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Royal Stoke University Hospital and County Hospital

Healthcare

Royal Stoke University Hospital

The University Hospitals of North Midlands NHS Trust (UHNM) was formed in November 2014 following the merger of the University Hospital of North Staffordshire NHS Trust (UHNS) and the Mid Staffordshire NHS Foundation Trust.

The new UHNM Trust includes Royal Stoke University Hospital and County Hospital, and is one of the largest trusts in the Country. Caring for more than two million people a year, UHNM is highly regarded for its facilities, teaching and research.

UHNM has a large private finance initiative (PFI) contract, and is a complex mix of in-house and outsourced estates and facilities services.

 

Background

The relationship between Sodexo and UHNM began in 2007, when we were appointed as the PFI FM provider to UHNS. We delivered FM services in a phased manner, in tandem with the construction programme, from 2009 to 2012.

Today, we are responsible for the soft FM services throughout the PFI and part of the retained estate, and hard FM services to the PFI at Royal Stoke University Hospital.

Our 1,000-strong on-site team deliver patient and visitor catering, cleaning and infection prevention, security, waste, portering, maintenance, helpdesk, and lifecycle management services.

 

The early days

Relationships in the early days were challenging. Typical of many private/public sector contracts at that time, an adversarial approach to managing the contract was in place, with the contract being king. However, all parties recognised that, for the contract to be successful in the longer term, something fundamental had to change. We had to move from the traditional, adversarial relationship to one of partnership working.

Our solution

All parties agreed to improve performance and patient care by investing in partnership working.

We introduced a framework to provide a structured approach that helped to transform our relationship from one based on coercion to one of co-ownership.

To help us move along the framework to a win-win position, initiatives we implemented included:

  • developing a joint vision to ensure both organisations were aligned to the same goal to put the patient at the heart of our operations: Service excellence in everything we do
  • establishing a culture that puts the patient at the heart of our PFI by aligning our values and objectives of quality, safety and value
  • introducing strong, visible leadership to role model our one-team approach
  • ensuring people with the right skills, knowledge and experience were in place to deliver against our challenging agenda by reviewing management and team structures
  • bringing the team together and highlighting our commitment to the relationship by holding partnership days
  • encouraging team members to think about how they would expect their own mum to be treated at each stage of the patient journey by applying the My Mum test, which is designed to help them understand their role in delivering service excellence for patients
  • demonstrating our shared commitment to delivering consistently high standards of estates and facilities services by organising joint workstreams and monitoring the progress of agreed actions
  • developing a shared staff engagement plan, recognising the importance of having an engaged team to deliver better and safer care, with activities designed to give individuals and teams the tools and confidence to deliver against our joint vision and objectives, with:
  • engagement champions, representing all stakeholders, appointed to share information and provide feedback
  • focus groups to promote two-way dialogue at all levels, and encourage idea generation and knowledge sharing across the team
  • timely, transparent and accurate communications to build trust and confidence, with all-party involvement in key Trust meetings, informal meetings, and a joint newsletter to help the team respond to any issues and changing service needs in a more timely manner.

Understanding delivery blockers

It was important for all stakeholders to understand the blockers to service delivery and to design enablers to improve contractual performance. Examples of how we achieved this include:

  • a five-year maintenance/PPM programme: we are contractually obligated to submit the five-year maintenance programme 80 business days before the contract anniversary. We now provide it 12 months in advance and, wherever possible, we align the same department and ward to the same week in the year as this helps clinical divisions plan their space availability.
  • a portering moratorium: the Trust was flexible about our performance and froze penalty deductions during a change management programme. This enabled us to make changes to improve long-term patient service delivery.

An example of the new partnership way of working and its positive impact on patients at UHNM is the transformation of the hospital room of a 19-year-old cystic fibrosis, palliative care patient who had been at the hospital for almost a year. This patient had always dreamt of visiting New York, so our on-site team worked with the Trust to redecorate their room with a New York theme.

 

The outcome

By developing shared objectives and joint workstreams, we transformed a broken-down relationship and poor performance into a successful working partnership.

The PFI is now one of the most successful performing contracts in the country, with highlights in service including the following:

  • Patient care and excellence in service delivery is illustrated by above-national-average PLACE results (in 2017 and 2018), and a CQC inspection commendation for the joint appointment of an estates and facilities matron, which was recognised as innovative practice.
  • Patient satisfaction with the patient meals improved following our introduction of the electronic meal ordering system, Saffron.
  • Delivering a staff engagement and partnership working approach, which has not only improved service quality but also staff morale and produc-tivity. Moreover, it has led to many improvement ideas being generated from the shop floor.
  • Partnership working has driven value for money, to date contributing one-off benefits and over
  • £2 million in reoccurring savings.
  • In response to the Carter Report, we have reviewed and considered investment-led opportunities to meet patient flow and demand to support the Trust’s clinical pressures, and release valuable expansion space.
  • Making significant progress towards our sustainability agenda. We supported the Trust’s Sustainable Development Management Plan, which includes increasing the Trust’s understanding of CO2 emissions related to its procurement activity, the renegotiation of the requirements for a clinical waste contractor to deliver cost savings, and the use of a local transport company to reduce transport miles and emissions and bolster the local economy. The success of these initiatives was recognised by an NHS Sustainability Award in 2017.
  • The partnership has gained further external recognition with a series of awards, including Partners in Healthcare at the PFM Awards in 2017, and Supplier of the Year and Partnership of the Year at the HSJ Awards in 2018.

Praise from our client

UHNM is very proud of the partnership it has with Sodexo, and the mutually agreed partnership outcomes achieved through joint working and successful collaboration. These have been instrumental in UHNM delivering its 2025 Vision and realising the full benefits of our PFI contract. This is achieved through putting patients first in all that we do, driving performance that enhances the delivery of the patient care and key operational efficiencies that provide for a better experience for patients at lower costs."

Lorraine Whitehead, Director of Estates, Facilities and PFI at the University Hospitals of North Midlands NHS Trust

February 27, 2019

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