Agenda item

-        Martin Havenhand, Trust Chair, to present

The Chairman welcomed Martin Havenhand (Trust Chair), Tracey McErlain-Burns (Chief Nurse), Jan Bergman (Director of Transformation/Deputy CEO) and Kerry Tate Maskill (Communications Officer) to the meeting who were present to give an update on the Operational Plan 2014-16.

 

The following presentation was given on the 2 Year Operational Plan:-

 

Vision

-          To ensure patients are at the heart of what we do, providing excellent clinical outcomes and a safe and first class experience

 

Mission

-          To improve the Health and Wellbeing of the population we serve, building a healthier future together

 

Values

-          Safe, Compassion, Together, Right First Time, Responsible and Respect will underpin the way we work and define the culture we wish to build within the organisation

 

Strategic Objectives

-          Develop high quality and safe services that effectively met the changing healthcare needs of the population it served

-          Achieve clinical and financial sustainability

-          Work with partners across the local health economy to ensure sustainability of wider healthcare provision

-          Ensure that it had the leadership capability and capacity to deliver the strategy and services

-          Ensure that its governance arrangements were fit for purpose and help shape the behaviours that would achieve the strategy

-          Meet its regulatory requirements

-          Develop and maintain an appropriately skilled and engaged workforce to meet service needs now and in the future

-          Develop a culture based on their values and behaviours

 

Trust Key Priorities

Strategy

-          Develop 5 Year Strategic Plan

-          Transformation Programme Action Plan

-          Board Development Programme

Structure

-          Appointment of CEO and Executive Team

-          Clinical Management Re-structuring

-          Board Committee Structure

-          Assurance Framework

-          Risk Management

People

-          Staff Communication and Engagement

-          People Performance Management

-          Performance Management Framework

-          Stakeholder Engagement Plan

-          Governor Engagement

 

Operational Objectives

-          To provide quality and safe health services

-          To address the underlying financial deficit

-          To successfully implement a £22M Cost Improvement Programme

-          To produce and implement Clinical Strategies which:

Identify those services that sustain a stand-alone Trust

Identify those services for increased collaboration

Identify those services to be provided by other providers

-          Deliver a Board Development programme

-          Establish the Executive Team

-          Implement Clinical Re-structuring

-          Embed and sustain new Board and Committee structures

-          Introduce and embed the Board Assurance Framework and Risk Management Strategy

-          Develop a staff communication and engagement process

-          Introduce the Trust Performance Management Corporate Report and monitor performance throughout the plan period

-          Undertake performance appraisal for all staff by Q1

-          Develop stakeholder engagement plans

-          Agree a forward work plan with Governors

 

Quality Objectives

Safe

-          Mortality

-          Harm Free Care

Reliable

-          Waiting Times

Caring

-          Friends and Family Test

All Domains

-          Nationally and locally mandated quality requirements

CQUIN

-          9 focus areas

 

Organisational Risk

-          Quality of Care

-          Commissioning and Competition

-          Operational Delivery

-          Cost Improvement Programme

-          Workforce

 

Operational Challenges

-          Unscheduled Care – in particular ageing population and increase in frail elderly demand for care

-          Managing Long Term Conditions in non-acute settings

-          Clinical Referrals Managements – delivering outpatient efficiencies

-          Service Transformation

-          Delivering 7 Day Working

-          Commissioning Intentions

-          Better Care Fund

-          Any Qualified Provider

-          Co-operation and Competition

-          Collaboration and Integration

-          Service Specification Development

-          Clinical Service Sustainability

-          Recruitment of Registered Nurses

-          Development of motivated, engaged workforce

 

Conclusion

-          Delivery of financial and operational plans was critical to ensure sustainability

-          Engaging the workforce at all levels would be critical to delivery

-          Effective leadership and ownership was required to challenge progress and performance

-          Clinical Strategies would drive changes to deliver improved pathways for patients and subsequently improve efficiency

-          Ongoing engagement with other local providers to explore opportunities for collaboration and partnership working was vital

 

Discussion ensued with the following further information provided to Members:-

 

-          The breaches put in place by Monitor were not likely to be lifted until April, 2015

 

-          5 year Strategic Plan to be submitted by 30^th June, 2014

 

-          Consultation would take place on the 8 strategic objectives over the coming months as required by Monitor

 

-          The Board had recently identified the key priorities that were “must dos” in order to provide the quality of care and services the public of Rotherham would want to be provided and to ensure the Trust functioned efficiently and effectively as a good quality organisation

