Ten Year Vision and Five Year Strategy

Transcription

1 Ten Year Vision and Five Year Strategy Mid Cheshire Hospitals NHS Foundation Trust, Leighton Hospital, Middlewich Road, Crewe CW1 4QJ

2 Purpose of this Document This document has been produced for Governors and Members of Mid Cheshire Hospitals NHS Foundation Trust (MCHFT), and states the ten year vision and five year strategic direction for the Trust, setting out its: - Organisational Vision, Mission and Values; - Strategic Principles; - Strategic Objectives; - Strategic Direction; - Strategic Plans; - Approvals and Implementation Plans; - Supporting Strategies. Stakeholders - Expected Outcomes and Key Questions Key Questions What will the services delivered by MCHFT look like in ten years time? What is the long term direction of the organisation? What is the organisational capability to match activities to both the environment in which it operates as well as its resource capability? What resource issues are expected? What stakeholder issues are expected? Outcomes - MCHFT will... Understand the national, regional and local context; Own the vision for the Trust (its role within the local community and the services it will provide); Understand the key local challenges and major changes required; Agree the strategic plan (route map for the remaining four years of the strategy); Agree the priority actions for 2012/13 and beyond; Recognise the pace of change required. The Strategic Planning Process The planning process for this strategy began in 2010 with the development of the Clinical Services Strategy (CSS). This was a bottom up approach, clinically led with engagement of wider stakeholders including Governors, Clinical Commissioning Groups and the Primary Care Trust (PCT). The CSS was approved by the Board of Directors in December The development of the overall Trust Strategy concluded in November This document therefore forms the basis of a long-term (ten year) vision and direction for the organisation from which the Trust will develop a five year strategy and work programme, with agreed timescales and accountable officers for its delivery and against which other supporting strategies will evolve. 2

3 Overview of the Document The process of developing this strategy has considered wider internal and external environments and the Trust s overarching organisational vision. Mission and values External Environment Commissioning Intentions Population Demographics / Expected Growth Political Interventions Developing technology Specialised services Local need to maintain District General Hospital Trust Strategy Strategic Objectives Divisional Clinical Services Clinical Service Strategy Internal Environment Acute Care Core Business Size of hospital Financial viability Infrastructure Estates issues Significant workforce redesign Services in Northwich Need for 7day hospital Blurring of roles between primary & secondary care services Patient and Public Involvement (PPI) Strategy Estates Strategy Quality, Safety & Improvement strategy Governance & Risk Financial strategy Workforce / Organisational Development Strategy Information Management and Technology Strategy Membership Strategy Annual Plan Nursing & Midwifery All supporting and enabling strategies and plans will also be developed / revised as necessary Key Principles of Strategy The Board of Directors, led by the Strategy Group, have agreed the following key principles that govern strategic decision making of the Trust: Partner Perspective Reciprocity; Mutual dependency; Control or greater influence ensured. Stakeholders The Trust will require the support of: Patients; GP; Staff; Governors and Members; Clinical Commissioning Groups; Local MPs; Monitor; Local Authorities and Healthwatch; Local business community; General public and wider community. Sustainability Ability to invest; Financial efficiency; Viability over the longer term, ie 10 years and beyond; Adaptability to changing demographic needs; Agility to political change; Delivery of a unique, distinctive competitive advantage; Ability to retain and attract workforce; Ability to retain as many services as possible locally; Ability to match patient flows; Is a core, central or agreed discretionary service; Enhances organisation reputation. Performance Fulfils compliance requirements; Improves clinical outcomes; Improves patient experience; Improves staff satisfaction. 3

