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TRANSCRIPT
Our strategy 2019 - 2022
Supporting our communities to live life well
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Contents
Welcome....................................................................4
Executive summary...................................................5
Who we are...............................................................6
Our culture................................................................7
Our focus on quality.................................................8
Our partnerships.......................................................9
Local needs..............................................................10
Our strategic priorities............................................12
Our enablers............................................................22
Monitoring delivery................................................23
* Wording in italics throughout the document denotes direct references from the NHS Long Term Plan.
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Welcome to North West Boroughs Healthcare NHS Foundation Trust’s strategy for 2019-2022.
As a Trust which prides itself on doing things differently to achieve the best possible outcomes for our patients and service users, this strategy outlines our ambitions for the next three years.
We believe what sets us apart from other healthcare providers is our welcoming and supportive culture and our approach to building relationships and working in partnership.
Significant progress has been made since our strategic priorities were established in 2018. This updated strategy moves us towards achieving our ambitions, while taking into account the changing national and local environment within which we must operate.
In line with the recently published NHS Long Term Plan which sets out how the NHS will ensure it is fit for the future over the next 10 years, we will have a continued focus on partnership working, digitally enabled care, workforce, value for money and prevention to support us to deliver quality, safe and efficient services to support our communities to live their lives well.
Our start well, live well and age well principles mirror the national aims of giving everyone the best start in life; helping people live well with long term conditions, such as cancer and dementia; and helping people to age well.
We welcome the proposed national investment for mental health and community services. We will be looking at how we can use this locally and within the two Integrated Care Systems in which we operate to support service expansion and faster access to community and crisis mental health services for both adults and, particularly, children and young people.
The NHS Long Term Plan has a strong focus on out-of-hospital care and joining up primary care and community services which echoes our aspirations to improve community services closer to home to help reduce pressure on emergency hospital services.
Our established partnerships with other NHS providers, commissioners, local authorities, police and third sector organisations, alongside our proven success in collaborative working, puts us in a strong position to make the most of local investment opportunities when they become known and are available.
As a fast follower on the national Global Digital Exemplar programme, we have clear direction to help us realise the NHS Long Term Plan’s vision for digitally enabled care.
We look forward to working with our staff, governors, patients and their families to further improve the care we deliver, ultimately creating positive experiences for our services users.
Welcome
Simon Barber, Chief Executive
Helen Bellairs, Chairman
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In March 2018, our Trust Board agreed six strategic priorities for the following three years. These remain fit for purpose for 2019-2022. These are:
1. We will deliver quality, safe and efficient services with a highly skilled and motivated workforce.
2. We will deliver whole person care through targeted growth.
3. We will retain our values and culture. 4. We will engage with our communities and staff to deliver services differently.
5. We will play an active role in place-based care systems to maintain a whole person care focus and high clinical standards.
6. We will grow and develop the Trust at scale, being seen as an equal partner in any system-wide collaboration.
Following progress made during 2018/19, we have reviewed and updated the statements which sit alongside these priorities, detailing the progress we intend to make by 2022.
In creating our strategy, we have considered the aspirations in the NHS Long Term Plan, NHS England’s Five Year Forward View for Mental Health and NHS Improvement planning guidance and aligned our activities accordingly.
The NHS Long Term Plan highlights the importance of increasing digitally enabled care to improve access, outcomes and experience. We are increasing use of mobile technology within our services to enable self-care, reducing the number of face-to-face appointments, supporting people to stay well by managing their own health and allowing more people to stay at home.
The plan also sets out how the NHS will move to a new service model in which patients get more options, better support and joined up care.
We see partnership working as intrinsic to this, delivering services in a different way. This is about not only treating the illness or condition a person is experiencing, but considering everything about the individual which could impact on their mental or physical health and wellbeing.
Providing personalised care in this way includes social and environmental factors such as living arrangements, relationships, family and lifestyle as well as body and mind. It is also about discussing options and enabling people to make the right decision for them.
To enable consistent understanding of what we mean by whole person care, we are engaging with our staff, service users and partners to agree our definition of whole person care.
We welcome the NHS Long Term Plan commitment from NHS Improvement to support collaborative approaches across trusts. We actively work with partners across our footprint on a day-to-day basis to make sure mental and physical health services are delivered in a joined up way, leading to different ways of working through place-based service delivery, resulting in significant benefits for individuals and communities. Find out more in the ‘Our partnerships’ section.
We believe it’s not just what we do that is important; it’s the way we do things which sets us apart – our culture and our approach. For this reason, our culture and values are central to our organisation, supporting our skilled, experienced and motivated workforce to deliver quality, safe and efficient services.
