Business Plan 2017-2018 Summary Version Through partnerships, improve lives the quality of care
Introduction The Trust s Board of Directors approved our 2017/18 Business Plan in March 2017. The plan sets out our priorities work programme for the year. It describes our context summarises our major service developments. It outlines our priorities around quality, patient safety, workforce development, Information Management Technology (IM&T) estates. It also sets out our financial plan, including a summary of our efficiency programme investment commitments. This Summary Business Plan provides an overview of the full plan. The purpose of the plan is to ensure we continue to provide safe, effective efficient care support to the patients communities we serve. Our Context The national local context The Trust operates in a complex challenging environment. The financial challenges facing the Trust all other parts of the health social care sector are significant the austerity measures facing all public services are not easing. We have had a successful financial record in the past, but for the Trust to remain sustainable, we now need to think seriously about the future how we can protect the quality of what we deliver to our patients, service users carers. Our plan has taken account of the key themes within relevant national local plans strategies. Sustainability Transformation Plans (STPs) The Trust operates within two STP footprints: i) Nottingham Nottinghamshire ii) South Yorkshire & Bassetlaw. Both STPs have much in common share aspirations to scale up primary community services deliver more integrated care. New Models of Care Vanguard Programme The Nottingham Nottinghamshire STP is testing different models through the national Vanguard Programme for managing improving population health. The Trust is an active partner in local Vanguards in 2017/18 the focus of our work in the programme will be: Rushcliffe Principia Multi-speciality Community Provider (MCP) - to work with PartnersHealth, the local GP partnership, to further develop implement new clinical pathways to bring care closer to home to improve care for people with complex health problems. Mid Nottinghamshire Primary Acute Care Systems (PACS) - to continue to develop the Alliance way of working develop new clinical models; for example, a new model for musculoskeletal (MSK) services. Full details of all of our services are accessible on our website: www.nottinghamshirehealthcare.nhs.uk/our-services Our Strategic Vision Objectives In 2016 we developed a new five year strategic framework, setting out our vision four strategic objectives: Our Vision: Our four strategic objectives what they mean: Through partnerships, improve lives the quality of care Ensure everybody who uses our services has a positive experience in which they feel involved in their care the decision to support their recovery Demonstrate robust use of outcomes across all services to drive improvement Deliver evidence based practice innovation in all our services Demonstrate a culture that listens responds to all the feedback we receive Deliver integrated, coordinated care by working with our partners Deliver holistic patient centred care responsive to the needs of our patients, service users carers Maintain our financial sustainability Target reduce unwarranted variation to maximise productivity efficiency Fully maximise the efficiency benefits to be released from delivering our digital strategy An engaged workforce, whose behaviours reflect our Positive values that is well led A diverse workforce that is reflective of the diverse communities we serve
Quality Priorities We will finalise our quality priorities in May 2017 will publish them on our website. Our emerging priorities for 2017/18 will be framed around five core areas below: Domain Safe Caring Effective Responsive Well Led Priority Reduce avoidable harm Identify clinical risks, where identified, ensure action is taken reflected in care planning Improve experience through better management of complaints better understing response to issues raised through complaints Development implementation of a Clinical Outcomes Framework Effective monitoring learning from deaths of patients who die whilst in receipt of services or within six months of discharge Accuracy timeliness of record keeping Improve communication between staff patients Continue rollout of Electronic Patient Record Enable information sharing across clinical information systems Focusing on the right care in the right place at the right time Efficient coordination between teams care coordinators Maximise responsiveness timeliness of initial assessment commencement of treatment ensuring that patients are seen, treated discharged within national local stards Ensure the Trust has a culture that encourages staff to have the freedom to speak up Design initiate a Culture Leadership Review Sustain compliance with the Mental Health Act Service Developments We are committed to a wide range of significant service developments in 2017/18. Highlights include: Integrating physical mental health care joining up care across our physical health mental health services to improve clinical outcomes. continuing our work to reduce the use of tobacco products by people with long term mental health problems. Children, Young People Families Services The Trust is building a new campus style development, recently named as Hopewood. This will increase our Children Adolescent Mental Health Services (CAMHS) inpatient services from 13 to 24 beds. There will also be a new 8-bed Psychiatric Intensive Care Unit; a new Education Centre for CAMHS inpatients; a new CAMHS community unit. It will also re-provide perinatal mental health inpatient beds, increasing the number of beds from 7 to 8. Construction of Hopewood is due to complete towards the end of 2017/18 it will become operational from Spring 2018. mobilising the new Healthy Families integrated service model embedding mental health interventions into all areas of family development. Mental Health Five Year Forward View additional psychological therapy provision for adults, children young people. Early Intervention of Psychosis Crisis services to achieve quality waiting time targets. expansion of community perinatal services. implementation of 24 hour provision of acute mental health liaison services in both of the two local acute Trusts. Adult mental health continuing the transformation of community mental health services, developing a business case for a more sustainable viable model of inpatient care, including a review of bed management processes step-down capacity. Intellectual Development Disabilities - continue the Transforming Care Partnerships (TCP) programme which aims to develop community services reduce the need for inpatient beds. This will include a pilot Intensive Community Assessment Treatment Team to offer a more proactive preventative approach. High Secure Services mobilising the disinvestment in Dangerous Severe Personality Disorder services by commissioners through the reduction of 17 beds in line with the National Offender Pathway Plan. developing specialist treatment approaches to enhance patients skills improve prospects for release as part of sentence planning. reviewing men s personality disorder services developing an integrated single care treatment pathway. New Forensic Care Model - across high, medium low security community forensic services for the East Midls population. Pharmacy Medicines Optimisation continuing to develop the Trust s pharmacy services to support the optimal use of medicines, including the deployment of automation IT systems.
