slide deck for iln symposium
TRANSCRIPT
Welcome
#ILNsymposium
Tom LindleyFounder, Inspiring Leaders Network
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Chris BainCEO, Rotherham Doncaster & South Humber NHS Foundation Trust
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Morning Session 1
The Importance of Integration for Innovation
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Carol WilbyHead of Commercial & International Innovation, NHS England
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www.england.nhs.uk
Innovation in healthcare
Carol Wilby
10 March 2015
www.england.nhs.uk
• The 5 Year Forward View identified a number of priorities to accelerate useful health innovation including new treatments and diagnostics and new ways of delivering care specifically through “combinatorial (integrated) innovation”.
A manifesto for the NHS
www.england.nhs.uk
• Sustainability & viability in delivering care that is “best in class”
• Developing the NHS as an innovation incubator - doing more of the same is not an option!
Why should we innovate?
www.england.nhs.uk
The power of innovation
www.england.nhs.uk
What’s stopping us?
www.england.nhs.uk
• Data & information• Innovation Scorecard• NHS Exchange• Innovation Connect
• Financial Incentives• Innovation tariff • CQUIN
• Leadership• Leadership & accountability framework
Key programmes
www.england.nhs.uk
Reward & Recognition
• Challenge Prize Programme• NHS Innovator Accelerator
System Architecture
• AHSNs• NICE Implementation Collaborative• Office for Innovation
Tools & Capability
• Innovation Compass• AHSNs• National Clinical Director for Innovation
Key Programmes
www.england.nhs.uk
Tools & Capability
Reward and Recognition
Access to data
• Uptake & Utility
• Profile & Priority
• International Blueprint
• Improved relationships
System Architecture
Financial levers
Culture
How are we doing?
www.england.nhs.uk
High volume of redundancies
1. Policy Framework for innovation is well regarded
2. Give it time, be patient – no overnight solutions
3. The more data you have the better
4. Need the right policy, regulatory and financial environment
5. Must collaborate
6. Need support at grass roots level
7. Finance is the elephant in the room
8. Need patient demand for innovation, top down won’t work
LearntLessons learnt
www.england.nhs.uk
A new industry council puts industry at the heart of policy development
More routine and systematic dialogue with AHSNs, and reduce the number of cotact points
A ne signposting and support service for industry
What might the future hold? look like?
www.england.nhs.uk
• Deliver partnerships with patients, social care, local authorities, citizens and technology industries to:• Use technology to increase social inclusion• Develop processes that are clinically supported and have
patient consent• Deliver personalised care/fully interoperable care record• Assist with the delivery of the digital health agenda• Delivery of high impact innovations
Further work to be done
www.england.nhs.uk
• Partner with the EU to deliver more “bang for the buck” that:• Utilises incentive based innovation funding that galvanises the use of ground-
breaking innovations in the NHS• Creates incentivised technology adoption in the NHS• Transforms the lives of individuals and families and enable people to stay healthy
and prevent hospital admissions
Increasing the size of the funding pot
www.england.nhs.uk
• Making Innovation everyone’s business, will significantly change the culture, the NHS’s greatest asset is its staff, but we do not harness their skills, ideas or knowledge as effectively as we could
“you need every brain in the game to win”(Jack Welch , Business Executive and former CEO at GE)
The NHS has 1.3 million brains
Whose business is it?
www.england.nhs.uk
Finally..
Andrew RileyMD, Yorkshire & Humber Academic Health Science Network
#ILNsymposium
Adopting Excellence, Creating Opportunity
www.yhahsn.org.uk @AHSN_YandH
AHSNs InnovationAndrew Riley MBA
Managing Director Yorkshire & Humber AHSN
www.yhahsn.org.uk @AHSN_YandH
Outline
• Brief introduction to AHSNs• Spotting innovation• Due Diligence• Building Partnerships• Improvement and Change• Evaluation and Evidence• Summary
www.yhahsn.org.uk @AHSN_YandH
National AHSN Picture
North West Coast North East and North Cumbria
Greater Manchester
Kent Surrey and Sussex
Yorkshire and Humber
East Midlands
Eastern
UCL Partners
Imperial College Health PartnersOxford
Wessex
South LondonSouth West Peninsula
West of England
West Midlands
www.yhahsn.org.uk @AHSN_YandH
The Yorkshire and Humber AHSN
• Population covered 5.8m
• Annual Budget £5.2m
• 47 NHS Members
• Regional NHS budget £12bn
• >180 Health related SME
• >20 health related MNO
• 2/8 English Core cities
• Regional economy £80bn
www.yhahsn.org.uk @AHSN_YandH
15/16 Strategic Objectives & Programmes
Population HealthEmpowering Citizens to manage their own health
Healthy Active Ageing
Improving HealthcareAcross Systems
In Organisations
Economic Growth
Accelerating Industry/NHS Partnerships
Accelerating Spread and adoption
Maximising International Growth
www.yhahsn.org.uk @AHSN_YandH
Spotting Innovation
• Innovation Scouts• Partnership with HEI and Business• Open Innovation• Investment and sponsorship, Dragons Den• International liaison and Partnerships
www.yhahsn.org.uk @AHSN_YandH
Due Diligence
• Search for Evidence, JED (Just Enough to Decide)• Due Diligence;
• On the company• the concept• the market• benefits
• Market Analysis; New, “me too”, cost• Health Economics
www.yhahsn.org.uk @AHSN_YandH
Building Partnerships
• AHSN + HEI • Translating research output into service impact
• AHSN + Business• Developing ideas• Proof of concept• Funding• Navigating the system• Connecting to the NHS
• AHSN + NHS• Innovation Scouts• Communities of best practice• Open Innovation Workshops, Show casing, workshops, conferences
• AHSN + Patients• Patient pull, early engagement and co-creation
• Right Organisations
• Right people
• Clearly defined need
• Safe Environment
• Time and Space
• Leadership
• Results
www.yhahsn.org.uk @AHSN_YandH
Improvement and Change
• Proven Techniques for improvement and change• Stick to the process• Education and Training• Cross cutting/system• Develop organisations to become change ready/ eager• Build team confidence, coach and support in choppy waters• Rapid feedback• “Dare to try” culture
www.yhahsn.org.uk @AHSN_YandH
Evaluation and evidence
• Credible reviewers/auditors; HEI academic rigour• KPI/ Outcome measures• Return on Investment• Patient Outcome Measures• Scalability• Spread and Adoption
www.yhahsn.org.uk @AHSN_YandH
Summary
• AHSN’s role in innovation• Making innovation real
Morning Session 2
Structuring successful Integration: What does good look like?
