Can IT Save the NHS Dr Yvette Oade

Can IT Save the NHS? Dr Yvette Oade Chief Medical Officer

Can IT Save the NHS • What are the problems – Demand – Demographics – Complexity – Workforce – Money

30 years of progress • • Imaging Medical Record Knowledge – literature search Outcome data

5 year Clinical Business Strategy • • 15, 000 staff Over 100 specialties 19 CSUs Every one of them said IT was part of their solution

What will your Medical Director be worrying about?

Q 1 15/16 Q 4 14/15 Q 3 14/15 Q 2 14/15 Q 1 14/15 Q 4 13/14 Q 3 13/14 Q 2 13/14 Q 1 13/14 Q 4 12/13 Q 3 12/13 Q 2 12/13 Q 1 12/13 Q 4 11/12 Q 3 11/12 Q 2 11/12 Q 1 11/12 Q 4 10/11 Q 3 10/11 Q 2 10/11 Q 1 10/11 Q 4 09/10 Q 3 09/10 Q 2 09/10 Q 1 09/10 Q 4 08/09 Q 3 08/09 Q 2 08/09 Q 1 08/09 Q 4 07/08 Q 3 07/08 Q 2 07/08 Q 1 07/08 Todays Problems LTHT Trust apportioned CDI cases per quarter 220 200 180 160 140 120 100 80 60 40 20 0

Falls Improvement

Mortality Rates

Primary drivers Goal Reduce cardiac arrest calls by 70% on pilot wards by July 2015 Identify and respond to deterioration Secondary drivers Culture, teamwork and accountability End of Life Care Effective management of life threatening medical conditions Taking timely action on NEWS Own/ understand, and act on your data Identify education and support needs to change local practice and behaviours Strengthen team working – celebrate success Timely Identification of all patients approaching end of life Timely Advance Care Planning (with DNA CPR discussions ) We want to reduce avoidable deaths in our Trust

Never Events

What do our patients want? �Reliable and Effective Care �Basic care �Infection �Mortality �Every element of the bundle �Good communication �With themselves and their family �With each other – clinical team �Accurate records �Seamless Care �Into and out of hospital

Building a Culture of Compassionate Care �Having confidence in our care �Making it easy to do the right thing �Using care bundles �Measuring our compliance �Reducing variation without removing clinical judgement �Showing real improvement

Which patient do you want to be? Patient Process A B C D Admit ASU Yes No Yes 75% CT scan in 12 hours No Yes Yes 75% Consultant No review in 12 hours Yes No 50% Swallow assess in 24 hours Yes No Yes 75% 50% 100% 75% 25%

Can IT solve patient safety problems? • PACS • Order Comms

e-Observations [Image removed]

e-Prescribing [Image removed]

Small sample of one! • Ask one junior doctor – Can IT Save the NHS? • Too many systems • Not joined up • They never work properly • Nobody takes any notice of what we tell them • Its about behaviours not IT

Engaging future medical leaders

MES: Medical Engagement Scores

Medical Engagement Scales: Relative Normative Feedback for Leeds Teaching Hospitals NHS Trust (n=399)

Percentage of Respondents (n = 399) who fell into High, Medium and Low Normative Bands Medical Engagement Index Meta-Scale 1: Working in a Collaborative Culture Meta-Scale 2: Having Purpose and Direction Meta-Scale 3: Feeling Valued & Empowered High Medium 9. 8% 69. 7% 21. 0% 18. 3% 65. 4% 14. 8% 10. 0% 79. 7% 22. 1% 8. 3% 69. 7% 20. 5% Low

Lessons from Most Engaged Trusts n n n n n Leadership is stable, relationship oriented and leading by example Future oriented and outward looking culture Attention to selection and appointment of the right doctors to leadership roles Providing accessible leadership development and support High profile induction, organisation wide, emphasising organisational values, priorities A series of improvement projects involving doctors (at every level) and other staff, reported to Board Effective two way communication, acknowledged and valued Promote understanding, trust and respect between doctors and managers Clarity of roles, responsibilities and real empowerment of doctors Setting expectations, enforcing professional behaviour and firm decision making

Features of Successful Clinical Leaders Bravery and resilience Clinical credibility Mentoring and coaching Vision Recognise opportunities Developing network Optimism

So, where did we start?

The Leeds Way Our values, goals and vision Our Vision To be the best for specialist and integrated care Our Goals A centre of excellence for specialist services, research, education and innovation Our Values The best for patient safety, quality and experience The best place to work Seamless integrated care across organisational boundaries Financial sustainability Collaborative Fair Empowered Patient-centred Accountable

What staff engagement looks like #The. Leeds. Way

IT can be a lifeline for the NHS