MC strategyannexes

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Published on February 7, 2008

Author: Paola

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GST’S REPUTATION WITH PATIENTS: 1 GST’S REPUTATION WITH PATIENTS Source: Picker Institute 2004 (Hospital choices report) Perceived reputation of the originating Trust Guy’s and St. Thomas’ St. George’s Barking, Havering, Redbridge Mayday Healthcare Barnet, Chase Farm Excellent/very good Good Fair Poor/very poor Proportion of patients in each Trust willing to consider an alternative hospital Guy’s and St. Thomas’ Barnet, Chase Farm Barking, Havering, Redbridge St. George’s Mayday Healthcare No, not under any circumstances Yes, possibly Yes, definitely 2 BREAKDOWN OF ACTIVITY AND INCOME: 2 BREAKDOWN OF ACTIVITY AND INCOME Admitted patient care Outpatients Commercial and other Teaching and training Other patient care Research A&E Admitted patient care Out patients A&E Other patient care Teaching and training Research Commercial and other Activity 2003/04 22,072 elective FCEs* 48,289 non-elective FCEs 39,671 day-Cases 1,287 beds used 138,452 new attendances 356,576 follow-up attendances 157,301 attendances 25,002 renal patient visits Direct access 505 undergraduate medical students (years 3–5 only) 658 junior doctors in training 373 research projects ongoing at end 2003 834 papers published in 2003 Private patients British forces in Germany Other, incl. parking, accommodation Clinical care 1 2 3 4 Income breakdown, 2004/05 plan % 100% = £579m * FCEs: Finished Consultant Episodes Source: GST finance CURRENT PERFORMANCE ON CLINICAL CARE vs. LONDON UNIVERSITY HOSPITAL PEERS: 3 CURRENT PERFORMANCE ON CLINICAL CARE vs. LONDON UNIVERSITY HOSPITAL PEERS Source: DoH; Dr. Foster’s; annual reports; GST Average length of stay (mean) MRSA (rates per ‘000 bed days) Day case rates (%) Royal Free Hammersmith UCLH Bart’s & London GST King’s College St. George’s South of river North of river Hospital cleanliness (max 5.0) Only on average length of stay does GST outperform peers PERFORMANCE AGAINST PHYSICIANS’ REFERRAL CRITERIA: EXTENDED TME VOTING RESULTS : 4 PERFORMANCE AGAINST PHYSICIANS’ REFERRAL CRITERIA: EXTENDED TME VOTING RESULTS % responses Source: Extended TME voting “What is the most important driver of referral choice for physicians?” “What is GST’s overall performance on each driver (from very poor to excellent)?” Something else Appointment and/or bed availability Timeliness of follow-up contact Accessibility and responsiveness Personal relationship and family Clinical quality 58% respondents rated GST as poor/very poor on Accessibility and responsiveness, believed to be the dominant driver of referral choice for physicians % Poor/very poor % Good/excellent n/a n/a BREAKDOWN OF GST’s SLA* INCOME BY ENGLISH COUNTY: 5 BREAKDOWN OF GST’s SLA* INCOME BY ENGLISH COUNTY SLA income by English county, 2002–03 <1 3-9.9 10-20 >20 % totalSLA income 1-2.9 100% = £283m Over one quarter SLA income is from outside London However, London and Kent together comprise 90% SLA income Essex 1% London 74% Kent 15% Sussex 4% Hampshire 1% Surrey 2% * SLA: Service Level Agreement Source: GST Business Objects 2002/03 BREAKDOWN OF GST’s SLA INCOME FROM LONDON BY PCT: 6 BREAKDOWN OF GST’s SLA INCOME FROM LONDON BY PCT * Other London PCTs in total contribute £28m in SLA income Source: GST Business Objects 2002/03 Income from Lewisham is less than half Southwark and only one-third of Lambeth 14% London income is from PCTs beyond South East group 6% 6% 6% 11% 24% 4% <3 5-9.9 10-20 >20 % SLA income from London PCTs 3-4.9 SLA income by London PCT, 2002–03 100% = £206m 30% GST’s OVERALL FOOTPRINT: 7 * Market share