Executive summary
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Who we are
North West Boroughs Healthcare NHS Foundation Trust delivers a range of health services across a population of more than 3.5 million people within Cheshire, Merseyside and Greater Manchester.
These include community-based physical health services, as well as mental health and learning disability services to support our local communities to live life well.
Our overall Trust purpose is:
To take a lead in improving the wellbeing of our communities in order to make a positive difference throughout people’s lives.
We actively participate in and contribute to the two largest Integrated Care Systems in the country – Cheshire and Merseyside Health and Care Partnership for services delivered across Halton, Knowsley, Sefton, St Helens and Warrington; and the devolved Greater Manchester Health and Social Care Partnership for services delivered in Wigan, Bolton and a small number of services delivered across Greater Manchester.
This complexity sets us apart from others and, while we recognise the importance of having ambitious aims for the future, we acknowledge there are challenges which extend beyond our organisation and are not wholly within our ability to overcome.
This will require effective working with partners from the health and social care system.
A specific challenge will be to capitalise on the investment in the NHS Long Term Plan and attract, develop and retain a workforce which is supported to deliver care in the best and most appropriate way.
We are working with both our Integrated Care Systems to make shared decisions on how to use resources, design services and improvement population health.
This partnership approach is bringing about shared accountability and responsibility for managing the population health needs in each area and will support the aims of the NHS Long Term Plan to support people to take more control over their own health and the care they receive.
In order to effectively address our different population needs, the majority of our services are delivered at a local or place-based level through borough management and clinical teams. Place-based is about working in an integrated way with our NHS, local authority and voluntary sector partners in each of our boroughs, rather than delivering services in an isolated or independent way.
This model enables us to respond to the specific challenges and opportunities within each place and work with partners to deliver effective and efficient whole person care.
We acknowledge the changing NHS and wider social care environment could impact the way we structure our organisation and how our services are managed and delivered in the future.
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Our positive culture is one of the things we believe sets us apart from other organisations and is something we are very proud of.
Feedback received from our staff tells us they feel welcome from day one, appreciate the visibility of senior leaders and value development opportunities, including access to personal coaches and mentors.
Embedding shared values and behaviours which represent what we stand for in everything we do increases staff engagement, improves outcomes and creates a positive experience for patients and service users.
Our values were developed in partnership with staff and provide the basis on which our organisation operates. Our Trust behaviours have been introduced to strengthen these values and represent how we want to interact with one another. Teams are now being encouraged to develop team charters outlining how they will embed and bring the behaviours to life within their own team.
Our culture is visible in everything we do. For example, our values are part of our recruitment process and feature at the heart of our staff induction programme. We want our staff to feel welcome from day one and have everything they need to do their job well.
Our annual performance development review process focuses on how objectives are achieved – behaviours – rather than just whether they have been achieved – results. This prompts supportive conversations between staff and line managers about the positive behaviours demonstrated or expected in achieving outcomes.
Our culture of care puts a clear focus on delivering high quality care for our patients, service users and carers. This is how we have chosen to implement NHS England’s 6Cs – care, compassion, commitment, courage, communication and competence – which we believe don’t just apply to our nursing staff, but to every member of staff.
The NHS Long Term Plan recognises national workforce challenges, stating that a Workforce Implementation Plan is due to be published in 2019 which aims to ensure a sustainable overall balance between supply and demand across our workforce. Our People Strategy and supporting plans over the three years will see our Trust being a consistently great place to work with a modern employment culture promoting flexibility, wellbeing and career development and a focus on addressing discrimination, violence, bullying and harassment.
Managing our workforce to recruit new talent, retain expertise and develop staff effectively will enable us to deliver our strategic priorities. As
such, we recognise the importance of supporting our 4,000 staff to learn new skills and become the best they can be.
Our coaching culture promotes individual responsibility and accountability, which, underpinned by the right staff support and development, leads to improved quality and safety of our services and a more motivated and engaged workforce.
Championed by our Chief Executive, our coaching culture is embedded throughout the organisation – from our Trust Board through to senior leaders and team leaders. In addition to a bespoke coaching development programme which continues to increase the number of staff supporting their teams in a coaching style, we also have plans to train coaching supervisors.
Throughout the lifetime of our strategy, we remain committed to maintaining our values, behaviours, culture of care and coaching culture.
Our culture
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We have a strong track record in the delivery of good quality services which will continue through our 2019-2022 strategy.
We are committed to the delivery of high quality care and support underpinned by well-established and effective quality and safety management and a culture of learning and improvement.
