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Additional 2007-08 Investment Bids Appendix 7
(Bring Forward Funding)
Is Funding
Funding in 2007-
Describe Target/ Required Full Year Effect in
Proposal Lead Director 08
Outcome to be Achieved to Continue into 2008-09 (000)
(000)
2008-09?
Complaints Interim Support To provide adequate Complaints Team staffing during No Hazel Braund 10
period of unavoidable staff redeployment. To reduce
risk of failure to achieve 85% of complaints responses
within 25 days.
Datix Upgrade Electronic reporting of incidents resulting in quicker Recurring annual Hazel Braund 13 4.5
Upgrade of Datix incident reporting software and more accurate notification. The package also charge of £4,500
(migration from Datix on-line to locally facilitates the interrogation of the Datix database above existing
hosted DatixWeb) remotely enabling greater use of the information. commitment to
datix.
Portable Audit System Purchase of a portable audit system and loop system Yes for equipment Hazel Braund 12 1
To equip the Trust with the correct that can be used in all venues. maintenance and
equipment required to hold a public meeting service
within a venue that cannot provide the Consideration will need to be given to the funding and
needed facilities. resourcing of supporting the maintenance of this
equipment
Promotional DVD The DVD will provide a visual presentation of how we This is a one-off Hazel Braund 20
Production of a promotional DVD to are/planning to implement our vision and apply our cost for 2007-08
highlight the vision and values of the PCT values. It will make use of service, health promotion
and promote our key service priorities. and partnership case studies to tell the story.
Patient Information (Box Folder) The outcome is to improve the standard, quality and Phase 1 2007/08. Hazel Braund 10
To implement a two stage project to consistency of patient information produced by Care Phase 2 2008/09.
improve the standard, quality and Services, promote the availability of services and
consistency of care services patient and promote the PCT‟s visual identity.
carer information.
Bus Advertising To increase awareness of the PCT Gloucestershire This is a one-off Hazel Braund 24
To fund a bus advertising campaign NHS Support to Stop Smoking Service, increase the cost for 2007-08
promoting the PCT‟s key role in improving number of people accessing smoking cessation
the health of the population (smoking services and support the PCT in meeting performance
cessation). targets.
Cardboard Matrons Increased awareness/profile of the Clean your Hands No Hazel Braund tbc
To produce „cardboard matron‟ stand signs campaign message amongst NHS staff, primary care
for ward areas within the PCT‟s Community practitioners and members of the public.
Hospitals promoting the hand hygiene
(Clean your Hands) campaign message.
Travel Plan To gain a detailed understanding of the modes of No Hazel Braund 5
Staff travel survey to support development transport and travel behaviour of staff moving to the
of new HQ. new GPCT HQ in Brockworth.
Seldom Heard' Groups To increase opportunities for the PCT to engage with No Hazel Braund 5
Early implementation of Involvement „seldom heard‟ groups including BME by recruiting a
Facilitator for „Seldom Heard‟ groups PCT Involvement Facilitator.
PCT Involvement Strategy To describe the baseline of current involvement, No Hazel Braund 5
Mapping exercise to support the engagement and partnership opportunities to support
development of the PCT Involvement the development of the PCT‟s Involvement Strategy.
Strategy
Carers: Review of Strategy & Mapping To create a multi-agency Carers Standards for No Hazel Braund 5
Gloucestershire
Early implementation of the Involvement The Facilitators would provide information and No Hazel Braund 22.5 45
Facilitators feedback
The proposal describes the commissioning
of 6 „independent‟ facilitators to support the
delivery of a Communication and Public
Involvement Network based on district
council areas.
Performance Accelerator Organisation wide systematic support for performance Subscription for use Hazel Braund 25 + VAT set up
To purchase a performance management review and management of system plus
tool, which will enable access to
performance updates on key indicators.
Remedial action plans are linked on the
system. Outputs will feed into the business
planning process and the assurance
framework.
Centralise Advertising Centralise advertising for more cost effective use 50 Nuala Ring 25 50
Future Recruitment Campaigns
25 remaining 2007-
08
CRB Clearances Possible future changes will require all employers to Potential cost of Nuala Ring N/A 175
carry out at least basic checks for all staff not covered new requirements
by Standard and Enhanced clearances. implemented (we
may wish to assume
they will be), 1st
year approx £175K
Achieving CRES Identify service efficiencies (process improvements No John Ford 30 N/A
Consultancy sessions in lean e.g. reduce “hand offs”, increase streams, reduce
working/Statistical Process Control for: variations). These will be used to achieve 08/09 3%
- Podiatry CRES
- OT
- Dentistry
- GUM
1
Additional 2007-08 Investment Bids Appendix 7
(Bring Forward Funding)
Is Funding
Funding in 2007-
Describe Target/ Required Full Year Effect in
Proposal Lead Director 08
Outcome to be Achieved to Continue into 2008-09 (000)
(000)
2008-09?