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Professor David WelbournMD, EutropiaVisiting Professor, CASS Business School
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Eutropia Limited © 2015 Company registration no. 7551009. Registered address 132 The Street, Rushmere St Andrew, Ipswich, IP5 1DH
Structuring Integrated Care
David Welbourn
Eutropia Limited © 2015 10 Mar 2015 37
“We must find and create tensions—force people
into different space for thinking...This is not just
a performance issue but a survival issue,
because managing paradox helps foster
creativity and high performance.”
Paul Polman,
Unilever CEO
Eutropia Limited © 2015 10 Mar 2015 38
A resourced plan to achieve defined goals Illustrated
experience of the journey
Tasks Behaviours Imagination & feelings
The way things are done
Framing the goal
Eutropia Limited © 2015 10 Mar 2015 39
A strong narrative provides:
Total clarity of a compelling purpose
A powerful picture describing outcomes
An enticing invitation to join the journey
A basis for distributed power & influence
Reason to be fully engaged
Inspiration for social movement to flourish
Offer of shared ownership and ambition
Flexibility to be resilient and sustainable
Eutropia Limited © 2015 10 Mar 2015 40
Gen Stanley McchristalFormer commander,International Security
Assistance Force,Afghanistan
“We had to change our structure to become a network…. Instead of decisions being made by people who were
more senior – the assumption that
senior means wiser – we found that the
wisest decisions were usually made by those
closest to the problem”
Eutropia Limited © 2015 10 Mar 2015 41
Redefining purpose
The NHS system was designed to make sick people well
30% of the population have health conditions from which
they can not be cured
70% of the NHS budget is spent treating failure to manage
their known conditions
Eutropia Limited © 2015 10 Mar 2015 42
Enabling communities to flourish and everyone to live fulfilled lives to the
greatest extent possible with their conditions.
Eutropia Limited © 2015 10 Mar 2015 43
Alan Lafley
CEO of Proctor & Gamble
“The firms with the
greatest capacity to
win, will be those
whose strategic
choices extend out to
networked
stakeholders,
suppliers and even
competitors in the
right circumstances”
Eutropia Limited © 2015 10 Mar 2015 44
Different problems: differing solutions
Help 30% of population live more effectively with their conditions
A coherent approach to urgent care
Encourage people to take more
responsibility for healthier lifestyles
Deliver “routine” acute care via best protocols
Concentrate complex and specialist care around very best
expertise
Eutropia Limited © 2015 10 Mar 2015 45
The business model
Governance
Model
The set of structures, processes and relationships within which decisions are made, resources deployed and accountability is managed to
achieve agreed purpose.
Eutropia Limited © 2015 10 Mar 2015 46
The business model
Governance
Model
Contracting
Model
Addresses how co-ordination is achieved for the service user. Defines how commissioner exerts their influence, and the manner in which the relationships
within the supply chain are managed.
Eutropia Limited © 2015 10 Mar 2015 47
The business model
Governance
Model
Contracting
Model
What is valued in the process? What will be paid for? How is each member of the supply chain paid?
How will payment be channelled?How will delivery be measured?
Reimbursement
Model
Eutropia Limited © 2015 10 Mar 2015 48
The business model
Governance
Model
Contracting
Model
Describes how the services are constructed and experienced by the service user. For best value and resilience, ownership should rest within the
provider supply chain, NOT with the commissioner
Service
Model
Reimbursement
Model
Eutropia Limited © 2015 10 Mar 2015 49
The business model
Governance
Model
Contracting
Model
Service
Model
Reimbursement
Model
Eutropia Limited © 2015 10 Mar 2015 50
Systems no stronger than weakest link
Acute & Specialist
health
Primary & community
health
Mentalhealth
Welfare & Housing
Social care
Value of voluntary
care
£300bn
Healthcare
Social
Volunteers
9m People
Eutropia Limited © 2015 10 Mar 2015 51
Integration - contracting model
Commissioner AllianceIndependent
Integrator
AccountableCare
IntegratedOrganisation
Network of peers act collaboratively to
deliver common goals
Traditional modelCommissioner letsand manages all discrete contracts
Specialist independent integrator manages
supply chain subcontracts
Single organisation has capacity and
capability to deliver full solution
Special purposevehicle
Partners invest equity to share ownership in a single organisation
as a joint venture
Single provider takes lead to be accountable for all the supply chain
partnerships
Eutropia Limited © 2015 10 Mar 2015 52
Aligning the model
Help 30% of population live more effectively with their conditions
A coherent approach to urgent care
Encourage people to take more responsibility for healthier lifestyles
Deliver “routine” acute care via best protocols
Concentrate complex and specialist care around very best expertise
Integration,Partnerships
Peer networks,Partnerships
Public Health & education
Hub & spokenetworks
Integration,Partnerships
Eutropia Limited © 2015 10 Mar 2015 53
Quality – A system responseThe vast majority of failures occur at boundaries!