Our ambition is to be delivering core services which have a Care Quality Commission rating of ‘Good’ and to challenge ourselves to do even better.
Our Quality Strategy is built around six pillars:
• Quality Assurance Framework • A focus on happy teams • A focus on a positive patient experience • A focus on preventing harm • A focus on value added care • A focus on new models of care
We recognise the challenges and opportunities presented within the NHS Long Term Plan and the Five Year Forward View for Mental Health. With this in mind, our strategy aims to achieve a standardised approach to service delivery which will ensure our services – regardless of where they are accessed – are delivered in line with national best practice.
While acknowledging quality of care and patient outcomes are measurably better than a decade ago, through our quality strategy we aim to further progress on care quality outcomes by reducing variation and tackling unmet need.
Our strategy will support us to embrace a new service model in which patients get more options, better support, and properly joined up care at the right time in the optimal care setting.
Making use of technology to improve the quality of clinical care will see a new system – ‘My Supervision’ – introduced to monitor frequency and quality of clinical supervision. This will support our clinical staff in their personal and professional development and in reflecting on their practice, ultimately improving the quality of patient care.
Our strategy will support us to deliver the NHS Long Term Plan by ensuring we strengthen our contribution to prevention and health inequalities. This will be achieved through our targeted work plan.
Our focus on quality
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Our partnerships
In order to effectively deliver whole person care, we must first understand the different demographic and social challenges faced in each of the places we deliver services. Some of these are outlined on the following page.
Partnership working is vital in meeting these challenges and something we excel at, with an approach which sets us apart from other organisations.
Our geographic location spanning Cheshire, Merseyside and Greater Manchester and our active involvement in six place-based systems means we manage a greater complexity of relationships than most trusts.
Working within the Cheshire and Merseysideand Greater Manchester Integrated Care Systems, we are able to set aside our own organisational needs and compromise with partners in order to deliver most benefit at a place level. As such, we collaborate in a way which recognises the strengths and experiences of each partner and strongly believe we do not need to be the lead organisation in all our partnership ventures to make them a success.
This approach is successfully demonstrated through the Bolton Community Child and Adolescent Mental Health Service we deliver in partnership with lead provider Greater Manchester Mental Health NHS Foundation Trust.
Greater Manchester Mental Health has experience delivering specialist inpatient mental health services for children and young people in Bolton and the wider Greater Manchester area, while we have experience delivering community mental health services, including assessment and response, for children and young people across a large footprint.
Recognising each other’s strengths and being open to learning from each other has enabled us to successfully combine our expertise and experience to provide a much improved community mental health service for Bolton’s children, young people and their families.
We are also actively taking opportunities to share resources where appropriate and now formally share a joint Chief Information Officer and an Assistant Director of Employee Health and Wellbeing with Mersey Care NHS Foundation Trust. This enables sharing of expertise and experience as well as power and influence to develop, purchase and roll out larger scale improvements where there are common objectives. One example is the RiO electronic patient record system which has now been implemented across all teams within both trusts by one central team of experts.
In addition, we are exploring opportunities to strengthen our links with academic partners, which will be a focus for 2019-22.
Throughout the lifetime of our strategy, we will build on our successful track record of establishing partnerships with a range of organisations across the NHS, social care, not-for-profit and private sectors. Our approach to developing partnerships will continue to be based on adding value to our existing service offerings and ensuring we continue to deliver high quality, safe and efficient whole person care.
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Local needs
By 2021, there will be 1.2% more people aged 15-64, yet a 5% increase in the population aged 65 and over.
By 2021, there will be 0.6% more people aged 15-64, yet a 6.5% increase in the population aged 65 and over.
By 2021, there will be 1.4% fewer people aged 15-64, yet an 8.7% increase in the population aged 65 and over.
By 2021, there will be 1.2% fewer people aged 15-64, yet a 6.9% increase in the population aged 65 and over.
By 2021, there will be 1.6% fewer people aged 15-64, yet a 5.8% increase in the population aged 65 and over.
By 2021, there will be 0.1% fewer people aged 15-64, yet a 4.4% increase in the population aged 65 and over.
By 2021, there will be 0.3% more people aged 15-64, yet a 5.2% increase in the population aged 65 and over.
Greater Manchester
Halton
St Helens
Wigan
Knowsley
Sefton
Warrington
St Helens Wigan
Greater Manchester (including Wigan)
Warrington Halton
Knowsley
Sefton
* Source: 2011 Census population projections, Office for National Statistics, www.ons.gov.uk
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Our strategy is based on being an organisation which supports each individual and their physical, mental and wellbeing needs.
