South Devon Healthcare NHS Trust

Integrated care delivery systems through High Performance Teams

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Overview

The vision of South Devon Healthcare Trust is to move towards a service which connects with the patients at the earliest opportunity through the optimum balance of case-mix and skill-mix. There will be an integrated programme of delivery of care, reflecting the need to reduce the service input from junior doctors to support compliance with WTD 2009 and provide an enhanced training experience through Modernising Medical Careers. South Devon health community has already embarked on a series of service improvement programmes to maximise the use of the acute hospital facilities. Through utilisation of the principals of the Integrated Service Improvement Plans (ISIP), this project will ensure that the benefits of the change programme to facilitate compliance with WTD 2009 are realised across the community.

Organisational background

South Devon Healthcare Trust covers 300 square miles serving a local population of 270,000 people. In addition it provides a service to the many thousands of holidaymakers that visit the region each year. It is one of Devon's biggest employers with over 3,500 paid staff .The biggest part of the Trust's work is emergency treatment. Nearly 100,000 patients come through the main Accident & Emergency Department in a year. The trust runs a large general hospital (Torbay), serving the South Devon area and works closely with the local Primary Care Trusts which cover South Devon and with the local strategic health authority - NHS South West. The three local PCTs run nine community hospitals and a wide range of services, such as district nursing.

Challenges

The trust is working within a strict financial plan that will ensure that maximum benefits are realised from all workforce, service and IM&T reforms. It is expected that the development of integrated, multi-disciplinary working will require some additional investment in the development of skills and new roles for the whole team. Changes in bed numbers and configuration of beds within the hospital will contribute to achieving the financial targets, allowing the trust to invest in the high performing multi-disciplinary team. This vision of integrated care delivery system will lead South Devon Healthcare Trust towards WTD 2009 compliance.

Specific objectives of the pilot

The specific objectives are to provide:

• A service that connects with the patients at the earliest opportunity through the optimum balance of case-mix and skill-mix
• High quality patient services through high performing, integrated teams providing cross-cover to a range of specialties
• A clear systemic alignment of the contribution of each department to ensure maximum quality and productivity
• An integrated team approach to delivery of care reflecting the need to reduce the service input from junior doctors to support compliance and provide an enhanced training experience through MMC
• An integrated care delivery system that will be supported by a programme of system re-design, team-development, new ways of working and clinical decision-making, handover and communication processes and maximising the use of IM&T systems

Delivering compliance

This pilot will deliver:

• Compliance to WTD 2009, staged in three phases
• New role development and structures to deliver the services
• Development of weekend team working and twilight teams
• Integrated high performance elective and emergency care pathways to deliver care and WTD compliance
• Communication and learning resources for the wider NHS.

The pilot started in July 2006 and is will be complete in December 2007.