Carnall Farrar and Isle of Wight Care System

The Isle of Wight health and care system has faced challenges regarding quality, finance and outcomes over several years. The Isle of Wight put out a tender to bring together the NHS, local government, general practice and the voluntary sector systems on the island and to then identify priority areas for improvement and support initial delivery.  

CF was selected due to both our track record in tackling similar issues within NHS systems and our ability to truly grasp what was being asked for us.  

Once we had been able to bring together the various stakeholders across the differing systems on the island, we were able to identify the challenges faced, and then set-out a three-year sustainability plan which would deliver the greatest impact to the local population and the system itself. 

As with any project which changes ways of working, we needed to demonstrate how to make change happen on the ground with care staff. Our approach of coaching for executive leaders combined with staff engagement for nurses, doctors and managers was the key to unlocking a delivery chain from “strategic vision’ to “frontline improvement”. 

The Isle of Wight system was able to have a real impact on three key areas; reduction in temporary staffing costs, reduction in unnecessary length of stay for patients and delivering sustainability in healthcare systems on the island. 

CF brought together a variety of different stakeholders to develop a single, shared strategy for the next three years across the council, Trust and CCG. 

As a result of our support and initial implementation of strategies, we have been able to deliver: 

  • A three-year plan to achieve the sustainability of health and care services 
  • Clearly established and communicated a case for change for mental health services  
  • Embedded the implementation plan into 2019/20 organisational plans 
  • Agreed investment in community services equivalent to over £1m per year 

By implementing “The Perfect Week”, it has not only been successful in increasing the number of discharges but also it has brought staff along on a journey and they are beginning to realise that change is possible and they can improve and fix the things that have been annoying them for years. 

The perfect week has energised staff around improvements and: 

  • Discharges increased from 210 to 231 
  • Recorded pathways increased from 43% to 79% 
  • Accurate Potential Date of Discharges (PDD) increased from 11% to 56% 
  • Increased discharges by 10% and by 18% at the weekend 

CF were able to improve the quality and timeliness of the rostering across the acute teams through a structured challenge process.  We provided the team leaders training in the new rostering process, to help improve utilisation of staff, whilst maintaining safe staffing.  Across the acute teams, all staff members are now rostered 9 weeks in the future which allows efficiencies in workflow management.  Within the first three months, the new rostering delivered £104k in savings, through the reduction of temporary staffing.  It is expected that there will continue to be further savings. 

View the Carnall Farrar profile in the MCA Members Directory.