To realise our ambition of delivering whole person care, we take a dual approach. Where we deliver both mental and physical health services in an area, we are focusing on integrating these services. Where we only provide one of these, we are working in partnership with other providers across the area to make sure whole person care is achieved. This is improving pathways and developing strong relationships which put the individual and their needs at the centre of their care.
Our ambition to support the whole person is mirrored in the emerging place-based care systems, and Cheshire and Merseyside and Greater Manchester system-wide strategies.
In March 2018, following engagement across the organisation, and reflecting on the external environment in which we operate, we developed six strategic priorities. These priorities remain the same for the period 2019-2022, when we intend to build on the work already done.
During 2018/19, we have made significant progress against these priorities, including the following achievements:
• Retained our Care Quality Commission overall rating of ‘Good’ following our latest inspection in summer 2018.
• Established safety huddles within all our inpatient teams to support the delivery of safe services.
• 99 per cent of new starters have spent their first day on our new corporate induction programme.
• Identified where peer support workers with lived experience will add value to our services and developed role descriptions.
Our strategic priorities
GoodWe are rated by the Care Quality Commission as ‘good’
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Our strategic priorities for 2019-2022 are:
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We will deliver quality, safe and efficient services with a highly skilled and motivated workforce.
We will retain our values and culture.
We will engage with our communities and staff to deliver services differently.
We will deliver whole person care through targeted growth.
We will grow and develop the Trust at scale, being seen as an equal partner in any system-wide collaboration.
We will play an active role in place-based care systems to maintain a whole person care focus and high clinical standards.
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How it all fits together
For each of our strategic priorities, we have explained what success will look like by 2022...
What this means
By 2022, we will: • Have worked with health and care partners to redesign and standardise pathways to enable delivery of whole person, place-based care.
• Have maintained the rating of two we receive from our regulator NHS Improvement throughout the strategy lifetime in order to deliver the best possible care.
• Be delivering core services which are all rated as ‘Good’ by the Care Quality Commission.
• Be using the latest technology and equipment in order to support our staff to have rewarding jobs, delivering healthcare in complex and often stressful circumstances.
• Have further reduced the rate of suicide among our population.
It is essential we deliver safe, efficient and effective services to the communities we serve.
As the health and social care landscape continues to evolve, we must build partnerships which make best use of the assets – people, services, buildings – already available in each area in order to deliver better care.
We will ensure our estate is fit for purpose and provides a positive environment for service users, patients, carers and our staff. During the lifetime of this strategy, we will remain compliant with buildings and facilities regulations.
Delivering on our financial responsibilities to become more efficient and making better use of technology will support delivery of safe and quality services.
Reducing suicide will remain a priority.
Having the right staff, with the necessary knowledge and skills remains a challenge and we need to position ourselvesto attract and retain a skilled and motivated workforce.
1We will deliver quality, safe and efficient services with a highly skilled and motivated workforce.
What this means
By 2022, we will:
Our ambition is to deliver whole person care to all our patients, service users and families.
This is about not only treating the illness or condition a person is experiencing, but considering everything about the individual which could impact on their mental or physical health and wellbeing.
Providing personalised care in this way includes social and environmental factors such as living arrangements, relationships, family and lifestyle, as well as body and mind.
Targeted growth is about identifying and bidding for services which contribute to this approach and will help us deliver whole person care, either within our Trust or with through working with partners.
• Have proactively engaged with patients, carers and communities to understand and better meet their needs.
• Have standardised, integrated pathways for physical and mental health which are co-created with our patients, service users and carers and have evaluated them to measure improvements in patient experience and outcomes.
• Have a lead role in coordinating and supporting local third sector organisations in the provision of whole person care.
• Have designed, implemented and evaluated a development programme to equip our staff with the knowledge, understanding, skill and ability to deliver high quality whole person care.
2We will deliver whole person care through targeted growth.
What this means
By 2022, we will:
We have a firm commitment to the culture and values we have developed and recognise that each and every one of us counts.
We visibly live our Trust behaviours on a day-to-day basis.
Our values aim to ensure we recruit and retain the best staff and we create the best environment for our staff to be happy in their work, with the skills, motivation and focus to continue to deliver the best possible care.
A key priority throughout the lifetime of the strategy will be to ensure our workforce feels welcome and has a consistent experience, and that those we support are engaged in discussions and changes which will take place during the next three years.
• Have delivered leadership and management development programmes to support good, compassionate and diverse leadership at all levels.