Reduce number of boundaries
Reduce risk of failure at
boundaries
Reduce impact of failure at
boundaries
Stronger standardsBetter informationMutual respect & understandingBetter communication
Redesign care to eliminate waste stepsReduce fragmentation
Focus on outcomesGreater oversight/ assuranceShared risk and rewardCommon leadership
Eutropia Limited © 2015 10 Mar 2015 54
Quality – a person response
Reduce frequency of
exacerbations
Reduce severity of exacerbations
Rapid and appropriate intervention
Better use of personal recordEarly detectionRegular monitoring and diagnosisMore appropriate intervention
Increased self awareness Changes in lifestyleBetter monitoring and diagnosisMore accessible care support
Joined-up planningRapid access to right careWider range of interventionsMore use of intermediate care
Focus on outcomes that matter!
Eutropia Limited © 2015 10 Mar 2015 55
“If you are not
confused about
current events, you
are not paying
attention”
Bob Johansen
Former President.
Institute for the Future
Eutropia Limited © 2015 Company registration no. 7551009. Registered address 132 The Street, Rushmere St Andrew, Ipswich, IP5 1DH
Further detailsDavid Welbourn 07889 [email protected]
• DisclaimerIn keeping with our values of integrity and excellence, Eutropia Limited has taken reasonable professional care in the preparation of this report. Although Eutropia Limited has made reasonable efforts to obtain information from a broad spectrum of sources, we cannot guarantee absolute accuracy or completeness of information/data submitted, nor do we accept responsibility for recommendations that may have been omitted due to particular or exceptional conditions and circumstances.
• Confidentiality This report has been prepared for the client within the terms of our contract, and contains information which is proprietary to Eutropia and confidential to our relationship. This may not be disclosed to third parties without prior agreement.
Except where permitted under the provisions of confidentiality above, this document may not be reproduced, retained or stored beyond the period of validity, or transmitted in whole, or in part, without prior, written permission from Eutropia Limited.
Eutropia Limited © 2015 Company registration no. 7551009. Registered address 132 The Street, Rushmere St Andrew, Ipswich, IP5 1DH
Additional materials
Eutropia Limited © 2015 10 Mar 2015 58
Mark Moore – strategic triangle
Authorisingenvironment
Legitimacy – is there political
& regulatorycover?
The practical reality – is it possible?
Operationalcapability
Public valueproposition
What matters – is the uniting
purpose valuable?
After Mark Moore, Creating public value – strategic management in government, published by Harvard University Press, 1997
Eutropia Limited © 2015 10 Mar 2015 59
Draw on widely diverse
perspectives
Adopt open enquiring mindset
Go out of your way to make connections
Tasks& ideas
Relationships & behaviours
Be Clear
Be Curious
Be Courageous
Invest in promoting
values
Establish compelling
vision
Embrace uncertainty
Distribute leadership &
decisions
System leadership characteristics
© 2012 Prof David Welbourn, Prof Dean Fathers
Eutropia Limited © 2015 10 Mar 2015 60
VUCAChaos &Paradox
If it were only complexity….
Uncertainty
Volatility Complexity
Ambiguity
Paradox:not susceptible
to logical analysis
high frequency,multi-dimensional
turbulence at scale
past experience is no longera reliable predictor
cause & effect relationships
are indiscernibleeven experts fail to make sense
of conflicting signals
Eutropia Limited © 2015 10 Mar 2015 61
Systems leadership
Shared Vision and Values
Burning platform vs burning ambition
Powerful narrative to energise/ motivate
An authorising environment
Ceding power for greater good
Magnanimity, humility, servant leadership
Cooking the conflict – managing the paradox
Information rich, deep engagement
Eutropia Limited © 2015 10 Mar 2015 62
Governance
Structures Processes
Agreed outcomesachieved
Accountability
Decisions ActionsResources
deployed
Wh
at..
. “
Stu
ff”
Eth
os.
..
“Sty
le”
Governance: Stuff ’n ’Style
Relationships
Peter CrowExecutive Director, Quarry Group
#ILNsymposium
What does good look like?Peter Crow | Quarry Group | New Zealand
Important considerations
• Islands of excellence
• Social, political and economic demands
• Acceptable rate of change
Purpose
StrategyExecution
Towards a working model
Underlying mechanisms
Conclusions
“Together” trumps “apart”
A commitment to a higher purpose
Active engagement of the board
[email protected] | +64 21 611 635 | @petercrow1
CoffeeBack at 12.00
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Case Study
Sheffield Hallam University Health & Wellbeing Programme
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Hanna LeahyBusiness Development Manager, SHU Wellness
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Adopting Excellence, Creating Opportunity
www.yhahsn.org.uk @AHSN_YandH
Workforce Health and Wellbeing Project
Hanna Leahy, MSc
Adopting Excellence, Creating Opportunity
www.yhahsn.org.uk @AHSN_YandH
Project Partners
www.yhahsn.org.uk@AHSN_YandH
Project Background
• Chronic disease and health inequalities are rising in an ageing population.