Improvement in services to carers No John Ford 30 N/A
(one off starting
mid February 2008
Community Hospitals – Carer Services
for 12 months)
Coordinator
Appointment of a short term (12 month)
post to establish systems and processes to
maximise access for carers to the right mix
of services to enable to patient to return to a
sustainable home situation. The coordinator
will also act as a sign-poster and respond to
direct carer enquires as a learning exercise
to ensure that we target support in the most
effective way. Post will be employed by
Gloucestershire Carers.
Children's Physiotherapy Implement “PhysioDirect” service 5 mornings per week Yes John Ford 10 33
Waiting list initiative to meet two week to triage referrals and provide immediate advice
standard. Introduce single point of access. (0.5WTE Band 6). Single point of access to the service
for all referrals (0.5WTE Band 4). Locums will be
recruited if possible in 2007/08.
Deep Cleaning Reduction in risk of infection in Community Hospitals Yes John Ford 35 50
Purchase of additional equipment and purchase of FYE of staff and
recruitment of staff to: equipment and recurring costs of
a. carry out deep cleaning using dry steam part year effect of maintenance and
following an infection staff van
b. undertake an ongoing deep cleaning
programme, meaning all clinical areas of
the PCT would be deep cleaned on an
annual basis
Children's OT Reduce waiting list to two weeks by removing an John Ford 105 152
To reduce waiting list to two weeks and additional 140 cases from the waiting list. Maintain the
achieve sustainable service that meets two week waiting time standard. Achievement by
ongoing demand. March 2008 will depend upon ability to recruit the
locums (medium risk).
Performance To be able to present the following information in a No John Ford 2.5
For six presentation boards (Reception and topical and relevant manner:
outside conference rooms at Arle Road) - Health and Social Care information
- Performance of Care Services
- Carers‟ information
Patient Experience Framework To further develop patient and carer focused services, No John Ford 10 0
For funding to support the delivery of the which meet Darzi aims of “fair, personal, effective and
Patient Experience Framework for Care safe”.
Services. This aims to triangulate patient
experiences of care, with performance on To explore these themes with patients and carers, and
key performance indicators (as agreed in agree any actions to improve and change the way in
the PCT Service Level Agreement) across which services are delivered, to better meet these
Care Services. This will be achieved aims.
through a Care Services-wide patient and
carer survey, as well as service-specific To be able to test empirical performance against
patient and carer involvement focus groups. patient experience, and thus develop a continuous
dialogue for service improvement.
Arle Road Reception To promote the services provided by the directorate as No John Ford 5 N/A
Update the reception at Arle Road and well as supporting the provision of a professional front
display information on Care Services of house service.
Specialist Wheelchair Service Reduce waiting time to 2 week standard for initial Yes - as identified John Ford 30 90 pa one-off
Waiting list initiative and achieve assessment and provision of wheelchair (or interim 118 pa recurring
sustainable service that meets ongoing arrangements whilst bespoke manufacturing process
demand takes place). This will be achieved by dealing with the
240 cases on the waiting list through a one off
initiative, plus redesign of the service to achieve
sustainable service (see separate report).
Achievement of 2 week standard by December 2008
dependent upon success in recruiting locums (medium
risk).
Urgent Care Existing service consists of PCT employed consultants John Ford 15 80 pa
Trauma Services – expansion of PCT and generates savings through reduced use of fracture
outpatient service and fracture clinic clinics and A&E/Outpatient attendance. Service needs
(*Linked into review of Trauma & to be expended to meet unmet demand; also to
Orthopaedics by Dr Graham Wilson) provide critical mass to ensure continuity during
absence of consultants.
District Nursing To ensure continuity of service. Without this addition Yes John Ford 10 45
To complete the development of 24 hour there is a risk to the whole service due to the level of
service management and leadership capacity.
Falls Co-ordinator Previous post deleted from establishment by Yes John Ford 11.25 45
Appointment of a falls coordinator based at predecessor PCT. Post holder works with GHT to
Cirencester. ensure that patient falls pathway is implemented,
reducing the number of emergency admissions, that
follow ups with falls clinics takes place and that
appropriate community based services are put in
place.
