Annual Report and Accounts - The Great Western Hospital

6. To work in partnership with others so that we provide seamless care for patients, more
systematically identifying and supporting those individuals at most risk of ill health and
delivering closer to home in rural areas.
With the effects of the national reorganisation of the NHS beginning to be seen during the year,
the Trust has established embryonic relationships with the various GP Commissioning
organisations that will soon take on full commissioning responsibilities from the Primary Care
Trusts (PCTs). Whilst these relationships are in the early stages pending the abolition of PCTs,
time and effort have been invested in exploring areas of joint interest and understanding future
commissioning priorities. The Trust holds regular meetings with Wiltshire Clinical
Commissioning Groups to discuss relevant issues.
The new NHS landscape will be more complex than previously and the Trust will need to
interact with many more groups with commissioning interests. This presents the Trust with the
difficulty of adapting the way we interact with our stakeholders and will require investment in
understanding their issues and concerns.
In Swindon, for example, the Trust has been working with the lead of the Transitional
Leadership Group (Dr Peter Crouch) on a new IT initiative called Optimise. Optimise is a GP
decision making referral tool, which has been developed locally by elected GPs and hospital
consultants in Swindon. It replicates many of the useful features of the previous e-referral
system and combines this with modern care pathways (e.g. Map of Medicine).
The Trust has also been a regular attendee at the Wiltshire Involvement Network (WIN) since
June building better relationships with patient representatives in that area.
3.6 Additional activity creating pressure on finances
The Trust continues to experience additional demand for services, over and above the levels we
are contracted to provide by our Commissioners. The following tables highlight activity levels vs
contracts by point of delivery for the GWH Acute and Community and Maternity contracts.
TABLE - GWH Acute Activity
Point of Delivery Contract Actual
(Under)/ Over
performance against
contract
Variance
%
GWH - New Outpatients 136,442 137,504 1,062 0.78%
GWH - Follow Up Outpatients 250,411 263,066 12,655 5.05%
GWH - Planned Same Day 22,654 27,320 4,666 20.60%
GWH - Emergency Inpatients 32,224 35,804 3,580 11.11%
GWH - Elective Inpatients 6,610 6,723 113 1.71%
GWH - Emergency Department
Attendances 63,006 70,731 7,725 12.26%
Total 511,348 541,148 29,800 5.83%
Page 19 of 211