New Director Appointed at NHS Improvement

Mark Hackett has been appointed as an improvement director at NHS Improvement.

The new director has an excellent grounding in NHS affairs, being a former trust chief executive.

Hackett has surprisingly quit his prominent role at University Hospitals of North Midlands Trust last year.

But he will now attempt to assist Torbay and South Devon Foundation Trust and East Kent Hospitals University FT on behalf of the watchdog.

East Kent Hospitals University FT has experienced financial difficulties following a £23 million deficit accumulated in the most recent financial year.

Board papers have revealed that the trust has been handed a £6.5 million deficit control target for the forthcoming financial year.

And Hackett will be essentially involved in devising a financial recovery plan for the struggling trust.

And while the details of this initiative have have yet to be finalised, it is known that reducing agency costs and the amount of money spent on supplies of services will be core aspects of the recovery scheme.

Reduced use of waiting list work, back office and clinical support consolidation, improving productivity, and effective vacancy management will also be involved.

The trust has already made some progress in achieving efficiency savings, with nearly £17 million being achieved over the last 12 months.

However, this is still a mere fraction of everything that the trust must ultimately achieve, as it is required to made £30 million worth of savings in the forthcoming financial year.

In order to achieve this, Hackett has already been collaborating with the finance team at the trust in order to deliver the largest savings plan in the region.

This new scheme has been described as “mission critical” by chief executive Mairead McAlinden.

In order to oversee the new planning, a financial improvement scrutiny committee will monitor the processes involved.

This has been set up specifically to report directly to the board of the trust, with McAlinden, non-executive director David Allen and Hackett all involved.

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NHS Improvement Hands Leadership Power to Four Outsanding Trusts

NHS Improvement has announced its intention to provide four particularly high performing trusts with the power to lead groups and / or chains of other NHS hospitals.

Bosses at the foundation groups in question will have the permission to oversee current partnerships and federations of hospitals, as well as being instantly involved with the process of merger and acquisition.

This new accreditation from NHS Improvement is intended to ensure that the outstanding trusts have the authority to execute the acute care collaboration vanguard projects.

The four trusts given “foundation group leader” status are Guy’s and St Thomas’ Foundation Trust, Northumbria Healthcare Foundation Trust, Royal Free London Foundation Trust, Salford Royal Foundation Trust.

All four of these organisations have been rated that least good by the Care Quality Commission, with Northumbria and Salford Royal considered outstanding.

NHS Improvement chief executive Jim Mackey believes that the announcement can be considered a big step forward for the health system, enabling patients and providers to benefit from superior leadership within the health service.

Mackey himself worked as chief executive of Northumbria Healthcare Foundation Trust until last year, and commented that the accreditation process will offer both quality and financial performance advantages.

“Being in a group isn’t right for everyone. The accreditation process considered not only the quality of services on offer and the management trusts have, but also the benefits that trusts will get from being part of a group and the potential risks they face.”

Northumbria management commented that thee new accreditation will make it easier to share best practice, knowledge and expertise with other trusts.

Chief executive David Evans indicated that the trust as already built up a significant reputation within the NHS as an innovator.

“For many years we have been at the forefront of innovation in the NHS, pushing the boundaries of excellence, pioneering new models of care and always thinking one step ahead about the challenges of delivering modern healthcare. The NHS is constantly changing, the needs of our patients are constantly changing and as medicine and technology advances, we must keep pace and create a healthcare system which switches our focus on prevention and keeping people well.”

Salford Royal has already begun working with local trusts in the area with the intention of establishing the first chain under the vanguard program.

Chief executive Sir David Dalton commented that the digital revolution that has been essential to the successes of the Salford will be central in the process, enabling a similar quality of care to be established across the NHS as a whole.

“The key aim of leading a Group of NHS providers is to deliver high quality care that is standardised and replicated across all organisations to improve patient outcomes and deliver better value for money. Assuring the reliable delivery of high standards, at scale to a greater population, allows quicker decision making and ensures that those decisions are taken in the interest of the population. This contrasts with delays in decision making which often occur when multiple organisations are assessing the impact of changes on themselves rather than the wider interests of the population they should be serving.”

Dalton also outlined details of the work that Salford Royal is already conducting with the Pennine Acute Trust.

“Salford Royal, which is one of only five Trusts in the country to be rated ‘outstanding’ by the CQC, has started this improvement journey with Pennine Acute Trust and I am optimistic that this is the beginning of an arrangement which can provide positive changes which will be appreciated by staff, patients and the communities we serve.”

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NHS Improvement Cites Savings in Consultancies and Agency Staff

NHS Improvement has reported that major financial savings have been made by the health service in the area of consultancies.

The health service spends a vast amount of money on consultants every year, and considering the perception in some quarters that there are too many middle-manager cooks tending to the NHS broth, this is considered an area with major potential for efficiency savings.

