Operational Plan 2017/ /19 Dartford and Gravesham NHS Trust

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1 Operational Plan 2017/ /19 Dartford and Gravesham NHS Trust Page 1 of 5

2 Introduction Our Family, caring for yours defines our purpose as an organisation. This captures the approach taken by our teams which makes the difference to the care that our patients and their families experience. The Trust already has a well-developed and embedded set of values that places the patient at the centre of everything we do. Our recent achievements include having: been selected by NHS England to progress an Acute Care Collaboration Vanguard with Guy s and St Thomas NHS Foundation Trust (GSTT) as part of the delivery of new models of care in the NHS Five Year Forward View; strong friends and family and patient survey results each year and consistently winning external awards such as CHKS, HSJ, Investors in People and sustainability awards; a strong track record and clinical strategy that has advanced a comprehensive range of core elective, non-elective, maternity and outpatient services as well as a number of specialist services through partnerships with other Trusts; and been categorised as a two in the Single Oversight Framework Segmentation by NHS Improvement. We aim for our way of delivering care to be extended into how we meet the challenge of our exceptional and unprecedented population growth (a 27% increase by 2026) as the new Ebbsfleet Garden City continues to be built. This challenge is set in the context of the Trust already experiencing very high occupancy rates and being constrained by the shortage of system capital and the footprint of our first generation private finance initiative (PFI) hospital at Darent Valley Hospital, Dartford (our main site). Our two year plan Our two year plan focuses on our journey from a hospital based model of care to a future of delivering modern care in the right setting enabled by partnership working, digital innovations and a sustainable workforce. To ensure our services can be delivered in line with the NHS s constitutional standards and meets the needs of our existing and future clinical capacity requirements we will be: investing in initiatives to reduce admissions to acute beds and improve discharges as well as maximising our clinical use of the elective centre at Queen Mary s Hospital; progressing our Transforming Healthcare in North Kent (THiNK) programme to transform how we deliver care to create modern services that meet the needs of our local population; continuing to explore an innovative group model to develop a sustainable local hospital with our partners GSTT as an Acute Care Collaborative Vanguard; working collaboratively with partners to deliver both Kent and Medway and South East London Sustainability and Transformation Plans; and developing a joint commissioner and provider strategy and plan to create capacity to provide services for the new population of Ebbsfleet. In addition, we are reducing our agency spend towards the cap through improved use of e- rostering, overseas recruitment and reviews of skill mix/safer staffing as well as developing a collaborative approach to agency and bank with our STP partners. The Trust is committing to achieve the control totals ( 1.6m surplus in 2017/18 and 4.0m surplus in 2018/19) including a 10.1m QIPP programme and 7.3m of Sustainability and Transformation (S&T) Funds for 2017/18; 8.4m QIPP programme and a further 7.3m of S&T Funds for 2018/19. We have sought to illustrate our journey using the following rich picture. Page 2 of 5

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4 Our clinical strategy The Trust s values, Clinical Strategy and a set of enablers are set out in the figure below: Local Specialist Services: we continue to work with Guy s and St Thomas NHS Foundation Trust (GSTT) as an Acute Care Collaborative Vanguard site to deliver new systems of acute care for patients. The partnership s vision is to develop a sustainable local hospital model without merger and acquisition activity that makes best use of scarce resource and can be replicated across the NHS. It will improve outcomes and access for patients, reduce costs and meet challenges of increased demand. The Trust has assumed that it will continue to receive funding to continue the development and testing of the Foundation Healthcare Group through the Kent and Medway STP. Transforming Core Services: The Trust has developed plans for the future that include a programme of work known as THiNK Transforming Healthcare in North Kent to develop, strengthen and transform its core services to manage the rapid increase in population due to Ebbsfleet. Through this programme, the Trust aims to deliver 7 day services, increase the ambulatory provision, improve pathways such as frailty pathways and implement the Lord Carter recommendation on productivity and efficiency. For example, the Trust will have an integrated pathology service with Medway NHS Foundation Trust from 2017/18. The diagram opposite shows the focus of the THiNK programme in delivering the Transforming Core Services aspect of the clinical strategy. Page 4 of 5

5 Hospital Without Walls: The Trust is committed to developing new pathways with a community and home focus to improve the flow of patients to the right setting of care. The Trust is actively engaged in the development of the local care pathways within the Kent and Medway STP with end of life / palliative care in the community being of particular importance as the local demographics suggest a 45% increase in the over 85s in the next ten years. In addition, the Trust is exploring a number of ways to develop discharge and admission avoidance initiatives that will result in greater acute provision at home; working with GP federations and linking with the Bexley Local Care Network and the developing Integrated Care Organisation being developed in Bexley as part of the South East London STP. Sustainability and transformation plans The Trust is a member of the Kent and Medway STP and an associate of South East London STP as we provide outpatient and diagnostic activity at Queen Mary s Hospital and Erith District Hospital. A key aim for the STPs will be to obtain the right workforce and capacity to meet the healthcare demands it will encounter in the future, recognising the pressures in social care given significant budget reductions. There is a risk to the supply and retention of workforce due to the geographical location of Kent and Britain s exit from the European Union which will need to be addressed nationally and as part of the STPs. There is currently an imbalance in the admissions and discharges at the Trust due to our rapidly increasing population. The Trust (with Dartford, Gravesham and Swanley CCG) will continue to identify solutions to the capacity challenge that can be delivered during whilst also developing longer-term plans as part of the Kent and Medway STP. The Trust s ten year sustainability strategic outline case has been included in the capital plan in the Kent and Medway STP. Efficiency programmes Our THiNK and QIPP programme has limited scope due to the PFI and therefore our plans for are focused on innovative ways to drive efficiency and productivity through our workforce and technology. Plans will include: delivering new agile ways of working to develop a more sustainable workforce model that, improves staff experience, minimises non-clinical space at the hospital and at least maintains staff productivity; embedding LEAN initiatives identified by staff; and harnessing information and technology to create digital solutions to enable new models of care, improve clinical information and allow patients to better manage their conditions. Page 5 of 5