2
Additional 2007-08 Investment Bids Appendix 7
(Bring Forward Funding)
Is Funding
Funding in 2007-
Describe Target/ Required Full Year Effect in
Proposal Lead Director 08
Outcome to be Achieved to Continue into 2008-09 (000)
(000)
2008-09?
Heart Failure Services The service responds to around 1100 referrals/annum. Yes John Ford 10 70
Enabling the service to maintain its This has grown by 9% in the last 2 years. Each new
response to referrals within 1 to 2 weeks. case avoids a first outpatient appointment or follow up.
The service is strongly supported by clinicians in GHT
and practice based commissioners and is recognised
as a national leader. The increase in activity is placing
the service under considerable strain with patients
having to be referred on to GHT to maintain patient
safety. Recruitment of a Band 7 specialist nurse/team
leader and a Band 5 development role would stabilise
the service and allow it to continue to respond to the
demand.
Independent Living Centre DDA DDA compliance No John Ford 4.4
Compliance for Staff
To provide a disabled parking space for a
member of staff working at the Independent
Living Centre. The existing allocated
disabled parking space is some distance
from the centre and is not suitable for use
as a disabled space.
Independent Living Centre Toilet DDA compliance No John Ford 3.7 N/A
Alterations
Extend the toilet at the Independent Living
Centre to accept a free standing couch
Dentistry Reduce waiting list for special needs so that all Yes John Ford 62.5 250
Waiting list initiative for patients with special patients with special needs receive treatment at the
needs and to produce a sustainable appropriate frequency. To be met through existing
service. One off initiative to scope need in shortfall in capacity. Separate general waiting list
care homes. Waiting list initiative for initiative to use existing capacity at Springbank
general waiting list patients (4000). (Cheltenham), Cirencester, Stroud and Dursley.
Improvement Grants for GP Surgeries The proposed developments will provide improved and No Simon Hairsnape 25 (without N/A
Small premises developments extended accommodation for GP primary care services Frithwood)
(Improvement Grants) for GP surgeries in where there has been an identified need. 58 (with
line with the NHS (General Medical Frithwood)
Services – Premises Costs) Directions
Diabetes (Psychology) Increased consultant and nurse clinic capacity by Yes - however, will Simon Hairsnape 8 (for pilot option) 8 + infl. Uplift
To provide psychology input in the removing frequent attenders with psychological issues depend upon or 2 (3 months)
management of the highest risk diabetic thus supporting the delivery of the 18 week target. outcome of pilot
patients. To provide training, education and which is expected to
support for existing clinical teams to demonstrate
optimally manage patients with common significant clinical
psychological issues relating to their benefits and
diabetes. potential cost
savings.
Carers Training for Dementia Support for carers, reduce waiting list for carers in Yes this is a bring Simon Hairsnape 10 35
Grant to Alzheimer‟s Society to support Gloucester, run courses in other parts of the county. forward proposal
expansion of Carer Training for dementia. To increase carer capacity to manage and feel from 08/09.
(Bring forward from 08/09 LDP) confident in their role as part of the care team.
Controlled Drugs This will enable the PCT to more effectively comply No Simon Hairsnape 3 0
To design and implement an information with its obligations outlined in the recent DoH guidance
analysis system that will allow the ongoing, on the local monitoring of Controlled Drugs following
detailed monitoring of the prescribing of the learning from the Shipman enquiry. The reports
Controlled Drugs (CDs) across primary care produced will show trends in CD prescribing by GP
in Gloucestershire. practice and individual drugs, highlighting any unusual
prescribing that might benefit further investigation.
CHC Support All retrospective CHC reviews are dealt with in line with Yes to support Simon Hairsnape 20 75
Fund additional admin and assessor end of March target set by SHA increased demand
support to CHC team for CHC
assessment and
review
General Dentistry & Orthodontics General Dentistry: This would result in practices Additional UDAs: Simon Hairsnape 315 0
Discussions have already been held with maintaining their lists open for longer, or possibly No 15,000 UDAs
Finance with regard to the Dental Budget, opening whilst currently closed. It may help prevent a
and plans are being prepared to increase slow down to the year end as practices manage to Additional 409
spending on Non Recurrent additional target. Orthodontic UOAs: 7,000 UOAs
General Dentistry and Orthodontics. Orthodontics: The outcome will be reduced waiting Some planned carry
lists in specialist practices for Orthodontics, below 6 forward of funding
months. will be necessary.
