Mutuality
• Passion
• Humour
Working with fellow OH Providers
The recipe for a long term relationship BUT
both partners have to work at it!
Every patient matters Every pound counts
EFFICIENCY PROJECTSEFFICIENCY PROJECTS
Better ValueMaking best use of technology Working with other NHS OH
Challenges facing Occupational Health in the UK
• detachment from mainstream health care
• little communication with other specialties
• limited remit
• uneven provision, only in workplaces
• diminishing workforce
• shrinking academic base
• lack of good quality data
• image and perception
Working for a healthier tomorrow, 2008
Working in silos
The challenge for NHS OHS
Einstein said…
“If you keep on doing the same things and expect things to change, then that’s a definition of insanity.”
The world has changed….
Investing in good health at work
meansorganisational
change….
presents a huge opportunity for our profession
30th November 2010
Public Health strategy launched
Healthy Lives, Healthy People: Our strategy for public health in England.
To change or not to change….that is the question
Investing in good health at work
‘At a Tipping Point’• External Drivers• Internal Drivers
• OH reconfiguration response
The full cost of poor healthfor employers
30% S/A costs
AbsenteeismOvertimeTurnover
Temporary StaffingAdministrative Costs
Replacement TrainingOff-Site Travel for Care
Customer DissatisfactionVariable Service Quality
70% Health-related Productivity Costs
(adapted from R. Loeppke, US National Business Group for Health, Philadelphia 2009)
50 % of deaths
1. Tobacco use
2. Physical
inactivity
3. Poor diet
3 risk factors 4 chronic diseases
Globally, over 50%
of deaths are due to
these four diseases
4 chronic diseases
Three Four Fifty
Chronic
Respiratory
Disease
Cardiovascular
Disease
Obesity
Type 2
Diabetes
Cancer
Changing focus - 3 Risk Factors
3 Main Risk Factors can be attributed to the 4 main chronic diseases which lead to 50% of deaths in the UK. These risk factors provide a clear focus for action.
Proposal• A single collaborative OH service covers the whole of the
Manchester health economy • Provider of choice for OHS for all NHS in the area.• Service capacity and capability to provide a high-quality
occupational health service
• multidisciplinary includes nursing and medical staff with OH technicians, counsellors, cognitive behavioural
therapists, physiotherapists and other professionals • New standard care pathways • Innovative and better working practice
Proposal 2• project group to established of key personnel to agree
the outline service • period of consultation will take place involving all the
Trusts who want to be involved, the service users and
their representatives. • focus on outcomes with flexibility and imagination in the
creative joint working with Trusts • meet emerging demands including the well-being
agenda (Boorman), SEQOHS Standards, NHS
employers standards, etc
Proposal 3
• ANHOPS group to assist with benchmarking/audit • Links with Centre for Occup & Environmental Health,
University of Manchester - Largest postgraduate centre for OM in UK- Big research portfolio – HSE, EU, Research Council- Published on many topics incl backpain assesst & mental ill health
• Need experienced facilitator from SHA to work with experience of multi- trust service reconfiguration required to assist drive the project through to conclusion
The Door is Open
Any questions?