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Integrated Business Plan - Solent NHS Trust · elections, which are planned to ... INTEGRATED BUSINESS PLAN INTEGRATED BUSINESS PLAN 12 13 ... to re-design care pathways to include

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Page 1: Integrated Business Plan - Solent NHS Trust · elections, which are planned to ... INTEGRATED BUSINESS PLAN INTEGRATED BUSINESS PLAN 12 13 ... to re-design care pathways to include

to 2017

Precis for Health and Wellbeing Services

Integrated Business Plan

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As we continue our journey as an independent Trust and progress towards Foundation Trust authorisation in 2013, we are developing our vision and plans as an organisation.

This document provides staff with a summary of these organisational plans and how these relate to Health and Wellbeing Services.

If you would like more information, please contact: Alex Whitfield, [email protected] or 023 8053 8738

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Our philosophy is to make things better for our population

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master of our own

destiny

Why are we applying for Foundation Trust status?The Department of Health (DH) expects all NHS Trusts to achieve NHS Foundation Trust status on their own, as part of an existing Foundation Trust or in another organisational form. There are a number of benefits for the Trust and for staff in becoming a NHS Foundation Trust.

For the Trust these benefits include:

l Being ‘master of our own destiny’ that is accountable to an independent regulator (Monitor)

l Being able to build up and retain cash surpluses that can then be invested for the benefit of service users and the community we serve. For example, we plan to invest in our infrastructure especially information technology and to provide upfront investment in innovation and transformation

l Being able to keep some of the proceeds of any land sales that can then be re-invested

l Being able to borrow money from commercial sources without DH determination or prioritisation

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Our Vision and StrategySolent NHS Trust was established to manage care in the community, support clients’ independence and self-care by providing integrated physical and mental health and social care services based around GPs and their practice populations. We have particular expertise in providing integrated services to urban communities with complex health and social care needs. Our philosophy is to make things better for our population by taking a service user/family-centred approach which promotes wellness, self-care, recovery and personalisation. Our services enable people to remain safe and well at home with reduced dependency on acute hospital based services. Service users will experience home-based services that are reliable and available 24/7 and are organised with other providers around the care pathway.

The Trust’s strategy is to work closely with clinical commissioning groups and local health and wellbeing boards to lead a whole system change in the delivery of services.

Our goal is to shift the centre of gravity away from acute hospitals by offering clinically appropriate community solutions via a single point of access. The services we provide will be realistic alternatives to acute hospital care, rather than a duplication of services. Admission to acute hospitals will be necessary only for those with clinical acuity that requires the particular skills and infrastructure that only an acute environment can provide.

Long term conditions care pathways will be coordinated and delivered by single clinical multidisciplinary teams using the latest health technology including remote tele-healthcare. Service users will experience services that are better integrated and delivered from ‘one-stop-shops’ in community campuses, ensuring better outcomes for people living with multi morbidities.

All staff, unless they choose to opt out, will automatically become members of the Foundation Trust. Members, who will include service users and the public, will be invited to participate in focus groups and to comment on service changes and developments.

Members will be able to stand for election as a Governor and to vote in these elections, which are planned to take place this summer. There will be five staff Governors elected to the Council of Governors, which is an essential part of the unique governance structure of NHS Foundation Trusts and provides a link between the Trust, its staff and the community it serves. The Council of Governors has a key role in providing advice on the strategic direction of the Trust and the way in which it carries out it’s business. Staff Governors will have the opportunity to meet regularly with the Chairman and members of the Executive Team.

Our vision is to lead the way in local care

Our mission is to provide services in partnership to

deliver better health and local care

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At the heart of the Trust is the quality promise:

Patient SafetyPatient Experience

Clinical Effectiveness and Outcomes

Regulation and Assurance

We do no harm Improved satisfaction and patient reported outcomes

Clinical standards and evaluation

Monitoring evidence based practice and clinical outcomes

We will make safety everyone’s highest priority and have a no harm culture ensuring our staff do the right thing for every person, every time

We will improve experience by putting people at the heart of services and listening to people’s views, gathering information about their perceptions and personal experience and using that information to further improve care

We will achieve optimum clinical effectiveness and outcomes by ensuring the application of evidence and best practice is in accordance with NICE guidelines and all other national guidance. We will demonstrate compliance through clinical audit

We will achieve regulatory compliance by ensuring the governance and risk management framework is fit for purpose at all levels, being clear, understandable and seamless whilst supporting continuous quality improvement and meeting the requirements of our regulators and minimising risk

We will improve experience by

putting people at the heart of services

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Delivery of the Trust’s strategic objectives is dependent on a strong organisational culture focused on delivery of clinical and business excellence and compliance with commissioner and regulatory requirements.