• Absenteeism and a decline in productivity associated with chronic disease costs the UK an
estimated £100 billion every year (Nice, 2009).
www.yhahsn.org.uk@AHSN_YandH
ProductivityAbsenteeism• Short-term• Long-term
Presenteeism• Inconsistent quality (service/product)• High staff turn-over• Poor customer satisfaction• Temporary staff• Low levels of efficiency
www.yhahsn.org.uk@AHSN_YandH
The NHS
• UK's largest employer
• Health and health behaviour of employees is poorer than national averages... reflected by absenteeism rates
• Improving staff wellbeing is crucial for delivering improvements in patient care
www.yhahsn.org.uk@AHSN_YandH
Workforce Wellbeing Programmes
• Absenteeism and a decline in productivity associated with chronic disease costs the UK an estimated £100 billion every year ...
with a large proportion of this attributable to
physical inactivity in the workforce (NICE, 2009).
• Lifestyle changes that result from an effective workforce health programme can equate to at least a 400% return on investment for employers (Pricewaterhouse Coopers, 2008).
www.yhahsn.org.uk@AHSN_YandH
Workforce Wellbeing Programmes
Workplace Wellbeing
Programme
Behaviour Change
Improved Health and Wellbeing
Improved Productivity
• "Good health is good business" (Dame Carol Black, 2008)
www.yhahsn.org.uk@AHSN_YandH
SHU Wellness - The Model
www.yhahsn.org.uk@AHSN_YandH
SHU Wellness•Multicomponent programme:
– 1-to-1, hour long annual health and fitness assessment. – Includes measurement of blood pressure, cholesterol, blood
glucose, lung function, aerobic capacity, body composition.
•Motivational Interviewing (MI)
– Directive client centred collaborative approach to facilitate lifestyle related behaviour change goals.
www.yhahsn.org.uk@AHSN_YandH
SHUWellness STH Pilot• Representative cohort (N=50)
• Can be delivered and achieve same health impact in the NHS... in 6 months
• Significant improvements in total cholesterol, waist circumference, aerobic capacity
• 96% staff rating the experience as excellent or very good and 71% increased physical activity levels.
• ROI between 302% and 571% (YHEC, 2013)
www.yhahsn.org.uk@AHSN_YandH www.yhahsn.org.uk@AHSN_YandH
Regional PilotN= 277 (out of 300 at baseline) completed the programme
www.yhahsn.org.uk@AHSN_YandH
Results: Cardiovascular Risk
– Cardiovascular disease risk significantly improved, with observed improvements in the following:
• Blood pressure (systolic and diastolic)*
• Resting heart rate*
• Total cholesterol*
• BMI and body fat (%)*
• Aerobic capacity
• * denotes statistical significance
www.yhahsn.org.uk@AHSN_YandH
Results: Cardiovascular Risk
www.yhahsn.org.uk@AHSN_YandH
Results: Self-Report–Improvements in staff quality of life:
• Physical function*
• Vitality*
• Role Emotional*
• Mental Health*
–Improved Diet: Increased fruit and vegetable consumption*
–Increased physical activity* *statistically significant
www.yhahsn.org.uk@AHSN_YandH
What next? Regional roll-outProduct 1. Organisations who want external wellness service to staff
SHU/AHSN Spin-out company
2. Organisations who deliver SHUWellness to their staff
TTP Model
3. Organisations who deliver SHUWellness to their staff and their clients
TTP Model
4. Roll-out across other AHSN's
TTT Model
Fees Delivery of service Staff software licence Staff software , Client , Community Licence
TTT licence (franchise)
Examples SME's, Schools NHS, Councils Sheffield Utd community foundation
Other Universities
Product/
Services
Annual individual health check and lifestyle review
Online follow-ups
Online workshops
Individual and company wellness reports
Complimentary services
As product 1, plus
Yearly refresher course
Quality assurance/sharing practice workshop (SHUWellness network)
As product 2 The whole SHUWellness offer
www.yhahsn.org.uk@AHSN_YandH
Regional Roll-out
• Train the practitioner– 5 day training course for suitably
qualified staff
• SHU delivery via a spin-out company– affordable labour via SHU graduates
"The tutors had an obvious passion for the subject and a great
communication style."
"A great training course! The facilitators were patient,
knowledgeable and approachable which made it an enjoyable
programme."
"I liked how the trainers adapted the programme flexibly to suit us to
meet our needs."
www.yhahsn.org.uk@AHSN_YandH
The 'Offer'
• Y&H AHSN fund organisations to receive FREE:
– Wellness taster sessions for up to 3-5 organisation 'opinion leaders'
– Delivery training via the 'train the practitioner' course
www.yhahsn.org.uk@AHSN_YandH
Additional Services
Wellness Software Active Challenge
www.yhahsn.org.uk@AHSN_YandH
What are the costs?
