Chief executive of Whittington Health, Dr Yi Mien Koh, explains to Jessica Fuhl that the biggest challenge to integration and efficiency is getting staff on board
Whittington Health has ambitions plans for the future. It hopes to achieve foundation trust status by 2014 and its first step to ensure it made sufficient efficiency savings in order to do so was to fully integrate local community services with the hospital last year. In January it had reached 98% of its cost improvement programme (CIP) target for the financial year as a result.
The integrated health organisation is a merger of the formerly named Whittington hospital, Islington PCT and Haringey PCT – including Haringey children's services.
Dr Yi Mien Koh was appointed as chief executive of the organisation almost a year ago in time to oversee the integration of the services. In an interview with the Guardian's healthcare network at the Nuffield Trust health policy summit last week she said that one of the biggest challenges of the merger was integrating staff's ways of thinking.
"It was three different cultures, three different ways of working, three different sets of conditions. But as a result what we now have is one structure that takes the patients all the way from the front door in to the community."
Koh has had to find new ways to incentivise staff as the trust moves forward with its strategic plan for to improve efficiency and the quality of healthcare through integration.
"Incentivising clinicians to work in a different way is key", she said. "For example, not asking patients to turn up at out patients, but instead asking can we go out in to the community; asking clinicians to work via telephones and emails."
The trust has already introduced telephone consultations with patients, something to be continued in the long-term provided all clinicians adopt the approach. For some staff, "taking the patient all the way from the front door" is taken so seriously that they communicate with patients online via online platforms such as Twitter.
Koh explained: "Certainly with children, for example, who have long-term conditions like diabetes, they are already communicating with their pediatricians how to manage their condition on a day-to-day basis through Twitter. The young people get real time feedback which is better."
The chief executive has asked GPs to adopt other new ways which she hopes will drive efficiency and improve the quality of care at Whittington Health. GPs are incentivised to communicate with patients through emails by being paid a small amount extra for each email correspondence used instead of letters.
Whittington Health has also bought a new electronic patient records system that will integrate GP and social care systems next year. But, according to Koh, buying the IT is only part of the challenge.
"Ten per cent of the challenge is finding the money, and 90% is culture change – getting staff to want to use it. The NHS is very good at implementing new technology, but keeping the old. We're just not keeping the old.
"What we want to do by the end of the year is have 50% of all communication with patients by emails. But the GPs are actually resisting because they say that patients who don't have internet access will have to print it off anyway, as will GPs who don't adopt the electronic patient records system.
"We are thinking about how we can make electronic the easier option, as it costs a lot of money to process the paper."
For Koh the challenge to drive innovation and efficiency at Whittington Health is a big one, but it is one she is determined to meet by bringing her staff with her.
"We're on a triathlon. This is the analogy I usually use for my team. We have the swimming and the cycling and the running. We are now starting to swim but we are only are only in the beginning – we still have cycling and running to do. So I say, don't tire yourself out too much. We still have a lot to do.
"But some people, if they are not fit, then you're just going to drop out half way. So we need to be leaner, and part of being lean is getting the organisation of staff structurally fitter.
"It is very challenging but the biggest thing for me is bring staff with me on this journey. So that we have the same goal and that we share the same vision to provide high quality care for the population." Guardian Professional.
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