The Trust’s Strategic ObjectivesOur strategic objectives set out what we want to achieve as an organisation over the next 5 years:

Strategic Objective 1To provide services which enable improved health outcomes with particular focus on areas of known health inequality

Strategic Objective 2To deliver care pathways that are integrated with local authorities, primary care and other providers

Strategic Objective 3To ensure sustainability of services through clinical and business excellence

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Clinical Strategy Health and Wellbeing Services

We are developing Clinical Strategies for each of our defining services which underpin delivery of the overarching Strategic Objectives

providing services which promote healthy lifestyles and enable improved health outcomes

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We have also set out our five year quality objectives

These 4 domains are underpinned by 13 high level quality improvement priorities which provide a secure framework by which annual corporate and divisional quality objectives are set and which reflect known and evolving risks.

Solent NHS Trust Quality Objectives 2012-17

1 Achieve NHSLA Level 2 (2014/5) and level 3 (2017)

2 Maintain CQC compliance for all 26 standards supported by the Solent NHS Trust ‘s Getting the Basics Right Programme and No Needless Harm initiatives on-going from 2012

3 Reach the top quartile of national patient surveys and benchmarks relevant to the organisation by agreed milestones by 2015

4 Reach the top quartile of the staff survey for agreed milestones by 2015

5 Achieve the top quartile scoring for the High Impact Actions by 2013

6 Achieve ‘green’ ratings across all Quality Risk Profile categories by 2013

7 Achieve top quartile rating in mental health surveys and Care Programme Approach by 2015

8 Be recognised nationally as a leading community and mental health research organisation by 2017

9 Board to Floor processes seen as part of every executive and non-executive member of the organisation’s responsibility on-going from 2012

10 Strengthen the culture of innovation across the organisation by encouraging new ideas and rewarding those individuals, services and organisations that adopt best practice from 2012

11 Quality Impact Assessments undertaken for all change programmes to assess impact on safety and delivery on-going from 2012

12 Deliver on the NHS Outcomes Framework domains

13 Deliver on the NHS Mandate and Constitution principles

Adults with long term conditions and elderly with complex needs including Primary Care Services

Adults with mental health conditions and Substance Misuse Services

Children and Families

Health and Wellbeing

Sexual Health Services

Dental Services

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The clinical strategy for health and wellbeing identifies priorities for development including

Priority Area Action

Access and Health Inequalities

Increase access to services for client groups with the highest needs, through marketing of services and engaging with targeted communities

Increase access and referrals to children’s centres of families with poorest health and highest income poverty

Increase knowledge of benefits and increase referral and signposting to Citizen’s Advice Bureau, Social Services and other benefits advice and support services

Develop better integrated pathways to prevent people ‘falling out of the system’, both adult and child services and working with Social Services and other relevant agencies

Induction of new staff to include Trust’s objective to reduce inequalities

Client Focus Responsibility for every healthcare professional to make ‘every contact count’ by developing simple health inequalities interventions

Promote Solent Health Improvement Training Programme to a wider audience, including community groups which can access groups the NHS traditionally finds hard to reach

Lifestyle and Outcomes

Increase the number of referrals to smoking cessation services

Reduce numbers of people overweight by referring to Health Trainers, physical activity services and healthy eating programmes

Reduce levels of alcohol harm by increasing the number of referrals to alcohol services and Health Trainers through delivering alcohol brief interventions

Environment Implement the Solent NHS Trust Estate Strategy

Our health and wellbeing vision is to:

Achieve the best health outcomes for patients and staff by working in

partnership with Public Health, primary care, social care, the acute sector

and other stakeholders to deliver improved outcomes, improve wellbeing

and tackle health inequalities focused on six core principles

l Improving access and tackling health inequalities

l Focusing on individual client needs

l Providing services which promote healthy lifestyles and enable improved

health outcomes

l Ensuring the environment in which we operate is fit for purpose, safe,

secure and conducive to the delivery of high quality services

l Ensuring our workforce is happy, healthy and here

l Improving integration and partnership working with primary care, the

acute sector, local authorities and other stakeholders

The key elements of the clinical strategy for Health and Wellbeing Services are summarised below.

Health and Wellbeing Services

Solent NHS Trust provides services to meet the physical, mental and psychological needs of children and young people aged 0-19 years. Services are delivered across three care pathways – Universal, Targeted and Specialist according to clinical need. Each of the care pathways encompasses elements of prevention, planned care and urgent care.

For adults and older people, Solent NHS Trust provide a wide range of services to improve health and wellbeing, from our sexual health screening and treatment services, through supporting people with substance misuse issues, and delivering smoking cessation and healthy living interventions. In all the care we provide we aim to Make Every Contact Count, in order to improve health as well as simply treat illness.

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Supporting StrategiesAlongside the clinical strategies, we have explained how other areas of the Trust’s business will help us achieve our plans. These include:

Research and Development including Primary Care Services

Estates

Information Management Technology (IMT)

Market Development

Workforce and Organisational Development

Priority Area Action

Healthy Workforce

Develop Workforce Wellbeing Strategy to promote culture of ‘Happy, Healthy and Here’ and achieve the following outcomes

• promotinghealthandwellbeingatwork;

• improvingaccesstohealthandwellbeingwhilstaswork;

• achieveareductioninthedayslostduetosicknessabsenceto <3% and

• achieveInvestorsinPeopleHealth&Wellbeingaccreditation

Partnerships Work with commissioners, primary care and other stakeholders to re-design care pathways to include interventions that improve health and wellbeing and reduce health inequalities

Develop working relationships with community groups and other partners and provide training, where appropriate, to improve access to hard to reach groups

Key services to link with Hampshire Fire and Rescue service to target key areas for free support on fire and safety measures

Monitoring and Evaluation

Service managers to develop service relevant KPI’s and to identify SMART ways to monitor and evaluate progress towards achieving outcomes in improving access and reducing inequalities.