4 Strategic Context - National, Regional and Local National Regional Local The health service is undergoing the most radical change in its history. Significant financial and service risk is evidenced in provider organisations. Demand for specialist services is increasing. Policy directives eg guidance in cancer, and other national directives are increasing. The Department of Health supports the introduction of fines and penalties associated with failure to deliver against nationally agreed targets and standards and not meeting minimum quality requirements. There is approximately 11bn of healthcare cost in the Northwest. Over the next 4 to 5 years there is a planned reduction of 3bn funding. Strategic Health Authorities (SHA) and Primary Care Trust (PCT) Clusters have key objectives to deliver large efficiency programmes. Evidence to date indicates that efficiency opportunities are not transformational enough and are still reliant on cost reductions. The local health economy has a budget of around 700m per annum. MCHFT has a contract value of 136m which equates to approximately 19% of this budget. Historic activity growth has been approximately 3.5% pa. Local demographics show increased health needs, and a growing population evidenced by All change for Crewe project. Clinical Commissioning Groups offer new opportunities for changing relationships and developing a joint strategy for the future. The fundamental principles of this relationship are: - New growth is unaffordable - Greater effort has to be made by all parties to understand true demand / population needs - MCHFT levels of cost reduction require a different and radical approach. Vision and Mission The Vision for Mid Cheshire Hospitals NHS Foundation Trust: To Deliver Excellence in Healthcare through Innovation and Collaboration The Mission of Mid Cheshire Hospitals NHS Foundation Trust To be a provider that: Delivers high quality, safe, cost-effective and sustainable healthcare services; Provides a working environment that is underpinned by values and behaviours; Is committed to patient-centred care; Treats staff and patients with dignity and respect. Our Values Commitment to quality and safety; Respect, dignity and compassion; Listening, learning and leading; Creating the best outcomes together; Every1Matters. 4 Our Behaviours I will act as a role model; I will take personal responsibility; I will have the courage to speak up and make my voice heard; I will value and appreciate the worth of others; I will play my part to the best of my ability.

5 Strategic Direction - Ten-Year Vision To achieve our Vision and Strategy we will: Focus on Acute Care (Planned and Emergency). Maintain independence to maximise local benefit. Develop collaborations and partnerships (where mutual benefits are identified). Develop MCHFT reputation and brand (building on stakeholder feedback and high-quality outcomes). This will be enabled through: Quality strategies that focus on a cycle of continuous improvement. Finance strategies that are underpinned by robust performance management tools. A workforce that is fit for purpose, supports the development of new skills and roles and is founded on employee engagement and health and wellbeing. Programme of Estate modernisation and Information Management and Technology (IM & T) infrastructure development. Commitment of a Patient Public Involvement strategy that engages and involves patients, Governors, Members and the wider public in the future of the Trust. Key Aims Progress with a programme of radical and transformational change through organisational development to retain a local, independent and sustainable District General Hospital. Maintain clear focus on core District General Hospital services - Emergency Department; - Acute Paediatrics; - Anaesthesia and Critical Care; - Maternity and Obstetrics; - Acute Medicine; - Diagnostic Imaging; - Emergency Surgery; - Biochemistry and Haematology. Build on a portfolio of elective services, focussing on centres of excellence such as colorectal and orthopaedic services, whilst developing others in meaningful partnerships that are mutually beneficial (eg, Vascular, Urology and Haematolgy services). Use technological advances in Information Technology (IT), medical and diagnostic equipment to improve communication, patient outcomes and patient experience. Prepare to disinvest in services which no longer align to the strategy and are better delivered by others. Deliver care in appropriate settings / locations, with partners where applicable, with Northwich remaining a strategic priority. Develop integrated high quality services connecting primary, secondary and social care. Evaluate all opportunities to expand into associated services, for example, intermediate care, out of hospital, specialist day care / virtual hospital using telemedicine / health park. Pictured (L-R): Elmhurst Intermediate Care Centre, Winsford; Treatment Centre at Leighton Hospital; Victoria Infirmary, Northwich 5

6 Key Targets 2015 Clinical Service Strategy delivering high quality, cost-effective services with benchmarked evidence of best quality nursing care, high patient satisfaction and high levels of staff engagement. Improved estates including neonatal unit and outpatients. Clinical workforce model implementation with extended consultant delivered services Fully integrated patient record between primary and secondary card. Consultants / GPs providing community / home based, non-elective care - including day hospital % of Outpatient services delivered in community settings. Strategic partnerships fully embedded. Disinvested in some non-core discretionary services Theatres rebuild programme on track. Cheshire Fire and Rescue phase one complete. Year Two Clinical Service Strategy delivered, including Midwifery / Consultant pathways implemented. Five day consultant ward rounds, Non-Elective programme. Benchmarked key performance indicators in line with other hospitals (eg, length of stay, mortality rates, readmissions). Full compliance with regulatory requirements Ward refurbishment programme on track. Extensive integration of technology and IT. Northwich Health Park. Specialist flag-ship service - orthopaedics, colorectal, obstetrics. Financial surplus to support investment needs. Patients preferred place of care with 90% market share in all specialties. Strategic Objectives The Trust s strategic objectives are the key mechanism through which the vision, values and behaviours are embedded throughout the organisation. These objectives are the touchstone that determine the choices made by the Board of Directors and align to the agreed strategic intent. Strategic Goals are aligned to each objective and delivered through agreed programmes of work and monitored by sub-committees of Board. Progress will be reported six-monthly and will be made available to Members and Governors. Emergency Preparedness (Major Incident Planning) Fit-for-Purpose Infrastructure Quality, Safety and Experience Board Assurance Framework Describes principal risks Monitors key controls Identifies gaps & control Assesses progress Workforce Development and Effectiveness Strong Progressive Foundation Trust Organisational Delivery 6