Constraints on consultancy spending in the NHS saved £42m in the third quarter of 2015 and restrictions on agency staff could reduce costs by £160m by the end of the financial year, NHS Improvement has found.

If this pattern could be repeated between now and the end of the decade, it would mean that the health service could save in the region of £1 billion.

This would be considered particularly valuable considering that the government has set a target of £22 billion of efficiency savings for the NHS by 2020.

The health service regulator stated that Department of Health restrictions on the use of management consultants had reduced spending from £145m, incurred between July and September in 2014, to £103m in the same three months in 2015.

And this wasn’t the only valuable morsel of financial news for the NHS.

NHS Improvement also discovered that the health service could make massive savings by dealing with the issue of agency staff more effectively.

The watchdog found that caps on agency staff spending could remove as much as £1bn from the health service’s pay bill by 2018.

With the complex structure of the contemporary NHS, the number of agency staff being hired in order to carry out the day-to-day running of the health service is quite considerable.

Indeed, hospitals spent £3.3bn on agency staff last year following a move to increase staffing levels on wards in the wake of care failures revealed at Mid-Staffordshire hospital.

The double-whammy of £2 billion worth of savings could contribute in the region of 10 per cent of the overall savings targeted by the government.

And health secretary Jeremy Hunt claimed that the figures collated by NHS Improvement indicate that it would be possible for the health service to make savings and improve patient care at the same time.

“Our plans to clamp down on management consultants and rip-off staffing agencies are bearing fruit. Patients will see the reward with savings being reinvested in frontline patient care,” Hunt commented.

The £22 billion efficiency target is set out in NHS England’s Five Year Forward View programme.

Figures have already indicated that the NHS is likely to accumulate a deficit of £2 billion in the existing financial year alone.

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NHS Improvement Acclaims Efficiency Savings on Agency Staff

The health regulator NHS Improvement suggests that measures which were introduced in June 2014 have saved the health service in the region of £250 million.

This clampdown that NHS Improvement approved as part of a wider package of hospital efficiency savings has paid off significantly according to the regulator’s figures.

In particular, measures aimed at achieving hospital efficiency savings targeted management consultants and “rip-off staffing agencies”, limiting the amount hospitals could pay for agency staff.

Evidence was collated earlier this year which suggested that the NHS spends billions every year on agency staff.

In total, in the financial year which began in 2014, hospitals spent in excess of £3.3 billion pounds on agency staff.

This followed a drive to increase staffing levels on wards in the wake of the mid-Staffordshire scandal, in which neglect killed hundreds of patients.

In this context, the Conservative government claims that it is encouraging trusts to employ permanent staff, with the aim of providing a superior continuity of care for NHS patients.

It is forecasted by NHS Improvement that this measure will shave £1 billion from the agency staffing bill over the next three years.

The savings are part of the NHS plan for the future, The Five Year Forward View, which the Government is backing with a £10 billion investment.

Commenting on the issue, Health Secretary Jeremy Hunt was positive about the government’s scheme.

“Our plans to clamp down on management consultants and rip-off staffing agencies are bearing fruit. Patients will see the reward with savings being reinvested in frontline patient care. I want the NHS to be the most efficient health system in the world and these figures show that, thanks to hardworking NHS staff and strong leadership, we can make savings and improve patient care at the same time.”

However, critics of the government’s plans believe that the savings are another blow to an NHS that is already overburdened financially.

Responding to the scheme being run by the Conservative government, Andrew Gywnne, Labour’s shadow health minister, suggested that ministers should look closer to home for the cause of the problems of the NHS.

“However much ministers try to spin this, financial pressures facing hospitals are a direct result of decisions ministers have made. Cuts to nurse training places have forced hospitals to hire expensive agency staff. This is one of the main reasons they are facing such massive deficits this year.”

Gwynne also suggested that there is little room for positivity about NHS finances.

“The extra money announced at the Spending Review is going to get sucked into a black hole that has emerged in hospital finances under the Tories. The National Audit Office has also raised serious concerns about whether actions being taken by ministers are going to be enough to fix the damage they’ve done.”

The NHS has been tasked with making efficiency savings of £22 billion by the end of the decade.

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NHS Improvement Contract Ready to be Announced as Countdown Continues

An important contract relating to NHS Improvement will be awarded this week as organisation in the health service continues to evolve.

The contract to design the structure of the NHS Improvement organisation is reported to be worth more than £1 million in total.

As part of the process of drawing up the structures related to this organisation, the successful consultancy will work alongside an integration director, producing a comprehensive operating model by February.

It is suggested that the work could also incorporate a leadership review and leadership development interventions of existing employees within the NHS Improvement organisation.

This wide ranging modus operandi will cover every aspect of the way that the new monitor will operate, with both structure and culture considered particularly important.

