Doing an MDT approach with clinical leads

Please add the volume of activity associated with the GIRFT metrics. These metrics are very specific but it is difficult to know how much weight to assign to them without the associated activity e.g. is a day case rate based on just a handful of procedures?

GIRFT used a methodology to determine frailty in their data packs. It would be great if this could be included in the Model Hospital to show admissions and length of stay for frail patients.

The In Year Productivity data provides an overview of the change in organisation performance. A similar breakdown across Clinical Service Lines, and indeed all clinical compartments, would help identify positive and negative changes to allow review of effective local initiatives

Can Clinical Haematology (spec function 303) be added as a service line?

As service model are further rationalised, different service models have been developed. We contract with local Trust's to deliver our activity in their Trust for a number of specialties and get recharged for this service. As per guidance this is classed as non pay and hence distorts our costs.
Likewise we provide a £1m service to a neighbouring trust in order for them to deliver a specific specialty. Hence our pay costs are high but as confirmed NHSi, we are treating this as income which isn't factored in.

It would help if you could benchmark services and have the data based on those trusts who run specialist regional centres for example the effect of being a regional cancer centre and how this has imaging scans drug spend and pathology testing.

ESR data has been used to reflect the staffing by specialty however the way specialties have been defined is by "Area of Work". This is not a mandatory ESR field and often staff in a specialty come under differing areas of work eg administration.

Internally we use cost centers. When we compare our departmental staff to your breakdown of our staff they are significantly different - eg T&O in the model hospital reports 70.8 FTE, we actually have just over 123 FTE. Therefore an inaccurate view of a specialty which we therefore cannot benchmark against other trusts.

This is an area with highest potential productivity opportunities and clinical staff need to look at best practices in other trusts to improve pathways and productivity. Sharing this as soon as possible would be helpful to engage doctors and staff in the current Model Hospital analysis we are doing.

Currently the data on staff cost per WAU only includes employed staff this does not reflect the true cost which can include large amounts of agency spend. This means that areas that are fully established and use little agency look less efficient than under established areas with a large agency bill. This is perverse and is driving some very odd/dangerous ideas in our trust as to where savings can be made.

Please develop a way of carrying out data collection that enables us to exclude costs for providing activity to other providers as it skews our cost per WAU and makes benchmarking pointless. It would also be really helpful if costs and activity carried out by another organisation for us could be identified.We need to be able to identify our own services productivity and are overall value for money.

Does WTE pertain to 1 person that could be doing 10PAs or 14 or does it pertain to 10 PAs total work. To see if a service is efficient we need to compare output per PA not output per person listed on ESR