Annual report 2010-2011
Chair's statement
Remotely delivered services help manage the pressures on already stretched primary and secondary healthcare, by reducing avoidable demand on face-to-face services and by steering demand to the right setting at the right time. They support patients to take greater control and exercise greater choice over their health and healthcare, and how they access services. They do so in ways which promote patient safety and support the achievement of high quality health outcomes.
In 2010/11 we took significant steps towards the Trust’s vision to provide remotely delivered care that is increasingly valued by patients and the wider health and social care system. The Trust aims to be a trusted delivery partner in every local NHS health community.
We continued to work in partnership with the East of England Strategic Health Authority (SHA) – which commissions the national 0845 4647 service – and local health commissioners, GPs and other NHS organisations, to increase the value of the service for both patients and the NHS, and to reduce its cost.
During 2010, the Coalition government announced its plans for the national rollout of a new NHS 111 telephone service for patients with non-emergency health needs, which will ultimately replace the 0845 4647 service. We are very pleased to be involved in all of the first four pilots of the new service. The government’s broader plans for reform to NHS commissioning, the introduction of greater competition, and the requirement for all NHS trusts to become NHS Foundation Trusts, have profound implications for us. The consequent risks and opportunities have been recognised by the Board, and the whole organisation is now gearing up to the challenges ahead. I was pleased to able to confirm, with the valued support of both the Department of Health and the East of England SHA that the Trust will seek NHS Foundation Trust status from April 2013.
Over the last year, we have taken further steps to strengthen our Board. We appointed Dr Brian Gaffney as Director of Public Health/Acting Medical Director, with a specific brief to ensure the Trust reaches out to the medical profession, both nationally and locally. Ronnette Lucraft was appointed as Chief Operating Officer, and has led the Trust’s plans to improve its operational efficiency. We also saw Tricia Hamilton step up as Chief Nurse and Clinical Director, and Alan Bentall join the Board as Chief Information Officer on a permanent basis. Steve Duncan joined the Board as a Non-Executive Director, bringing with him experience from a distinguished career leading consumer-facing healthcare and pharmaceutical businesses.
Our non-executive directors with medical backgrounds, Dr Luisa Dillner and Dr Tim Heymann, appointed in late 2009, have been able to provide valuable additional clinical direction to the development of the Trust and its services.
We recognise that we ask a great deal of our staff. They tell us that the degree of change we are facing as an organisation creates considerable uncertainty for them, in addition to what is already a stressful job. We take these concerns extremely seriously. It reinforces our determination to engage staff at every level in shaping our plans for the future and to demonstrate our appreciation for their continuing commitment to patients and the service.
In the coming year, we look forward to playing a leading role in supporting the NHS to exploit the full potential of multi-channel, remotely delivered clinical care. We are excited about our new role in supporting NHS 111 and about creating new remote and digital channels to meet the growing and changing demands for healthcare, helping the NHS to catch up with other sectors of the economy.
We look forward to working within the new commissioning and competitive provider regime to clearly demonstrate the value offered by our services, for the mutual benefit of patients, the wider public, and local and national health economies.
Joanne Shaw
Chair, NHS Direct National Health Service Trust
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Chief Executive's statement
We have been working with other NHS organisations to pilot NHS 111 since the spring of 2009, and the work we’ve undertaken over the last year has helped us to focus our future plans and ambitions. It is our intention to compete for future NHS 111 business, working alongside other NHS providers, and we envisage that we will have a new role as a major provider of the new service.
Although NHS 111 has been a significant area of work in 2010/11, we have not neglected the important job of providing trusted health information and advice to the millions of people who use our existing telephone and online services.
Last year, 4.7 million patients used the 0845 4647 telephone line, and a further 5.6 million patients used our range of online health and symptom checkers. We have seen an increase in popularity of our online tools, and the numbers show that more people are initially accessing our services online than over the phone.
Over the last year, we have rapidly developed these services and we now have nearly 40 health and symptom checkers available on the web and a mobile app, which allows people to access our services more conveniently wherever they are. The added benefit of our web tools is their link to our telephone service, so our patients know they can speak to one of our nurses should they need additional support. Over 90% of our patients continued to rate our services as good or excellent last year. This lets our staff know that what they do is of huge value and that their efforts do make a difference.
We have played an important role in the wider NHS landscape, by taking pressure off other NHS services and significantly contributing to the £20 billion of efficiency savings the NHS needs to be able to make to keep up with rising demand for healthcare from England’s ageing population. We reduced the cost of providing our services to the rest of the NHS by £11.1 million in 2010/11. By the end of 2011/12, we will have reduced the cost of our service to the NHS by £33 million a year.
The services that we provide enable patients to care for themselves, where this is appropriate, and reduce unnecessary A&E attendances and GP surgery appointments. During the year, over half of the patients who contacted our 0845 4647 service were able to care for themselves with the advice given to them by our staff and did not require onward referral to another part of the NHS.
Because of this we estimate that in 2010/11 the core service saved 1.6 million unnecessary GP surgery appointments, 1.1 million A&E attendances/999 calls, and 0.5 million other face-to-face appointments.
In 2010/11, we developed 42 local innovation pilots with local health communities to test out the use of remote telehealth monitoring, and online patient decision aids. Our ambition is to develop these pilots to support patients with long-term conditions and provide more patient choice. We hope that these services will make an important contribution to patients and commissioners. The pilots provided a great opportunity to work closely with other NHS organisations and with our commissioners, the East of England SHA, who have supported this programme of work.
As always, our staff have played a vital role in the last year, and will continue to as we move forward. This includes those people working on the front line in our 31 contact centres, those working behind the scenes supporting services, and over 100 home-based nurses who have demonstrated that it is possible to provide a professional, safe and effective service in another setting.
Although the level of recruitment we needed to make over the year fell, the stability of our front line resource was evident, and at the end of the year, almost 90% of our front line staff had been in post for longer than 18 months. Internally, the Trust reduced its management costs by 28% during the year, and improved front line efficiency by 15%. Staff sickness fell by 13% from the levels of the previous year, but reducing staff sickness absence still remains a priority for the Trust.
As ever, I would like to record my personal thanks to staff at every level within the Trust for the commitment and skill that they have shown during the year, to the partnership of many organisations with whom the Trust works closely, and to our members and users of the service who help us to improve through their engagement with us.
Nick Chapman
Chief Executive, NHS Direct National Health Service Trust
Related Links
NHS Direct executive directors
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