Pharmaceutical Needs Assessment Contribute to the decision making process of 3 Simon Hairsnape 15 3
To commission a Gloucestershire commissioning of new additional pharmaceutical Update report
Pharmaceutical Needs assessment. services from Community Pharmacies annually
Contribute to dispensing panel decisions relating to
pharmaceutical applications for provision of NHS
pharmaceutical services.
Respiratory (Health Economist) Comprehensive health economic analysis of No Simon Hairsnape 40
Commission a health economist from respiratory disease within Gloucestershire.
Birmingham University or equivalent to
undertake an analysis of respiratory
disease (linking with Kathy Cambell) to
understand the interlinks between
increased prescribing costs, rate of
admissions and prevalence.
3
Additional 2007-08 Investment Bids Appendix 7
(Bring Forward Funding)
Is Funding
Funding in 2007-
Describe Target/ Required Full Year Effect in
Proposal Lead Director 08
Outcome to be Achieved to Continue into 2008-09 (000)
(000)
2008-09?
Scriptswitch To reduce prescribing spend in high cost practices No Simon Hairsnape 20 0
To introduce „Scriptswitch‟ into the highest
spending practices across the PCT.
Scriptswitch is a leading software provider
of real time prescribing support tools
allowing advice to be presented to clinicians
at the point of prescribing. The company
provide prescribing support tool offering:
Automatic advice in a single window at the
point of prescribing A specific drug
alternative in lines with the PCT „formulary‟A
clear indication of cost differences.
Health Transport Review The review will assess the ongoing commissioning of Yes, the residual Simon Hairsnape 12 25
PTS as well as options for a comprehensive and amount from the
sustainable transport model to support the health and LDP bid would be
well being of patients who do not have access to their £25K
own transport.
Choose & Book Trainer 90% utilisation target. Yes but submitted Simon Hairsnape 40
Increase training support for practices using as part of LDP
Choose & Book
MS Project Management Effective project management Yes Simon Hairsnape 5 5
Purchase 5 additional MS project
management software licences for PbC
team
Liaison Psychiatry Improving the county Mental Health services Yes – However this Simon Hairsnape 40 160
To increase the capacity and service Reducing A&E admissions and length of inpatient stay proposal is also
coverage of Specialist Psychiatric Nurses Reducing self harm and suicide rates being submitted as
from GPFT in GRH & CGH Accident & Reduce the number of patients who represent due to an Invest to Save
Emergency Departments. self harm. scheme and through
Reduce the number of patients who present with LDP.
alcohol
National target for reducing suicide rates –
Gloucestershire is currently underperforming against
local target.
Maximum 4 Hr A&E waiting time target.
Increase opportunities for capture and engagement
with patients who would be referred to Early
Intervention service and contribute to Healthcare
commission target
Bereavement Services To provide adequate information for future planning One off funding Simon Hairsnape/ 20
To review the bereavement services and investment in appropriate services to ultimately Jill Crook
currently available to carers in order to ensure consistency and develop services where
improve understanding of the different appropriate
levels of service and identify gaps in
provision.
Humana - Operational support Procure expert contracting support from Humana as 190
part of the development of commissioning capability
and capacity
Telecare project (GCC matched funds) Provide matched funding to enable telecare equipment 500
to be provided free of charge to eligible users across
the county.
Falls equipment (GCC pooled) Increase purchasing of equipment to prevent falls and 100
to support people who have suffered a fall
Health & Safety Additional investment to improve health and safety for 135
staff and patients
DDA compliance - Ensure that all PCT premises are DDA compliant tbc
Wheelchairs service (equipment) Early achievement of reductions in waiting times 300
Contribution to GPT for flood related 100
costs
PbC clusters - pump priming funds Provide funds to clusters to pump prime clinical 250
pathway changes that will result in savings in future
years.
Improvement grants Increase investment in improvement grants for primary 250
care premises
Patient therapy Provide additional psychological therapy support 200
services to support flood victims
Waiting List activity - accrual for March Bring forward reductions in the waiting list to reduce 1000
numbers to be treated in 2008/09
Review Balance Sheet 50
Investors in people Move towards Investing In People status 6
Project Management Extend the existing programme of PRINCE training 45
Conflict resolution training Provide further conflict resolution training 8
Management training Invest in a programme of management training 20
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