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Increase the scope of research activity, the number of patients recruited into research, and the number of staff that are engaged with research and service evaluation activity. A particular focus will be placed on attracting commercial and National Institute for Health Research funding

Consolidate the incorporation of best evidence and evaluation findings into service delivery and be at the forefront of evidence based translational innovative care and practice. This will involve dovetailing health intelligence and information across research, evaluation and audit to inform outcomes and quality improvements

Involve patients and the public in research and evaluation so that they can work in partnership to develop projects that will benefit our population and improve our service delivery

Broaden and strengthen collaboration and partnerships with relevant organisations

Reinforce and streamline management and governance processes, ensuring that Solent NHS Trust meets national targets and attracts the best quality research. There will be support for staff to engage in the best standards of research, evaluation and audit, via access to training and other resources

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Research and Development

It is our plan that Solent NHS Trust will be recognised as a leading community and mental health research organisation and will be a leader in the involvement of service users and the public in research. Over the next five years, research and service evaluation activity will be embedded into services in a cycle of continuous improvement, to transform and deliver innovative, effective high quality care.

To achieve this aim the Research and Service Evaluation Strategy embraces five key goals:

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Workforce and Organisational Development (OD)

We aspire to be the local healthcare employer of choice, an organisation with learning at its core, providing the best workplace experience and quite simply a great place to work. Our staff are our greatest asset and we will strive to enable them to feel valued, involved and proud, creating a culture which ensures excellent services, excellence in all that we do. How we recruit, retain and develop the right people with the right skills at the right time will be a critical success factor in delivering business and clinical excellence.

OurWorkforce&ODStrategyisdesignedtorespondtothechallengesofthe changing environment, our organisational strategic objectives and our ambitious transformation agenda.

Key themes within the strategy are to strengthen the culture of the organisation, develop organisational capability and build organisational capacity to ensure operational effectiveness aligned to delivery of our strategic objectives. Greater emphasis and investment has been placed on creating a more effective clinical leadership infrastructure and ensuring that accountability for service development and governance is jointly owned at service leadership level.

Estates

A significant proportion of the facilities from which Solent NHS Trust provides services transferred to the Trust in April 2013. Facilities Management staff have also transferred to Solent NHS Trust.

Across the estate there are issues of underutilisation and buildings that are not fit for purpose. The Estates strategy therefore aims to improve utilisation so that the number of properties being fully utilised increases from 70% to 80%. Capital investment has also been identified to improve the overall condition of the estate both in terms of physical condition and also functional suitability and quality.

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Information Management Technology (IMT)

Although our use of tele-health is leading edge, our IT systems are not. Significant capital investment is planned to enhance our care record and performance monitoring capabilities. This includes

l A single domain for Solent NHS Trust

l Procure an integrated network across Hampshire to support shared patient pathways and facilitate organisational change

l Maximise recent investments by expanding:

o Voice over internet protocol (VOIP) communications links betweenPortsmouth&SouthamptonconvergingwithIT network

o Investment in virtualised environments – rolling out desktop virtual desktop infrasture (VDI)

l Refocus the clinical applications strategy to include shared community/primary care systems to encourage greater engagement between primary and community services

l Build a new business intelligence infrastructure to replace the existing data warehouses and introduce new contract monitoring and performance management systems to improve reporting capability within the organisation

l Develop a fully scoped and costed mobile working strategy for administrative and clinical staff that supports clinicians on the front-line and increases productivity.

Market Development

Our market development strategy sets out the significant changes in the NHS and economy that will impact on Solent NHS Trust’s market position.

l The changes to the commissioning environment with clinical commissioning groups, services moving to be commissioned by local authorities and the development of the National Commissioning Board

l The challenging economic climate reducing commissioning budgets

l The increasing competitive environment with increasing competition from private and third sector organisations

To respond to these changes our market development strategy focuses on areas where the Trust is clearly differentiated from other providers:

Focused on urban areas where there are complex health and social needs

Integrated with social care

Delivery fully aligned to practice populations

Organised with other providers around care pathways

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The market development strategy has two parallel themes:

Firstly, securing our position as the provider of choice for locality teams in cities and supporting the shift of service provision away from acute hospitals and into patient’s homes and the community.

Secondly, the development of specialised services, such as substance misuse, specialist dentistry and sexual health, across a wider geography.

focusing on individual client needs

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www.solent.nhs.uk

To become a member of Solent NHS Trust, please visit www.solent.nhs.uk/membership

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