The new regulator has been created by the merger of Monitor and the NHS Trust Development Authority, and early plans suggest that it will come into force at some point in 2016.

Reports indicate that the principal focus for NHS Improvement will be to drive and support both urgent operational improvement at the front line and the long-term sustainability of the healthcare system.

As is increasingly the case across the NHS as a whole, it is suggested that collaborative working will be central to the plans of this organisation.

A successful bidder for the contract will ultimately work alongside an internal program management office.

It is suggested that this office will comprise around twenty people, with an integration director in place in order to oversee the operation.

The consultancy selected will have been judged on organisational design and a “high level transition plan and pipeline”.

This process will lead to a draft organisational structure being produced by the beginning of December, with a final version to follow by the end of 2015.

A comprehensive operating model is also considered particularly important to the bidding process, with metrics for assessing quality, finances and sustainability central to this notion.

The final strategy document is to be submitted by March of next year, and major organisations Deloitte, McKinsey and KPMG have reportedly been shortlisted.

Northumbria Healthcare Foundation Trust chief executive Jim Mackey was named as the first head of the new organisation earlier this month.

The creation of NHS Improvement comes at a time when regulation of the NHS is particularly important.

The existing regulator Monitor has had to take action against numerous trusts in recent months as financial difficulties across the NHS become increasingly apparent.

This was only too succinctly illustrated by recent financial results which suggests that the NHS as a whole will be £2 billion in deficit by the end of the existing fiscal year.

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Chief Executive of NHS Improvement Appointed and Revealed

The Chief Executive of the newly formed NHS Improvement has been announced.

Jim Mackey, Chief Executive of Northumbria Healthcare NHS Foundation Trust, will fill the role going forward.

Earlier this year it was indicated that NHS Improvement will play a major role in the healthcare sector in the foreseeable future.

Back in July, the Secretary of State for Health, Jeremy Hunt, announced the creation of NHS Improvement.

The organisation will be tasked with the job of driving and supporting urgent improvements at the NHS frontline, and delivering long-term sustainability of the healthcare system as a whole.

NHS Improvement will also play a major role in health sector regulation, alongside existing bodies such as Monitor.

Speaking about the appointment, Ed Smith, Chairman-designate of NHS Improvement, was keen to emphasise the qualities of Mackey which have made him ideal for the role.

“I am delighted to announce the appointment of Jim Mackey as the Chief Executive of NHS Improvement. He was the unanimous choice of the appointments panel. He has an exceptional track record in delivering change in the health sector, with 25 years’ experience in the NHS. He joins us from Northumbria Healthcare NHS Foundation Trust where he has been Chief Executive for the last 10 years.”

Smith also expanded on the role he expects Mackey to play in the future, and how the NHS hierarchy would deliver a structure in order to support his aims.

“Jim will draw on this extensive experience of improving services for patients in leading NHS Improvement and will build both a great team around him and strong collaborations across the NHS and care systems.”

Mackey himself was naturally extremely grateful for the opportunity to fill this new position, and also spoke fondly of his previous duties working in Northumbria.

“It has been a huge privilege to lead Northumbria Healthcare through its most successful time as an NHS foundation trust. Over the years, I have worked with so many caring and dedicated members of staff and every day have been humbled to see them all go above and beyond the call of duty to provide excellent care to patients.”

In addition, Mackey was also keen to place the existing situation of the NHS in a wider context, making reference to the challenges that the health sector faces.

“This is without doubt a difficult time for the NHS. We collectively need to improve NHS services for patients and the local communities we serve, alongside being more efficient and effective in our use of the NHS pound. The gap between the quality of care provided within the NHS must be reduced, and our grip on managing our business and finance must be improved. This will be my priority and focus for the coming years ahead and I look forward to working with health partners across the NHS and social care to support a more sustainable and integrated service for patients.”

The aforementioned Hunt was also keen to offer support for this appointment.

“Jim Mackey will bring a wealth of experience to NHS Improvement and ensure that patient safety and higher quality care are embedded at the heart of all NHS organisations. He will continue the work to align Monitor and the Trust Development Authority and ensure that all providers are supported to provide excellent care every day of the week.”

Finally, Malcolm Grant, Chairman of NHS England, suggested that the appointment of Mackey will play a major role in the entire organisation of the NHS, with a new, superior structure having been put in place via the creation of NHS Improvement.

“Jim Mackey’s appointment marks the beginning of a new era of national leadership and partnership between NHS Improvement and NHS England. I am delighted that NHS Improvement has succeeded in attracting to the job someone who has a real track record of success already in transforming NHS services, and the ability to work closely with trusts across England to bring the Five Year Forward View to fruition.”

Mackey will start to bring together expert teams to deliver all of NHS Improvement’s responsibilities in due course. He will be in post full time from 1st November 2015.

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