Workforce The Board of Directors approved a new five year People Culture Strategy in February 2017. The strategy can be found on our website at www.nottinghamshirehealthcare.nhs.uk/working-for-us The strategy sets out our four people priorities as: Resourcing, Retention Recognition Health Wellbeing Recovery Resilience Equality Diversity Inclusion Education Learning Development Talent Delivered in partnership through our people priorites resourcing, retention recognition health, wellbeing, recovery resilience equality diversity inclusion education, learning development talent management A detailed workforce development plan has been developed for 2017/18 Developing our People Culture Together Developing our People Culture Together Programme will ensure: a constant commitment to quality of care effective, efficient, high quality performance support, compassion inclusion for all patients staff continuous learning, quality improvement innovation enthusiastic cooperation, team working support within the Trust other organisations Financial Plan Workforce Plan Our plan predicts a number of changes in the composition of our workforce as summarised below: Staff Groups Workforce Projections 2017/18 March 2017 31-Mar 2018 Medical dental staff, total WTE 263 263 Non-medical, clinical staff, total WTE 5,700 5,376 Non-medical, non-clinical staff, total WTE 2,213 2,071 Total substantive WTE 8,176 7,710 Bank staff, total WTE 464 407 Agency staff, total WTE 156 136 Total WTEs 8,796 8,253 Table above includes the impact of contract changes service developments (such as the new CAMHS services). The financial plan, submitted to NHS Improvement approved by the Board of Directors, showed the Trust s Cost Improvement Programme (CIP) savings target for 2017/18 of 17.5m. This is an extremely challenging target for the Trust whilst numerous plans are in place that bring us closer to reaching this target, there remains a significant level of unidentified CIP for 2017/18 which equates to a gap of 3.8m. The Trust is working hard to identify new schemes to release further savings efficiencies to close the gap. FINANCIAL SUMMARY PLAN 2017/18 INCOME & EXPENDITURE m Total income 446.6 Total operating costs -437.0 Net Surplus before impairment 9.6 Net I&E margin % 2.1% OTHER KEY FINANCE INFORMATION Year end cash balance 36.5 CIP Target 17.5 Capital cash expenditure (before disposals) 19.4 Single Oversight Framework (Use of Resources) 1 Table sets out the key financial information contained in the plan.
Annual Work Programme 2017/18 Estates Facilities During 2017/18 we will continue to ensure we deliver services from high quality buildings that meet the needs of our patients service users. We will focus on a programme to reduce ligature risks in our clinical environments ensure we meet the privacy dignity requirements of providing care in mixed sex environments. Information Management Technology The Trust is developing a new three-year health informatics strategy which is due to go to the Board of Directors for approval in May. There are four key areas that we will be prioritising in 2017/18: The continued refresh strengthening of technical infrastructure required to support existing future system operations. The development of ways to ensure our systems can interface with each other both within the Trust across the County. Continued development of electronic patient records across the organisation. Developing the range of digital health tools or services that we offer to our patients. Our full Business Plan includes a detailed work programme for 2017/18 bringing together the key strs of work projects towards achievement of our strategic objectives. Examples of some of the key projects within the work programme are: Strategic Objective 1: Provide the Best Possible Care Support The transition of our new Local Partnerships Division to a new operating model structures, bringing better integration across physical mental health; efficient management structures a clear approach to place-based working. The development of a Trustwide Clinical Outcomes Framework; providing the ability to record, monitor improve outcomes, alongside ensuring more efficient services removing ineffective interventions. Strategic Objective 2: Demonstrate Best Value A streamlined integrated approach to estates, facilities capital planning to increase effectiveness efficiency. Roll out of the Electronic Patient Record to ensure accurate, upto-date clinical information which is easy to navigate, allowing for delivery of better care as well as reducing the costs risks associated with paper notes. Strategic Objective 3: Be the Service Provider of Choice Delivery of Hopewood, a child family friendly campus which brings care closer to home through increased provision improves the care environment. Working in partnership with commissioners to deliver a new care model across high, medium low security community forensic services in the East Midls. Strategic Objective 4: Make the Trust a Great Place to Work Launch deploy the new People Culture Strategy (2017-2022) implementation plan. Continue the roll out of e-rostering to support safer staffing levels. Proactively support the wellbeing of our workforce so that they can be good advocates for healthy lifestyle choices for themselves, their colleagues patients service users. Outcomes include improved outcomes for patients, reduced sickness absence, happier healthier staff improved workforce effectiveness engagement. Conclusion The Business Plan brings together a significant challenging annual work programme which we are confident can be delivered. The plan is an important mechanism to shape prioritise our actions in 2017/18 in order to continue to deliver our five year strategy realise our vision Through partnerships, improve lives the quality of care.
www.nottinghamshirehealthcare.nhs.uk May 2017