Ali Parsa and some of the team at Hinchingbrooke Hospital
Wednesday, February 1, 2012
6:00 PM
THE Circle revolution at Huntingdon’s Hinchingbrooke Hospital starts here today, with a 16-point improvement programme designed by staff to make it one of the 10 best district hospitals in the country.
1. Fix services thought to be unsafe
2. Stop the line’ on life-threatening incidents, and report to hospital chief executive and top medics within an hour
3. Zero harm – stamp out medical errors and infections
4. Compassionate care – patients to get two-thirds of nursing time within 18 months
5. Patient-centred pathways – patients to be seen wherever suits them best, cutting out unnecessary duplicated appointments
6. Patients will be told when their ideas will be implemented or why they would not work
7. Michelin-influenced patient food will be freshly-cooked, nutritious and locally-sourced where possible
8. In-patients to have a new, value-for-money entertainment system within a year
9. War on waste – and some savings have already been delivered
10. Smarter procurement to deliver big savings within two years
11. Hospital of choice – capturing 5,000 patients from within 30 miles
12. Better, simpler design of reception areas, and fairer car parking by April 1
13. Decisions on care to be taken by staff closest to patients, organised into two simple clinical units
14. Support services realigned to serve those units
15. Staff performance to be reviewed by direct reports, peers and self, not just line managers
16. Clinical and frontline leaders to be given the chance to take part in the ‘Circle Leadership Academy’
In what is seen by the NHS as a potential blueprint for hundreds of other hospitals, management of Hinchingbrooke has been taken over by John Lewis-style partnership Circle, more than 14 months after it was declared preferred bidder for the franchise.
For Circle, the reality is that the hospital will now be run by its doctors and nurses, technicians, cooks and cleaners.
Nearly every member of staff – a total of 1,500 of them – and many patients and other members of the public have taken part in an unprecedented consultation to identify what is right about Hinchingbrooke and what needs improvement.
That has led today (Wednesday) to staff being given a summary of what they told their new managers in 17 sessions over the last six months – in a venue suggested and prepared by staff members themselves – setting out the four objectives they themselves identified, each with four initiatives.
The single goal of putting Hinchingbrooke into the top 10 district general hospitals consists of making it the safest, the best for patient experience, top for value for money, and the happiest place for motivated staff to work.
Their new bosses told staff when they took over this morning: “We are above all the agents of our patients. We aim to exceed their expectations every time, so that we earn their trust and loyalty.
“We strive to continuously improve the quality and the value of the care we give our patients. We empower our people to do their best. Our people are our greatest asset.
We should select them attentively and invest in them passionately.”
n There are 1,700 staff working at the hospital serving a population of 161,000 in Huntingdonshire and surrounding areas.
n The hospital has in total more than 300 beds. There are 247 general and acute beds, 23 beds in maternity, 23 cabins in the treatment centre and nine in the critical care centre.
n There are nine wards at the hospital including isolation, maternity, day procedures, elective orthopaedic, general medical and surgical wards.
n The Huntingdon NHS Treatment Centre opened its doors to its first patients in 2005. It is a state-of-the-art facility for day care and 23-hour stay surgery.
n The centre now operates 90 per cent of Hinchingbrooke’s outpatient clinics and nearly all surgery with an expected stay of less than 48 hours is booked into the centre.
n The hospital’s £6million emergency care centre, opened in 2006. The hospital site is also home to a new £7.4m children’s unit, run by Cambridgeshire Community Services.
All employees are to become partners in the organisation and share the fruits of its success.
Chief executive Ali Parsa told The Hunts Post: “It’s ambitious, but it’s doable. We are putting all our resources into those things that will make a big difference.
“There are some things that have never been done in Britain before – such as getting nurses to spend two-thirds of their time with their patients. Care happens through contact.”
As reported exclusively in The Hunts Post last week, Circle today launches its new Michelin-inspired but simple menus, funding better-quality food by eliminating waste.
“We hope that Hinchingbrooke will have the best food of any hospital in the country,” Mr Parsa said. “We shall have done that by getting the catering staff to make good food. We brought in a Michelin chef and put him in Huntingdon. He will leave only when he is quite satisfied that the team is capable of doing it by themselves.”
The 16 new initiatives were not wishful thinking, he insisted.
“We are giving the players Premier League coaches, and in the next couple of months we shall be rolling out the concept of making only the kind of improvement that the patients have asked for. All this will be done within 18 months.”
Some physical improvements, such as re-designing the hospital entrance to make it more welcoming, will take a bit longer than two months, Mr Parsa conceded.
“If we can turn it into one of the top 10 DGHs, it will go to show that [the Circle philosophy of empowering employees and listening to patients] will work.
The company has promised to examine any ideas for improvement put forward by patients, staff and the public. “We won’t censor anything. If they are silly, we will tell them we think so. And we shall tell people when their ideas will start or why we won’t do what they have suggested.”
Mr Parsa said complaints at other Circle hospitals had been subjected to root cause analysis. The company had realised that food was cold by the time it was reaching patients so more staff were diverted to mealtimes. “We changed the system to fix it, so I’d be upset if we got the same comments the next time we sought patients’ views.
“It’s not magic. It’s simply about not accepting problems that you can solve.”
Escalating safety issues directly to the chief executive was routine in the mining and other safety-critical industries but, for some reason, had never previously been applied to the NHS.
“I think that will have a gigantic effect on the system.”
“GPs and patients must believe that Hinchingbrooke is the best place to go, and everyone should want to recommend it to their family. There must be no more hotspots. I’m very confident: turning Hinchingbrooke around into one of the best in the country is a much smaller task than many other NHS hospitals – as long as the Government nationally doesn’t do anything unreasonable, we can make it work.”
• HINCHINGBROOKE Hospital’s new managers today revealed who would be the key new people brought in to help run the facility.
Massoud Fouladi, Circle’s chief medical officer and head of operations, was a co-founder of Circle. A former chairman of the UK Association of Ophthalmologists and a practising NHS consultant in east Kent who has conducted extensive research on the best-performing healthcare organisations.
Ben Lloyd, Circle’s head of business development, was director of finance and performance at South Central Strategic Health Authority for four years. Before that, he led a transformation programme as finance director at Southampton University Hospitals NHS Trust.
Steve Melton, Circle’s head of mobilisation, has experience of leading large-scale transformation programmes in a retail setting, including in his last role as a supply chain director at Argos.
Andreas Wingert, Circle’s head chef, was poached from the Michelin-starred restaurant at the five-star Lucknam Park Hotel in Bath to deliver locally-sourced, freshly-cooked and nutritious food on NHS budgets.
Rachael Magnani, general manager of Circle’s Nottingham day-surgery hospital, who has 12 years’ experience as a senior NHS manager leading large change programmes.
Rob Middleton, consultant hip and knee specialist, is an internationally-renowned orthopaedic surgeon specialising in hip surgery at the Royal Bournemouth Hospital.
Nick Armitage, consultant digestive disease specialist, is a consultant general surgeon at Nottingham NHS Treatment Centre, where he specialises in colorectal surgery.
Roddy Nash is a consultant surgeon specialising in general and vascular surgery. A previous medical director and chief executive of an NHS hospital.
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