Cost
Start-up kit Approx. £5000
Cost per head Approx. £15
Delivery staff Approx. £25k p/a
Cost per head, delivered by SHU
Approx. £70
www.yhahsn.org.uk@AHSN_YandH
Uptake
• NHS – Engagement events – Tasters– Train the practitioners– Challenges
• Non-NHS
www.yhahsn.org.uk@AHSN_YandH
Summary
• The justification for workforce health and wellbeing programmes appears unambiguous... on an individual, employer, business and national basis.
• Yorkshire and Humber AHSN and SHU provide an example of an evidence-based, scalable and sustainable programme.
• Implementation is challenging without a profound culture change.
www.yhahsn.org.uk@AHSN_YandH
"In the early 90’s I used to smoke at my desk; now can you imagine anyone smoking
at their desk now? It’s just so completely out there. It would be nice to look back to
this time in 20 years and say can you imagine someone sitting for 6.4 hours a
day?
Can you imagine that?”
www.yhahsn.org.uk@AHSN_YandH
Results: Staff Feedback"The programme was excellent- the assessment
appointments and report were very thorough and gave me a great understanding of how lifestyle and
diet affect my wellbeing.
The information I was given empowered me to take charge of my own health.
The guidance provided me with the insights on what I could do to improve my health and how
different things affect me - not just nutrition and exercise, but general lifestyle, work and home life balance and stress management. I was given the
knowledge to help address the issues that are affecting me and how to tackle them. I would highly
recommend this programme!"
"I am really pleased that I took part in the programme as it gave me the motivation
to finally do something positive.
It also highlighted a health problem that I wasn't aware of which could have
potentially led to more serious health problems."
"This programme really did motivate me to stop smoking. Overall I found the programme really rewarding and the assessors were great too."
"I found the whole project very interesting. It enabled me to improve my exercise plan,
making it more achievable and realistic."
"It would be great if this programme could be extended. I would certainly welcome
repeating the assessment in a year or so to enable progression. Maybe this could be something that could be partly funded in the same way as the iChoose scheme?"
Afternoon Session 1
Provider Organisation and Public Sector Integration
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Sir Andrew CashCEO, Sheffield Teaching Hospitals NHS Foundation Trust
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Integration - the key to true ‘patient centred care’Sir Andrew CashChief Executive, Sheffield Teaching Hospitals NHS Foundation Trust
• Sheffield Teaching Hospitals NHS Foundation Trust is one of the UK’s busiest and most successful NHS Foundation Trusts (Est 2004)
• Above all, patients lie at the heart of everything we do
• 16,000 staff, 1960 beds, 2 campus sites, 5 hospitals and multiple community locations
• With a turnover approaching £1 billion
• Adult Community Services joined April 2011
About Sheffield Teaching Hospitals
Local and system wide Integration is proving critical to the delivery of these objectives
Integration is the key to true ‘patient centred care’.
National Level:
• NHS Five Year Forward
• Dalton Report
• Financial Climate
• Patient expectations
Trust Level:
• Adult Community Services joined 2011
• Opportunity to re-think how we delivered care across the pathway and across the local health system
• 3 years later we have combined acute medicine and community services into a Combined Directorate.
• New culture, approach and significant patient and organisational benefits.
• Discharge to Assess, virtual wards, joint social care and community care teams
Integration is the key to true ‘patient centred care’.
City Level:
• Right First Time Partnership formed in 2011
• Acute care, primary care, commissioners, Local Authority working together with a common set of goals
• Significant benefits achieved
• Phase 2 – Better Care Fund, Acute Provider Board, GP Provider Board, Health and Wellbeing Board
• Prime Minister’s Challenge bid
Integration is the key to true ‘patient centred care’.
Regional Level:
• Working Together Partnership – 7 acute Trusts across South Yorkshire and North Derbyshire
• Clinical and non clinical benefits realised since inception in 2012
• Vanguard bid - Exploring a Federated approach which will enable providers to explore the different options identified through the Dalton Review
• Aim is to support the sustainability of local, clinical and non clinical services and determine how best the different organisational models can facilitate wide scale change
Integration is the key to true ‘patient centred care’.