calculated average of inpatient and day case shares for each specialty (not weighted for number of episodes or income). Outpatient not included Source: 2001/02 HES data GST’s OVERALL FOOTPRINT Kent Sussex Surrey London 25+ 10.1-15 15.1-25 <1 Market share*%, 2001/02 1-5 5.1-10 23% SEL 22% 26% 31% 41% 46% 30% 12% 16% 25% 9% 9% 9% 12% 29% 1% 6% 0% 1% 0% 0% 4% 2% 4% 2% 3% 5% 5% 4% 4% 2% 10% 5% 2% 5% 7% GST all activity, share of episodes by PCT* Current footprint centres on South East London and Kent VARIATION IN SOURCE OF ACTIVITY ACROSS SPECIALTIES: 8 VARIATION IN SOURCE OF ACTIVITY ACROSS SPECIALTIES * Might differ from reported income for various reasons including rebates, items not in contract monitoring systems ** Excluding blood products Source: GST Activity reporting % of value of activity by geography Reported activity at cost, 2003/04 (specialties >£5m)* M Nets. Acute Ambula-tory Value of activity, £m* 323 Cardiac Tertiary Paeds Haemophilia** Paeds Crit.Care Secondary Paeds Oncology Renal & Transpl. Haematology Urology & Lithro Maternity & Gynae Plastics Trauma & Ortho ENT General Surgery Acute Med A&E Dermatology Dental services Ophthalmology In general, focus is referrals outside LSL Main activity as local provider for LSL In general, focus is referrals outside LSL Slide 9: 9 Ambulatory Care By division, share of episodes by PCT* * Market share calculated as the average of the shares for each specialty (e.g., not weighted for number of episodes or £); excludes Core Clinical Source: 2001/02 HES data 25+ 10.1–15 15.1–25 <1 Market share %, 2001/02* 1–5 5.1–10 ‘FOOTPRINT’ OF THE DIVISIONS Managed Networks Acute Each Division has a different ‘footprint’, but the pattern is consistent – low penetration in the west Relatively little activity in Surrey and Sussex Relative strength in Kent Potential to increase market share in Sussex and Surrey, where relatively little activity Kent picture partly driven by strong share in plastics Relatively little activity in Surrey and Sussex BREAKDOWN OF SLA INCOME BY SPECIALTY: 10 BREAKDOWN OF SLA INCOME BY SPECIALTY Specialty income as % total SLA income, 2003-04 Source: GST Finance Cardiac Haemophilia Renal Maternity and Gynaecology Acute medicine Oncology Tertiary paediatrics Sexual health Trauma & Orthopaedics Paeds critical care General surgery A&E Urology Dermatology Other specialties 100% = £353m A handful of specialties dominate GST’s SLA income from clinical care Cardiac, Haemophilia and renal account for 27% SLA income Top 10 specialities account for 64% SLA income GST DOES NOT CURRENTLY HAVE THE SAME FOCUS ON R&D AS OTHER LEADING ACADEMIC CENTRES: 11 GST DOES NOT CURRENTLY HAVE THE SAME FOCUS ON R&D AS OTHER LEADING ACADEMIC CENTRES 2002/03 R&D income of selected English institutions, £m Addenbroke’s Guy’s and St Thomas UCLH Hammersmith Hospitals Trust External R&D grants as % of total income External R&D grants*, £m Medical school links Cambridge Oxford UCL and Royal Free Imperial College * Rank based on external R&D grants as % of total income ** Total reported external R&D grants, e.g., MRC, other government grants and charitable foundation grants Source: GST R&D; Annual reports; web search R&D levy £m Bart’s and The London Trust Oxford Radcliffe 38 47 35 23 20 16 Bart’s & Royal London KCL Total £m 50 94 70 29 45 31 UH Birmingham 5 Birmingham 16 Rank* Royal Marsden Christie – 19 44 Manchester 1 20 U.K. top 2 by rank are cancer centres, indicating benefit of aligning to national priorities QUANTIFIED IMPACT OF THREATS AND OPPORTUNITIES FROM FINANCIAL MODEL: 12 QUANTIFIED IMPACT OF THREATS AND OPPORTUNITIES FROM FINANCIAL MODEL Bottom line impact 2008/09, £m Source: Scenario modelling DE: Procurement DE: LOS, Theatres DE: Nursing DE: Organisation Choice PbR Integrated care – CDM Independent sector Integrated care – Step down facility Research Teaching and training Threat Baseline + opportunity -50 +29 - 48 Success of DE is vital to delivering baseline Most important drivers to address are Choice PbR Integrated care (CDM) Independent sector BOTH IN U.S. AND IN U.K., DOCTORS ARE STILL THE DOMINANT SOURCE OF INFORMATION AND ADVICE: 13 BOTH IN U.S. AND IN U.K., DOCTORS ARE STILL THE DOMINANT SOURCE OF INFORMATION AND ADVICE Source: Picker institute; McKinsey U.S. patient survey My specialist or other doctor Health insurance approved list Friends or family Nurses or other healthcare professional Media/Internet Q: Please indicate which of the following sources are most important for making medical care decisions (Select up to 2 of 17) % selecting top sources, all respondents U.S. U.K. Sources of patient information and advice Points on 100-point scale GP Doctor at home hospital Internet NHS Direct Doctor at alternative hospital Family or friends My primary or regular doctor Preferred information source Preferred person with whom to discuss options RAIL TRAVEL TIMES TO WATERLOO AND LONDON BRIDGE FROM KENT, SUSSEX, SURREY AND HAMPSHIRE: 14 RAIL TRAVEL TIMES TO WATERLOO AND LONDON BRIDGE FROM KENT, SUSSEX, SURREY AND HAMPSHIRE Haslemere (47) East Croydon London Waterloo Southampton (73) Alton (68) Dorking (40) Maidstone (47) Littlehampton (109) Horsham (73) Aldershot(44) Winchester (62) Fareham (93) Havant(72) Guildford(34) Farnborough (37) Lewes (71) Uckfield (86) Redhill(27) Brighton (58) Chichester(89) Eastbourne (91) Hastings (83) Worthing (82) Bognor Regis (108) Haywards Heath (45) Tonbridge (24) Dover (99) Folkstone (87) Ashford (71) Chatham (64) Ramsgate (118) Margate (131) Rochester Woking (26) Gravesend (45) Gillingham Basingstoke (42) Portsmouth (92) Tunbridge Wells (34) London Bridge Seaford (93) Sevenoaks (24) Preston Park Petersfield (59) Faversham(88) Crawley (58) Gatwich Airport East Grinstead (54) London Kent Sussex Hampshire Surrey FRAMEWORK FOR SERVICE STRATEGY DISCUSSIONS: PLASTIC SURGERY: 15 FRAMEWORK FOR SERVICE STRATEGY DISCUSSIONS: PLASTIC SURGERY Other UK Other GST KENT 100% = 2,519 GST St. George’s Other SS Other London SURREY & SUSSEX 100% = 4,526 LONDON (EXCLUDING SE) 100% = 15,973 GST Other U.K. St. George’s GST Other UK BBG 100% = 1,493 GST St. George’s Other LSL 100% = 2,350 SE LONDON Source: 2001/02 HES data Share of episodes by region Bart’s & London Royal Free Other St. George’s Great Ormond St Other UK Brighton GST A SERIES OF STEPS TIGHTLY LINK THE VISION TO ACTION AND PERFORMANCE: 16 A SERIES OF STEPS TIGHTLY LINK THE VISION TO ACTION AND PERFORMANCE 5-year aspirations Used for internal and external communication Provide organising framework for portfolio of initiatives Agreement between CEO and Head of Service on what service will deliver 1. Centre on patients 2. Deliver quality and innovation to the local community 3. Shape growth in selected specialties 4. Be distinctive in care, research and teaching 5. Excite and develop people 6. Support effective front-line delivery Description Set of metrics and targets Provide basis for measuring performance Individually chartered projects Each has defined Owner Resource Milestones and specific objectives THE VISION’S ELEMENTS TRANSLATE INTO STRATEGIC THEMES, AROUND WHICH INITIATIVES CAN BE ORGANISED: 17 THE VISION’S ELEMENTS TRANSLATE INTO STRATEGIC THEMES, AROUND WHICH INITIATIVES CAN BE ORGANISED SUCCESS MEASURES CAN BE ALIGNED AGAINST THIS VISION: 18 SUCCESS MEASURES CAN BE ALIGNED AGAINST THIS VISION

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