7 Five Year Strategy The Trust strategic plan is underpinned by its Annual Plan, Strategic Objectives and other supporting strategies. Supporting strategies are under review during the financial year of 2011 / 12, to ensure alignment to the Trust and Clinical Services Strategy requirements. Accountable executives for the delivery of the strategic goals are detailed within the Board Assurance Framework and within the Terms of Reference and work programme of each subcommittee of the Board. This work forms the continuous annual improvement cycle of the organisation. The strategy describes that, for a number of services, partnership and collaborative working will be the strategic direction. Further review of this positioning will be undertaken as the external and political environment becomes clear. The plans for 2011 to 2015 are based on the development of a five-year work programme for the organisation to include: - Review of all existing partnerships to the Trust including tertiary partners - Maximising opportunities for wider collaborative efficiencies - Developing new ways of working with local providers - Care provided in appropriate settings. Strategic Plan - Objective 1 Review All Current Partnership Arrangements (including tertiary partner) During 2011 to 2015, the Trust will map each of its existing key partnerships. A time-tabled programme of reviews will be developed. Each partnership will be assessed over the period of this five-year programme A standard template partnership assessment tool will be devised to include the following criteria: - It remains within the strategic fit of the organisation; - It is viable and provides a contribution to the Trust; - It offers high quality services; - It is sustainable with robust governance arrangements; - It adds value to MCHFT portfolio of services; - It widens the footprint of referrals. The Chief Executive Officer will establish an Executive task and finish group with our main tertiary provider to agree the principles of partnership, develop a synergy model and agree future projects with timelines, identifying those that are both clinically and financially viable. The Board of Directors will make future decisions regarding whether to invest, disinvest, or find alternatives to these partnerships subject to a business case. Strategic Plan - Objective 2 Maximise Opportunities For Wider Collaborative Efficiencies The Trust is undertaking a review of a number of collaborative opportunities to improve quality, reduce cost and improve efficiency. 7

8 For 2011 to 2015 these include: Pathology; Out of Hours Imaging; Occupational Health; Back office functions. Business cases for each of these services will be submitted to the Board of Directors (via appropriate Board committees) to determine for each collaboration whether it enhances patient experience, provides value for money, delivers cost reduction, and complies with Trust governance standards. Strategic Plan - Objective 3 Review Opportunities for Partnerships with Local Providers (primary and community) The development of NHS reforms provides opportunity to develop strong, mutually beneficial partnerships that will transform the delivery of local services provided. These developments will be clinically led and offer opportunities for new ways of working across organisations. For those services where integration is appropriate, closer ties will be developed with primary care, Community and Social Care as well as third sector providers, eg Voluntary Sector. Our Trust will be a key partner in assisting the transition to deliver better patient care. For 2011 to 2015 we will: Understand and establish a baseline for the development of a partnership model, developing principles and protocols for new ways of working; Undertake a synergy model with agreed projects / services and timelines; Develop a financial assessment model; Develop joint business cases; Agree implementation plans. Strategic Plan - Objective 4 Care Provided in Appropriate Settings The Trust has proactively managed services in the community for a number of years including: phlebotomy, anticoagulation, midwifery, paediatrics as well as some dermatology and ear, nose and throat (ENT) services. The Trust will review the provision of discretionary services and will develop a plan to widen delivery where appropriate which will also include expansion for easier access in Northwich. For 2011 to 2015 we will: Develop a collaborative approach which supports patients through integrated clinical pathways across traditional boundaries; Establish a baseline for the development of an out of hospital service model; Develop a financial assessment model which may result in a local tariff as an opportunity cost of increased market share; Review marketing plan of each Division and agree clinical engagement processes to integrate primary and secondary care clinicians as the key mechanism for increasing market share. Further Information Regular updates on the progress of the Vision and Strategy will be communicated to Members and Governors. Feedback from a Readers Panel evaluation of this document has been positive and comments have been taken on board. For further information on the contents of this document, or to request this document in an alternative format, please contact the Trust Secretary on