Working Together
Professor Dean FathersChair, Nottinghamshire Healthcare NHS Foundation Trust
#ILNsymposium
115
“Provider Organisation &Public Sector Integration”
Inspiring Leaders Network (ILN)Annual Symposium
Presented by:
Dean FathersChair, Nottinghamshire Healthcare &Professor in Practice of Healthcare Management, Cass Business School
116© 2012 Prof Welbourn and Prof Fathers Cass Business School
Draw on widely diverse
perspectives
Adopt open enquiring mindset
Go out of your way to
make connections
Tasks& ideas
Relationships & behaviours
Be Clear
Be Curious
Be Courageous
Invest in promoting
values
Establish compelling
vision
Embrace uncertainty
Distribute leadership &
decisions
Desired leadership characteristics
117
Contact Details
Thank you for listening, if there are any questions I’d be delighted to answer them but if you wish to contact me later please do so. My contact details are:
• E-mail: [email protected]
• Mobile: +44(0)7970 183780
• Skype: DeanFathers1
• Twitter: @DeanFathers1
Julian HartleyCEO, Leeds Teaching Hospitals NHS Foundation Trust
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LunchBack at 14.15
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Afternoon Session 2
Integration with Industry: Delivering successful partnerships
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Richard StubbsCommercial Director, Yorkshire & Humber Academic Health Science Network
#ILNsymposium
Adopting Excellence, Creating Opportunity
www.yhahsn.org.uk @AHSN_YandH
Industry Integration – Powering UK plc
Richard StubbsCommercial Director, Yorkshire and Humber AHSN
www.yhahsn.org.uk @AHSN_YandH
Life Science UK – A Snapshot
Pharma MedTech & BioTech
UK Jobs 70,000 96,000
UK companies 477 4,400
Annual Turnover £30bn £20bn
The UK has a uniquely powerful combination of: • World-leading universities• Established industrial R&D, manufacturing and supply chain • Translational research infrastructure and clinical network • Globally renowned research charities • An NHS with 60+ million patients and access to unrivalled health data• A firm commitment to partner with industry and establish access points
for industry to the UK life science base
www.yhahsn.org.uk @AHSN_YandH
Our Challenge
The NHS is facing its biggest ever challenge:
• £20 billion productivity shortfall• a global economic crisis• a growing and ageing population• increasing costs of new drugs and
technologies • growing public expectations
www.yhahsn.org.uk @AHSN_YandH
Expectations
Technology and medicine are changing fast, as are people’s expectations:
• Technology – smart phones and wearable devices; “internet of things” and remote monitoring; outbreak of online transactions; smart medical tech; the Cloud and pervasive big data
• Medicine & Discovery – genomics; proteomics; personalised and stratified medicines; regenerative medicine; the end of blockbusters and the rise of niche-busters; the return to translational medicine; the challenges to “big pharma”
• Services – rise of social media; 24/7 access taken for granted; highly personalised and customised services; brands as purveyors of meaning and value
www.yhahsn.org.uk @AHSN_YandH129
Reduce variation in the NHS, and drive greater compliance with NICE guidance
Create a more systematic delivery mechanism for innovation
“If we always do what we always did, we will always get what we always got”
And that means increasing financial pressure on an already hard pressed service
www.yhahsn.org.uk @AHSN_YandH
What are Academic Health Science Networks?
• In May 2013, England became the first country in the world to create a nationwide system
of Academic Health Science Networks (AHSNs)
• Each of the 15 AHSNs has a five-year licence to deliver against four broad objectives:
• Focus on the needs of patients and local populations
• Build a culture of partnership and collaboration
• Speed up adoption of innovation into practice
• Create economic prosperity
www.yhahsn.org.uk @AHSN_YandH
2015/16 Strategic Objectives & Programmes
Population Health
Empowering Citizens to manage their own health
Healthy Active Ageing
Improving Healthcare
Across Systems
In Organisations
Economic Growth
Accelerating Industry/NHS Partnerships
Accelerating Spread and adoption
Maximising International Growth
Across Systems
In Organisations
www.yhahsn.org.uk @AHSN_YandH
2015/16 Strategic Objectives & Programmes
Population Health
Empowering Citizens to manage their own health
Healthy Active Ageing
Improving Healthcare
Across Systems
In Organisations
Economic Growth
Accelerating Industry/NHS Partnerships
Accelerating Spread and adoption
Maximising International Growth
Across Systems
In Organisations
www.yhahsn.org.uk @AHSN_YandH
Economic Growth
The healthcare sector contributes to economic growth in a number of ways: • By making people better and keeping people well
• Through working in partnership with academia and industry to grow research in healthcare
• Through accelerating the adoption and diffusion of innovation and best practice
• Through promoting services, innovations and expertise overseas
www.yhahsn.org.uk @AHSN_YandH
Economic Growth
Examples of the AHSN contribution to economic growth:
• Improving the health, and thereby productivity, of the population
• Improving productivity of healthcare providers
• AHSNs as market makers
• Making UK healthcare an attractive place to invest and do research
• Promoting UK healthcare expertise
www.yhahsn.org.uk @AHSN_YandH
Health and Wellbeing Programme
• Sheffield Teaching Hospitals, Bradford Teaching Hospital, Airedale Hospital – staff employed > 26,000.
• Exercise & fitness a competitive advantage.
• Evidence;• ROI for every £1 expect between £3-8• STH potential savings up to £2m pa not including productivity gains• Nationally £350m savings pa• Improved Staff satisfaction• Improved patient satisfaction
• Phase 1: > 750 staff recruited onto program• ↓ BP, ↓ Cholesterol, ↓ Waist circumference, ↓ BMI• ↑Aerobic Fitness, ↑ Staff satisfaction, 7:1 ROI to date
Rapid spread and adoption
Commercialisation through Franchising
model
Significant return on investment
www.yhahsn.org.uk @AHSN_YandH
Supporting Y&H SMEsRD Biomed: New innovative diagnostic device
adopted by AHSN
AHSN support enabled:
• Validated cost consequence models
• Focussed business cases
• Networks of key clinicians, GPs and support
agencies
Outcomes:
• Engaged with CCGs to start crucial audit studies
• Engaged with key hospital clinics
• Major collaborative study in London, Leeds and
Newcastle.
