Our strategy 2018-2021 Supporting our communities to live life well
3 Contents Welcome...4 Executive summary...5 Who we are...6 - Our culture - Our focus on quality The environment in which we operate...9 - Local needs Our strategic priorities...12 Our enablers...22 Monitoring delivery...23
4 Welcome Simon Barber, Chief Executive Helen Bellairs, Chairman Welcome to North West Boroughs Healthcare NHS Foundation Trust s strategy for 2018-2021. This is a great time for our Trust. We have recently grown both the services we deliver and the footprint in which we deliver them. This has strengthened our ability to deliver whole person care, supporting an individual s mental wellbeing as well as physical health needs to help them live their life well. The NHS, and the environment in which we operate, is continuously evolving and changing, bringing with it new opportunities and challenges. In order to respond to these effectively, our Trust Board and Council of Governors have reaffirmed our strategic direction for the next three years which is outlined in this strategy. We are committed to ensuring community and mental health services are delivered in a joined up way. We have a strong focus on delivering quality, safe and effective person-centred care, while developing and enhancing relationships with a range of partners and the communities in which we deliver services. Our values continue to underpin all we do. We value people as individuals, promoting dignity and respect; value quality and strive for excellence; encourage and recognise feedback; promote an open, listening and learning culture; and deliver on our commitments to the communities and people we serve. We are open and inclusive and our strategic priorities have been developed through consultation and engagement across the organisation, including with our Council of Governors, Trust Board and senior leaders. Approved by our Trust Board in March 2018, our strategy reflects the changes, developments, challenges and opportunities within the health and social care systems in which we operate. It provides a foundation for detailed annual operating plans to be developed outlining the actions we will take each year to achieve our objectives. We believe a focus on localities will enhance future quality of care. During the lifetime of the strategy, we are committed to playing a full and active role in the developing place-based care systems across our patch, as well as working with Cheshire and Merseyside Health and Care Partnership and Greater Manchester Health and Social Care Partnership to bring about system stability and find new ways to manage the ever-increasing demand for services. We recognise staff are our biggest asset and are proud of the work our people do every day to make a positive difference to people s lives. We will work hard to maintain this dedication and passion and bring staff with us on our future journey.
5 Executive summary North West Boroughs Healthcare NHS Foundation Trust s strategy, approved by the Trust Board in March 2018, outlines six strategic priorities for the period 2018-2021. 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 systemwide collaboration. Alongside each of these priorities are statements detailing the progress we intend to make by 2021. Our Trust provides services to a population of more than 3.5 million people across Greater Manchester, Cheshire and Merseyside. The majority of our services are delivered at a local or place-based level through borough management and clinical teams. Our teams work to support the emerging integrated care systems in each of the boroughs we deliver services Halton, Knowsley, Sefton, St Helens, Warrington and Wigan. As well as providing local services, we also deliver a range of specialist services which are best delivered across a larger geography due to their specialist nature or the way they are commissioned. These include some of our services delivered in partnership with other NHS trusts across Cheshire, Merseyside and Greater Manchester. Throughout the lifetime of our strategy, we will be working with partners to deliver the aspirations contained within NHS England s Five Year Forward View for Mental Health. Although there is no equivalent national blueprint for the delivery of community physical health services, we are committed to the development and expansion of these services. Delivering mental and physical health services in an integrated way will see significant benefits for individuals and communities. The key principles of delivering whole person care, delivering high quality care and ensuring our workforce has the skills, experience and motivation to deliver great services will be key to our success.
6 Who we are Good We are rated by the Care Quality Commission as good 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. As part of this, we are committed to providing whole person care. Within England, 29 per cent of adults with a physical health condition also have a mental health condition; while 68 per cent of adults with a mental health condition also have a physical health condition. Traditional models of care delivery often mean services work separately and opportunities to integrate care are missed. During the last five years, we have increasingly become a provider of both physical and mental health care in the same localities. During that period, where possible, we have been working towards integrating community and mental health services to provide whole person care. We believe providing care which focuses on the person, not the condition, benefits not only the individual, but their family, staff, our organisation and the wider healthcare system.