 

-          Throughout the recent difficult times, standards had been maintained in the quality of care in hospital and community which the staff and clinicians should be congratulated for

 

-          The 14 operational objectives were distilled from the 8 strategic objectives

 

-          Aim to communicate clearly and effectively with everyone who worked for the Trust so all were accountable for the delivery of the strategic objectives, therefore, all staff would have had a face-to-face appraisal by 30th June, 2014.  Appraisals had been conducted in the past but had not been diligently implemented and were not about performance or connected with a follow through down from the organisation’s strategic objectives.  It was important that all staff understood their role in delivering the objectives

 

-          The restructuring was almost complete with 4 Directors delivering the standard of care across the Trust

 

-          The Trust’s 2014/15 Quality Accounts would feature the 4 Quality Objectives – Safe, Reliable, Caring and All Domains.  It also wished to focus on standards for patients with Learning Disabilities so LD CQUIN would also be included

 

-          2 new posts had been created in the Executive Team – Chief Operating Officer and Director of Workforce and Transformation.  There was now a Workforce Committee within the Committee Structure.  The Group leading on Employee Relations within the Trust had been reviewed with a view to a member of staff taking on the role of Chair rather than a Senior Manager.  It was also suggested that consideration be given to a Trade Union representative sitting on the Workforce Committee

 

-          The 5 year plan would be based on reviewing the specialities within the Trust, looking at best practice, working with partners and ensuring it was fit for purpose

 

-          The Trust had to remove £22M from its budget over the next 2 years - £10.9M in year 1 and £10.8M in year 2.  It was the intention and plan to make a surplus of £0.7M in 2014/15 with a further £2.2M in 2015/16

 

-          It was key for the Trust to get out of the Monitor Special Measures and focus on issues that a Trust should focus on i.e. quality of patient care

 

-          The plan predicted a 5% Cost Improvement Programme – ambitious as most Trusts predicted 3.5% - which meant it had to save £10.9M this financial year.  The Trust planned to achieve £12.4M.  The Transformation Programme established 3 months ago was well under way and to date had achieved £8.44M savings

 

-          For the first time the Board had built in reserves – 1% contingency – plus £1.5M for Invest to Save

 

-          The last 4 months had seen an improving financial position – at the beginning of the financial year there had been a £4.6M forecast overspend but that had recovered and was now likely to be £3.2M

 

-          The 2 year plan addressed the key strategic and operational challenges and would also sit within the 5 year plan.  They had been derived from the issues the Trust needed to monitor and ensure were being satisfied throughout the process

 

-          A score card was produced for submission to the Board on a monthly basis and would be included on the website this would reference the operational challenges

 

-          The hospital faced real challenges and the citizens and Members of Rotherham wanted to see it work and have good quality health care in the town

 

-          Disappointment was expressed that reports from the Deloitte and PwC reviews had not been shared with the Select Commission previously.  It was noted that the EMR report had raised the issue of the organisational culture with staff being afraid of voicing concerns.  Those issues were being put right as the Transformation Programme moved forward.  There would always be some that said they were not fully informed but there would be a supportive approach.  The Trust would only succeed if it engaged with colleagues and supported them and there was a Board development programme including how they would engage and do things differently.

 

-          Examples of the new culture of working included the Chief Executive having worked over the weekend to understand and experience the new initiative being implemented following the review of Emergency Care and see what it was like to work in that Department.  Other members of the Executive Team regularly worked on the Wards at night to gain night staff experience.  Staff had fedback that they did not appreciate the use of agency staff and had recommended that they be encouraged to join the Nursing Bank and work within the Trust.  Within 3 days of receipt of that recommendation the Executive Team had listened and it had been announced that it would be implemented

 

-          Patient pathways were the key to transformation and there would be reports by late summer.  Many of the £8.44m savings had come from staff ideas rather than from the leadership team

 

-          Would be helpful for the Select Commission to receive performance outcomes against the plan

 

-          The cuts would mainly be against efficiencies and contract expenditure.  The length of stay for patients within the Trust was average - within Surgery it was good but within Medicine not so good with patients staying 1 day longer than average.  Working with Social Services would improve the situation.  Each of the 15 workstreams were led by an Executive Lead or a Senior Manager and have a support team

 

Martin, Jan, Tracey and Kerry were thanked for their attendance.

 

Resolved:-  That a special meeting be held on 25^th June, 2014, commencing at 9.30 a.m. to consider the Trust’s five year plan.