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WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY DEPUTY G.P. SOUTHERN OF ST. HELIER
ANSWER TO BE TABLED ON TUESDAY 22nd SEPTEMBER 2015
Question
"Notwithstanding his response to written question 8928 of 8th September 2015, will the Minister inform members what changes/reductions to service delivery are being "worked through" or are under consideration from the 12 areas listed on page 83 of the Annex to the Medium Term Financial Plan as well as any others to be delivered in 2016 or beyond and, if not, will he assure members that he will bring these measures to the Assembly before the MTFP is debated on 6th October 2016?"
Answer
The Annex to the MTFP sets out a number of schemes that are intended to deliver savings at HSSD. Some are self-explanatory, but for a number further information is provided.
To remind members, the 12 schemes are:
- a review of non-pay budgets and reduction in usage of supplies (stock reviews; procurement savings; renegotiation of contracts for high cost consumables; improved inventory management)
- reducing spend on patient food services for inpatients (patient ordering; change of menu; reduction of waste)
- reducing the number of FTE in management and administrative support areas
- improving procurement of specialist care in the UK to reduce cost (by negotiating on price and reducing the number of contracts)
- requiring efficiencies in contracts for services with on-island providers including voluntary and community sector partners
- restructuring management of Community and Social Services (to reflect the creation of a single adult mental health service)
- closing hospital beds at the weekends where safe to do so (consolidating empty beds to enable one ward to shut at weekends)
- reducing staff travel costs and patient travel subsidies (reducing the amount of travel through better use of technology such as webinar' workshops and other e-learning; more stringent controls; reviewing the travel policy)
- reviewing the provision of patient transport services
- improving staff absence management and the spend on agency and locum staff (robust application of the absence management policy; better rates for agency/locum staff; rota management/e-rostering; vacancy management)
- reviewing provision of some low level care services (such as domiciliary care services)
- implementing recommendations from the review of private patient income by the CAG (price reviews; activity capture; greater use of patients' medical insurance)
The department is seeking to deliver savings through sustainable efficiencies, service redesign and cost reductions. The intention is to deliver services in as efficient a way as possible; in terms of the impact on service delivery, any changes would only take place where safe to do so and would often involve working with partners in the voluntary/community or independent sectors to provide those services.
An example of improved services and improved value for money is the tendering of the off-Island Cardiology service. This approach will be expanded across other off-Island hospital services; it will save money and provide better services for patients. The grade and type of staff who deliver services is also being reviewed, for example for Older Adults Mental Health; this should result in more co-ordinated care, with a more attractive career path for many staff who will be supported to expand and utilise their skills – for example, by supporting nurse prescribers and enhanced role practitioners. These service models have been proven elsewhere, and need to be considered and applied to Jersey as part of our system redesign, to deliver safe, sustainable and affordable services for Islanders.
These savings initiatives are being led by my senior management team, with involvement from all levels of staff, and using lean management techniques. They are principally internal operational matters and it would therefore not be appropriate to bring them to the Assembly before the MTFP is debated on 6th October 2015. Change is a constant at HSSD and it would not be appropriate or indeed practical to seek the assembly's approval for every such initiative.