Birmingham Children's Hospital FT
Medical Mosaic have completed a programme to develop plans for three years of service and cost improvements for the Surgical Directorate.
The programme captured a number of pre-existing and Trust-wide initiatives and carried out a programme of clinical engagement to identify transformational change through pathway reform. It took the approach of ‘no stone unturned.’ Benchmark performance measures would not be used as a primary driver during engagement, though it would be used to contextualise projects and indicators.
A risk-share agreement was set up where payment of the fee was conditional on the submission of acceptable plans to maintain quality and realise the required values.
Having supported 10/11 CIPs with progress monitoring, issue and dependency management, these measures were incorporated into the Trust’s new Programme Management Office approach, allowing Medical Mosaic to focus on the creation of new and additional projects for future years.
Starting from a capture of candidate 11/12 projects and held an ‘Awayday’ for ideas and themes for improvement, we developed checklists for use with each specialty and pathway.
Engagement then covered all specialties, meeting lead consultants, lead nurses and health professionals. Meetings covered ideas for income generation, clinical pathway improvement, patient flow, sharing care with the healthcare community and needs for supporting structure and responsiveness. These were followed by research where it was needed, and definition of enabling projects for supporting functions (for example, in patient flow) realisation projects (for example, bed availability). Some projects naturally led to a need for interaction with commissioners.
Plans were submitted and accepted to show the required level of saving, with contingency, and a number of cost-neutral improvements in service and quality over the three-year period. The programme and project plans show the need for advance preparation and management of dependencies before the ‘high profile’ part of the projects come into focus.
A review has indicated a high level of awareness, understanding and approval of the programme across the directorate, with a collaborative working atmosphere on specific issues between directorates. There is a willingness to undertake 'component' projects in relative isolation, with the belief that they will contribute to a realisable whole. The theme of ‘no stone unturned’ helps focus on approved projects by eliminating unworkable ideas.
A full case study is available by contacting MML at the 'contact us' e-mail address.
BCH Surgical Directorate are confident of the plans and happy to proceed with internal resources. Medical Mosaic are continuing in a three-year arrangement with BCH Clinical Support Services to support delivery of their 3-year plan.