• Networked across North of England AHSNs
• Future International work
www.yhahsn.org.uk @AHSN_YandH
Open Innovation Programme
• Digital Health for Healthy Ageing
• 24 UK/China SMEs/Academics in Open Innovation programme
• Potential £2m in China funding for UK participants
• AHSN 7.5% equity stake in UK/China partnerships
• Funding provided by Guangzhou Development District
• 2015 – China part 2, Canada, India, Mexico
www.yhahsn.org.uk @AHSN_YandH
International Activity
• Close partnership working with other Government agencies including Healthcare UK, UKTI & Office of Life
Sciences
• Seeking projects bringing increased export opportunities and creating inward investment
• Quebec/Ontario
• Mexico
• Arab Health 2015
• UbiFrance Trade Development
• Africa Healthcare Summit 2015
www.yhahsn.org.uk @AHSN_YandH
The Ask From Industry
• Relationships based on trust not transaction
• Quicker adoption of new ideas
• Failing faster
• Better understanding of each others business
• Less criticism and more collaboration
• Co-development of patient-centred solutions
• Fewer access points
• Consistency of decision making
• Commitment to “do once”
Adopting Excellence, Creating Opportunity
www.yhahsn.org.uk @AHSN_YandH
Richard StubbsCommercial [email protected]@Richarddstubbs
Kevin Kiely CEO, Medilink
#ILNsymposium
1. Medilink integration
2. Technology integration
3. Cross sector integration
4. Cross national boundary integration
5. Brokerage & Translation
Clinical
Business
Academia
Où est le marché pour
cette nouvelle technologie ?
¿Cuál es la necesidad? Y ¿cuál es el modelo de negocio?
How can we solve this
clinical need?
Medilink Integration
Technology Integration
Cross Sector Integration
Cross National Boundary Integration
Brokerage & Translation
NOCRI
NICE
NHS England
DoH
NIHR
CLAHRC
HTC
DEC
AHSN
CCG
SMEs
LEPsLocal
Enterprise Partnership
s
BGHBusiness Growth
Hub
UKTI
Innovate UK
Universities
KTN
Embassies & Consulates
Innovation Patient Benefit
BBSRC
EPSRC MRC
WHO
FCO
Healthcare UK
Further Educatio
n
Northern Healthcare Alliance
Catapults
Creative Sheffiel
d
Case Study
3M & Nottingham University – Lymphoedema Project
#ILNsymposium
Professor Christine Moffatt CBEProfessor of Clinical Nursing Research, Faculty of Medicine & Health Sciences, University of Nottingham
#ILNsymposium
Carol AriesHead of Strategic Partnerships, 3M
IngeniousSolutions
Transforming Health
3M Confidential – Internal Use Only
Yorkshire and Humber AHSN Inspiring Leaders Conference – 10th March 2015
Chronic Oedema Programme
Carol AriesHead of Strategic Partnerships3M Health Care Limited
Professor Christine Moffatt, CBEProfessor of Clinical Nursing Research / Nurse Consultant University of Nottingham / Royal Derby Foundation NHS Trust
3M Confidential.156 April 15, 2023. All Rights Reserved.© 3M
Chronic Oedema Programme
Background Chronic Oedema and scale of problem Knowledge Transfer Partnership Programme Progress so far Alignment to integrated care Key learns
© 3M 2015. All Rights Reserved.
3M Confidential.157 April 15, 2023. All Rights Reserved.© 3M
Background
© 3M 2015. All Rights Reserved.
3M Confidential.158 April 15, 2023. All Rights Reserved.© 3M
Chronic Oedema Management
Coban 2 and Coban 2 Lite:― Saves valuable clinic time
― Supported with clinical evidence and cost effective
Key challenge - No clear national standard or care pathway
3M Critical & Chronic Care Solutions
Knowledge Transfer Partnership in Chronic Oedema – Supporting Service Transformation
3M Confidential.160 April 15, 2023. All Rights Reserved.© 3M
Knowledge Base Partner
Professor Christine Moffatt C.B.E.― Awarded a CBE in the 2006 New Year's Honours List
― Life Fellow of the Royal College of Nursing
― 2008 Nursing Times Diamond 20 Award (20 most influential nurses in the last 60 years)
― Experience in transferring care to community nurses
The KTP Associate - Rebecca Gaskin
- Skilled, motivated, enthusiastic, eager learner!
- Project manager
3M Confidential.161 April 15, 2023. All Rights Reserved.© 3M
3M Confidential.162 April 15, 2023. All Rights Reserved.© 3M
Chronic Oedema: An international problem…an international approach
© 3M 2012. All Rights Reserved.
KTP project to develop a chronic oedema community
pathway
International epidemiology Study LIMPRINT funded by research grant from 3M and
using electronic platform
10 countries participating
European Grant to define size and impact of CO and disease
mechanisms (LIMPRINT)
Development of Coban system from venous disease to chronic oedema
Evaluation of system in RCT and observational studies (UK and
Canada)Qualitative assessment of patient
impact and professional challenges
Cost effectiveness study
Understanding Coban Within specialist services
3M Confidential.163 April 15, 2023. All Rights Reserved.© 3M
Only 60% of sufferers being treated. Care provision limited by:― Nos. of trained specialists― Resources in specialist clinics― Leading to ad hoc management in the community
Background on chronic oedema
“…identification at general practice level… more specialist nurses….and
also the communication factor…(professionals) not being able to talk
to each other because of different trusts, or whatever it may be, it
seems totally farcical…”
.
Patient Feedback
3M Confidential.164 April 15, 2023. All Rights Reserved.© 3M
Prevalence and impact of Chronic Oedema x 3 higher than previously
estimated using the same methodology 10 years ago
Mean age of sample – 72.6 years
Leg ulceration in 50% of community patients
With 31% having an ulcer for more than 5 years
9% had previously quit work due to condition
© 3M 2015. All Rights Reserved.
