Frimley Health NHS Foundation Trust

Frimley Health NHS Foundation Trust

Background:

Essentia were appointed by a recently merged Trust which had inherited ageing and dysfunctional facilities reflecting a legacy of underinvestment. Recognising that long term clinical and financial sustainability required not only investment in new buildings but transformational change in models of care, patient pathways and ways of working the Trust has sought Essentia’s support across a number of domains.

How did we help?

Essentia provided healthcare planning support to business cases for new facilities for emergency and elective care and women’s services.

This included –

  • Demand and capacity modelling to determine future capacity requirements consistent with initiatives across the local Sustainability and Transformation foot print
  • Working with clinical leads to develop new models of care a
  • Identifying the realisable benefits from the new models to support the case for change and workforce redesign

Essentia were also commissioned by the Trust to develop an estate strategy across its three sites. With a gross internal area equivalent to 21 premier league football pitches the Trust will continue to have substantial investment requirements even after the new facilities come on stream. With no short-medium term prospect of a significant upturn in NHS capital availability, Essentia are supporting the Trust in finding ways to increase capacity via improved throughput in existing facilities, relocation of non core services off acute sites, employing IT enabled working and logistics and through joint ventures including potential Strategic Estate Partnership (SEP) models.

Kettering General Hospital – New Urgent Care Hub

Kettering General Hospital – New Urgent Care Hub

The issue:

Kettering General Hospital (KGH) found itself with an Emergency Department (ED) service that was too small, too limited in scope and unsuited to the spectrum of urgent care needs of its patients. The existing Emergency Department opened in 1994 to serve 50,000 attendances per year; this has since increased by 40%.

KGH realised that simply focusing on A&E does not recognise the scale and complexity of the urgent care needs. What is needed is a broad-based, multi-agency solution which provides a range of services.

Our unique approach

Essentia Trading engaged with the clinical team at KGH to crystallise their vision of a model that would challenge traditional boundaries, ultimately creating the Urgent Care Hub (UCH) model. The UCH concept provides an innovative and forward-looking solution, as it extends the A&E model to include all urgent care services – not just acute healthcare, but primary care, voluntary services, Social Services and Mental Health. This “single front door” and multi-agency approach aligns perfectly with the vision outlined in the NHS ‘Five Year Forward View’.

Essentia’s multi-disciplinary team gave us the breadth of industry skills and expertise to develop this concept into a series of real-world, operationally-viable and deliverable solutions, within the framework of a Strategic Outline business case (SOC):

  • Clinical strategy expertise and stakeholder engagement identified the core benefits of an Urgent Care Hub (UCH).
  • An estimate was drawn up of the floor space required to realise the new UCH.
  • Initial floor space estimates were mapped onto the KGH site; indicating the possible locations in which the UCH could be located.
  • Initial investment costs were estimated for a range of capital options.
  • Preliminary revenue analysis indicated that the on-going revenue implications of costs of around £39m could be offset by service efficiencies and productivity.

The outcome

Investment in the Urgent Care Hub was ratified by the Trust Board and Monitor.

The next step is to further develop this innovative model of care across the health economy, in conjunction with partner agencies. If successful, construction could begin towards the end of the 2016/17 Financial Year, with site works completed 18-24 months later, depending on the solution chosen.

The term ‘whole systems approach’ is typically over-used and under-delivered within the NHS and a lack of integration across health and social care is the deep rooted cause of many of the problems facing the service today. The Kettering project is a shining exception and, with an ambition to redesign the whole urgent care pathway, should be the shape of things to come.

John Kelly, Director of Healthcare Planning at ETL

King’s Health Partners – Strategic Site Configuration

King’s Health Partners – Strategic Site Configuration

The issue:

King’s Health Partners is one of five Academic Health Sciences Centres in England. It brings together a world-leading research-led university (King’s College London) and three successful NHS Foundation Trusts (Guy’s and St Thomas’, King’s College Hospital and South London and Maudsley). The Board has recently considered how the College and its partner NHS Trusts and can join-up their world-class research, teaching and clinical practices more closely to the benefit of their patients.

An external Management Consultancy engaged with Essentia Healthcare Planning team to support them in developing options for both site and strategic clinical service reconfiguration.  The plans include the 3 NHS Trusts, 4 acute sites and over 250 community and off-site properties.

Our unique approach:

Our Healthcare Planning team used their excellent analytical capabilities to carry out a rapid review of existing capacity and quality at each of the key hospital and College sites. The team’s multi-disciplinary skills and in-depth NHS knowledge enabled high level assessment of the strategic development potential for each site providing strong foundations for evidence-based design. Our scope included:

  • A review of clinical service plans and clinical dependencies for seven Clinical Academic Groups
  • Identification of strategic service relocation options with project teams
  • High-level demand and capacity modelling (beds, theatres, consulting rooms) for relevant services
  • High-level hospital sizing using space standards to assess future space requirements for a range of scenarios at the departmental level
  • Indicative capital costs for a range of strategic estates solutions
  • The development of a masterplan for each site, following international best practice

The outcome:

We successfully worked with key stakeholders to explore where the institutions would be located and developed a masterplan for each of the three acute sites. These demonstrate how the estate can be best configured to optimise the institute’s model to the benefit of their patients.

The plans will be taken forward to the next stage in creating an outline business case. We continue to be involved in the strategy, which is testament to how the client values our services.

At a time when capital is scarce in the NHS, it is imperative that Trusts continue to develop strategies for long term gains. The ability to rapidly iterate across a range of strategic scenarios to ensure investment is targeted at releasing maximum benefit is invaluable to our clients.

Tina Nolan, Director of Healthcare Planning at ETL

Guy’s and St Thomas’ NHS Foundation Trust – ‘The Fixed Cost Challenge’

Guy’s and St Thomas’ NHS Foundation Trust – ‘The Fixed Cost Challenge’

Guy’s and St Thomas’ NHS Foundation Trust (GSTT) is one of London’s leading Trusts and, like many NHS providers, is facing a significant financial challenge. As part of a comprehensive review of its cost base, GSTT recognised the need to reduce the fixed costs associated with its estate and identified this work as ‘The Fixed Cost Challenge’.

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