Chris Bown (Chief Officer) and Obi Hasan (Financial Recovery Director and Change Team Finance Lead) at Health and Community Services, are leading the Financial Recovery Plan Programme. They sat down to answer questions on the plan, in order to update Islanders on the progress.
What is FRP?
FRP is the Financial Recovery Programme.
We have offered to Government of Jersey a set of proposals – due to be finalised this autumn, which will enable Health and Community Services (HCS) to make savings, so that key services struggling with inflationary and other cost pressures, can be maintained. Some areas of this include cancer services, mental health placements, off-island care, expansion beds, high-cost drugs and social care packages.
The recovery plan is identifying opportunities for improved efficiency and effectiveness of services, to help reduce costs, and increase income to ensure that the service can be delivered within the revised budget limits.
The Council of Ministers have recognised that the delivery of these savings will take time, and it is anticipated that not all structural elements, i.e. those costs outside the direct control of HCS, can be resolved without impacting healthcare services and patients.
Why are you doing this?
Jersey’s Health and Community Services (HCS) form a vital pillar of support for all our people, enabling Islanders to live longer, healthier and productive lives. In order to deliver this, we need to provide safe, sustainable, affordable and integrated services for all. In recent years the affordability of this care has become more challenging, creating a risk to the future sustainability of services as they are currently delivered.
Is affordability of our Health and Community service, greater in Jersey than elsewhere in the world?
Jersey is not unique in this, with many health system globally challenged by the Covid pandemic, health worker shortages, inflationary pressures and changing demographics driving increased demands and rising costs. These, together with a number of unique island factors, have resulted in a current underlying financial deficit of £35m for HCS that necessitates urgent action to stabilise, and a comprehensive plan to address.
Why are we suddenly in this position?
This situation hasn’t arisen overnight, with problems compounding over several years. Many of these may not have been immediately obvious, and whilst identifying improvements that are in the direct control of HCS to deliver it is equally important to recognise that a number of distinct factors are outside of its control. For example, the need to provide expansion beds capacity due to delayed discharges of patients who are medically fit to leave hospital but are awaiting placements or care packages, extended recruitment times to hire which incurs avoidable premium costs, policy decisions on companion travel, amongst others.
So how much money do you need to save?
Such complex issues will take several years to fix, and this detailed plan clearly sets out our 3-year roadmap to deliver the necessary efficiency savings and income improvements identified of £25m that are within its control:
• £3m the current financial year
• £12m in FY24
• £10m FY25
Delivering this plan won’t be easy, and much of this task still lies ahead. There are several and challenges faced by HCS that are being addressing as part of FRP to ensure successful delivery. These include:
• Clinical and other stakeholder engagement
• Development of HCS capacity and capability
• Cultural state of readiness
• Leadership development
• Evidence-based decision-making
• Additional support from central services
• Political support
How are you doing this?
Our FRP is built on a set of core values that combine patient focused quality improvement, financial recovery, clinical, staff and stakeholder engagement, teamwork, and inclusive leadership to deliver sustainable improvements. The approach to the development of the FRP has been to engage widely with clinicians and staff to involve them in shaping the solutions at the frontline and co-developing our challenging FRP Programme. It has ensured joint ownership by Executive Leads, Care Group leadership teams, and clinicians (doctors, nurses, AHPs), and operational staff for delivery and meaningful accountability exercised through the Governance structure now established.
We are looking at every aspect of running the hospital with a fine tooth comb.
We have been developing the FRP Programme and the 7 workstreams where we have identified the £25m of opportunities for improvements in all areas including pay, non-pay and procurement, medicines management, clinical productivity and income. We have now completed the ‘planning phase’ of the FRP and are entering the ‘delivery phase’ from next month.
Two examples of early delivery are the reduction in medical locums and conversion to substantive (permanent staff), and the fantastic progress our radiology and radiography team have made in the last 2 weeks alone in rapidly reducing the public and private waiting list by 4 weeks by deploying both MRI scanners. They have demonstrated great teamwork and clinical leadership for the benefit of patients which has lifted the team morale. In the words of a clinical colleague ‘….such that the atmosphere in the department has been transformed, from one of doom and gloom, to a “can do, will and must do” one. Everyone is now extremely positive and walking round with a spring in their step and for that we are all truly, truly grateful. That’s what we in the Radiology department want to do. The best for our patients and colleagues and this is empowering us to do so’.
We have already started to build our capacity and capability to sustainably deliver these improvements, actively recruiting a permanent Programme Management and Delivery Team to work alongside the Care Groups and Directorates.
When will it be achieved?
This journey of improvement will take 3 years. The FRP Plan details all the schemes and how we will deliver the £25m of efficiency savings and income improvements identified that are within our control – starting with £3m the current financial year, £12m in FY24, and £10m FY25 to eliminate the deficit and achieve a sustainable financial position.
The Report will be made available to islanders in the coming days.