3.99/1000Overall Prevalence
10.31 /1000 65 - 74
28.57/100080+
Study in Derby, 2012
3M Confidential.165 April 15, 2023. All Rights Reserved.© 3M
Chronic oedema is a life long condition Related to long-term conditions including: obesity ,aging ,immobility and cancer
Prevalence and impact of chronic oedema
NHS Five Year Forward View 2/3 of us are overweight or obese Long-term health conditions = 70% NHS budget Sickness absence costs estimated £22 billion a year 2/3 patients admitted to hospital are over 65 1/6 people over 85 live in care homes
3M Confidential.166 April 15, 2023. All Rights Reserved.© 3M
Prevalence and impact of chronic oedema – hidden costs: Limited data – data acquisition is a key output of this project
Cellulitis is a common problem associated with chronic oedema London study: 53% chronic oedema patients suffered an acute infection since swelling commenced Average frequency of infection per chronic oedema patient = 7.4 9% of which required hospital admission Average length of hospital stay for cellulitus = 11 days HES 2011 / 2012 more than 25,000 acute admissions 65+ age range for Cellulitis (circa 24,000
in 19-64 age range)
Better management and earlier intervention can prevent incident progression reducing acute admissions and antibiotic prescriptions
© 3M 2015. All Rights Reserved.
3M Confidential.167 April 15, 2023. All Rights Reserved.© 3M
Knowledge Transfer Partnerships
Collaboration between Universities and industry for a specific project with positive financial outcomes for the company
Co –funded by Dept of Business, Innovation and Skills (50%) via Technology Strategy Board
Scheme running since 1976 with 800 ongoing in the UK across wide range industries
Graduate Associate appointed full time to project for 2 years Academic lead commits 10% time to project
3M Confidential.168 April 15, 2023. All Rights Reserved.© 3M
KTP Stakeholders:
KTP
University
Industry
Graduate
Specialist Community
Social Care
Patient
3M Confidential.169 April 15, 2023. All Rights Reserved.© 3M
Project aims
Deliver a “consensus care pathway”
“ An agreed, multi-disciplinary practice based on guidelines and evidence... for a specific patient group”
Implement a shared care model with appropriate trainingCollect data for CCG considerationPublications in leading journalsProvide business opportunity for Coban II
3M Confidential.170 April 15, 2023. All Rights Reserved.© 3M
Project steps…2 year plan and programme deliverables
• Plan• Consensus
meeting (Oct.)• Review pathway
Develop care pathway
• Embed in systems• Education• Data collection
Implement in community care • Publications
• Tool kit• HE case• Implementation ££
Build business case for CCG adoption
2014 2015 2016
3M Confidential.171 April 15, 2023. All Rights Reserved.© 3M
Stakeholder group
Pathway draft and consensus
Data collection Training and education
packages Pathway pilot Data analysis and
dissemination
Progress so far…
3M Confidential.172 April 15, 2023. All Rights Reserved.© 3M
Expected programme benefits
Better control of chronic oedema Improved experience of care and quality of life for patient e.g. Mobility Reduced incidence of secondary complications e.g. leg ulcers Reduced acute admissions with severe oedema Better understanding and control of/reduced use of antibiotic prescriptions Improved practitioner confidence and skills in delivering care.
Big data – better understanding of condition and causes UK reputation enhanced as we are leading the way globally on understanding and
treating this condition Cost saving to the NHS
© 3M 2015. All Rights Reserved.
3M Confidential.173 April 15, 2023. All Rights Reserved.© 3M
Alignment to integration agenda Project engaging all key stakeholders from primary, secondary and social care and
across all hierarchies and clinical expertise Anticipated care pathway will be patient centred drawing on appropriate clinical
and social care experts to manage cause and symptoms – move to a fully effective networked care management system.
Engaging full suite of relevant suppliers to ensure treatment solutions and care pathway are fully aligned.
© 3M 2015. All Rights Reserved.
3M Confidential.174 April 15, 2023. All Rights Reserved.© 3M
International interest in chronic oedema managementJapan
Japanese 5th ILFJ conference in Sapporo, September 21st 2015.
Integration with Dr. Kobayashi at Hokkaido University
France
Invitation to present project details and support similar prevalence n Montpellier France, October 2015
Integration with Prof. Isabelle Quere at University of Montpellier, France
© 3M 2015. All Rights Reserved.
3M Confidential.175 April 15, 2023. All Rights Reserved.© 3M
Key learns/observations
KTP pathway project approach is ideal for med tech products and care pathway design
Critical to make sure have strong stakeholder group – take time to research, engage and decide team
Ensure front line staff appropriately represented Regular project reviews – iterative process – amend project plan accordingly if its
not working. Manage widespread interest – say focused on the project and deliverables whilst
supporting wider interest e.g. this conference. Draw on expertise of all partners to help deliver the project e.g. commercial
facilitators.© 3M 2015. All Rights Reserved.
3M Confidential.176 April 15, 2023. All Rights Reserved.© 3M
Thank you3M.co.uk
Chris BainCEO, Rotherham Doncaster & South Humber NHS Foundation Trust
#ILNsymposium
Tom LindleyFounder, Inspiring Leaders Network
#ILNsymposium