• Have achieved a year-on-year reduction in instances of bullying and harassment and improved staff engagement and health and wellbeing, as measured by the NHS Staff Survey.
• Be playing an active role alongside partners to position the North West as a location of choice for working in health and social care services, attracting skilled and committed professionals.
3We will retain our values and culture.
What this means
By 2022, we will:
Delivering health and social care services in the same way they have always been delivered is not an option in the future.
As a result of our increased knowledge and understanding of healthcare, people are living longer and demand on services is growing. At the same time, resources available to deliver services have remained broadly static.
Health and care organisations must find new ways of working together to support effective and different delivery of new and existing services, moving to a culture of wellness from a culture of illness. This will involve new partnerships to deliver services differently.
There will be a role for our communities in developing and delivering preventative services and increasing effective self-care.
Our patients, service users and carers can play a vital role in helping us to deliver services differently and we will continue to talk to them through our Council of Governors, our service user involvement scheme and our service user and carer forums.
We recognise our staff have the knowledge and expertise to advise us on identifying and implementing ways to deliver services differently. We are therefore committed to a broad range of engagement opportunities to harness staff ideas. These will build on existing methods to capture staff views such as employee networks, Trust Board visits to teams, Ask Your Leaders Anything and Core Brief.
• Work differently to transform the systems in which we work, building partnerships with local organisations and communities.
• Have achieved widespread adoption of technology to improve access and experience for people with mental and physical health conditions, enabling them to take more control over their health and monitor improvements in their recovery.
• Have significantly increased the role of prevention and self-management within our services through partnerships with primary care and the third sector, with clarity around who is delivering which part of the service.
• Have increased roles and opportunities to harness the expertise of people with lived experience to help us deliver physical and mental health services differently.
4We will engage with our communities and staff to deliver services differently.
What this means
By 2022, we will:
Working at a place level in the communities we operate is important to make sure services reflect local need.
We remain committed to working with a wide range of stakeholders to ensure the physical and mental health services delivered by us and our partners are joined up and we make best use of resources available.
Place-based care systems continue to be developed, bringing together providers and commissioners to make decisionsabout what services are needed in each area and how they are delivered to best meet local need.
It is important all services we provide across all our locations are delivered to the same high standard.
• Be working in established place-based care systems which bring together providers, commissioners and other stakeholders to support the local population and reduce demand across the whole health and care system.
• Have co-developed a leadership structure in our place-based systems which enables us to play our part in the provision of joined up service delivery.
5We will play an active role in place-based care systems to maintain a whole person care focus and high clinical standards.
What this means
By 2022, we will:
We are an active partner in the Greater Manchester and Cheshire and Merseyside Integrated Care Systems, working with partners to deliver joined up physical and mental health care – whole person care.
We have developed positive working relationships and, where appropriate, we work together with NHS, social care, independent and voluntary sector organisations to deliver services.
At times, it makes sense to deliver highly specialised services at scale across a larger geography, either as an individual trust or with others. This ensures specialist services have a strong clinical model, delivered by highly skilled, specialist practitioners.
• Be recognised as a key contributor to the delivery of local population health solutions and have worked with our partners across both Integrated Care Systems to reduce duplication and make sure services are delivered in a consistent way, regardless of where they are accessed.
6We will grow and develop the Trust at scale, being seen as an equal partner in any system-wide collaboration.
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Our enablers
Our strategy does not stand alone. There are a number of focused enabling strategies which will support our future success as an organisation. Together, these will ensure we continue to deliver high quality care; attract and retain the right people, with the right skills; and are financially secure in the future.
Our Strategy
2019-2022
Estates Strategy
Quality Strategy
People Strategy
Digital Strategy
Financial Strategy
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Monitoring delivery
Alongside our three-year strategy, our annual operating plans set out our detailed objectives for each year to help us achieve our overall strategy by 2022.
Progression towards delivering our annual objectives and strategic priorities will be monitored through our internal governance system and will form part of our formal reporting structures.
Through regular review, our Trust Board and Council of Governors will ensure our strategy continues to meet the needs of our organisation and the communities we serve.
To find out more about North West Boroughs Healthcare NHS Foundation Trust, visit our website at: www.nwbh.nhs.uk
You can contact us in one of the following ways:
Email us: [email protected]
Call us: 01925 664 002
Write to us:
CommunicationsHollins Park HouseHollins LaneWinwickWarringtonWA2 8WA
Follow us on Twitter: @NWBoroughsNHS
Like us on Facebook: /NWBoroughsNHS
Supporting our communities to live life well