7 Our culture We build and maintain a positive culture with values and behaviours which represent what we stand for. We know that embedding these shared values in everything we do will increase staff engagement, improve outcomes and create 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. Alongside our values, we also encourage behaviour which further embeds our culture. For example, our annual performance development review process focuses on how objectives are achieved rather than just whether they have been achieved. This prompts supportive conversations between staff and their line manager about the positive behaviours demonstrated or expected in achieving outcomes. We recognise the importance of supporting our 3,800+ staff to learn new skills and become the best they can be. We expect our leaders to engage in our organisational development programmes which embrace a coaching culture; and we recognise the important role leaders have in providing regular feedback and opportunities for growth so staff are energised and engaged. Our coaching culture supports our belief that a culture based on individual responsibility and accountability, 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. Since the start of our journey, approaching 600 people leaders from across our Trust have engaged in a bespoke coaching development programme. 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. With this in mind, our interviews for new staff include values-based interview questions which link to both our culture of care and our values. This helps us find out more about an individual to make sure we recruit people who align with our values from the outset. Throughout the lifetime of the strategy, we remain committed to maintaining our values, behaviours, culture of care and coaching culture.
8 Our focus on quality We have a strong track record in the delivery of good quality services which will continue through our 2018-2021 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 build on our overall 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 Our strategy aims to achieve a standardised approach to service delivery which will ensure, regardless of where they are accessed, our services are delivered in line with national best practice. We recognise the challenges and opportunities presented within NHS England s Five Year Forward View and the Five Year Forward View for Mental Health which provide a framework which will drive us to enhance services to ensure we can provide the right care, in the right place, at the right standard. Although there has not been a similar national framework published for community services, as a significant provider of community physical health services, we are committed to investing in and developing these services. This is part of our focus to support more people to remain well in the community and in their homes for longer.
9 The environment in which we operate We are part of two health and social care systems 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 and a small number of services delivered across Greater Manchester. Both systems face significant financial and demand challenges over the lifetime of our strategy. Each system is working at a local borough or placebased level to find new ways of managing the increasing demand and making the required efficiency savings. We are actively engaged across Cheshire and Merseyside and Greater Manchester at both system and borough levels to support the transformation required. During the lifetime of our strategy, we know there will be a significant workforce challenge to ensure we recruit, retain, develop and support our staff effectively to enable us to deliver our ambitious plans to improve and integrate the delivery of physical and mental healthcare. In order to effectively address our different population needs, we deliver services on a borough basis. This borough model will enable us to respond to the challenges and opportunities within each locality and work with partners to plan for effective and efficient whole person care delivery over the lifetime of the strategy. Across our boroughs, we have partnerships with NHS providers and commissioners, local authorities and third sector providers. In each of these boroughs, providers and commissioners are coming together as integrated care systems. Although this new way of working is at varying stages of maturity, good progress is being made to bring about shared accountability and responsibility for managing the population health needs in each locality. We acknowledge this changing environment could impact the way we structure our organisation and how our services are managed and delivered in the future.
10 Local needs In order to effectively deliver whole person care, we must first understand the different demographic and social challenges each of our boroughs faces. Some of these are outlined on the following pages. Partnership working will be vital in meeting these challenges. Throughout the lifetime of our strategy, we will seek to build on the work we have already started to establish partnerships with a range of organisations across both the NHS and social care, and also in the not-for-profit and private sectors. Our approach to partnership will be based on adding value to our service offerings and ensuring we continue to deliver high quality and efficient care. There is already a strong sense of collaboration across mental health provider trusts in Cheshire and Merseyside and Greater Manchester. This ranges from bringing together clinical expertise from each of the organisations to bid for and deliver new services, to taking forward opportunities for shared delivery of support functions to ensure increased efficiencies and resilience within the health and care system. It is anticipated that, over the lifetime of our strategy, collaboration opportunities will be accelerated both at a local place-based level through the emerging integrated care systems, and at a system Cheshire and Mersey and Greater Manchester level as a key enabler to system financial and clinical sustainability.
St Helens By 2021, there will be 1% fewer people aged 18-64, yet a 6.8% increase in the population aged 65 and over. Wigan By 2021, there will be 0.2% more people aged 18-64, yet a 6.2% increase in the population aged 65 and over. 11 Sefton By 2021, there will be 2.2% fewer people aged 18-64, yet a 5.7% increase in the population aged 65 and over. Sefton Wigan Greater Manchester Greater Manchester (including Wigan) By 2021, there will be 1% more people aged 18-64, yet a 6% increase in the population aged 65 and over. Knowsley By 2021, there will be 2.2% fewer people aged 18-64, yet a 7.5% increase in the population aged 65 and over. Knowsley St Helens Warrington Halton Halton By 2021, there will be 1.8% fewer people aged 18-64, yet a 9.6% increase in the population aged 65 and over. Warrington By 2021, there will be 0.7% more people aged 18-64, yet an 8% increase in the population aged 65 and over.
12 Our strategic priorities 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 will improve pathways and develop 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 being developed at borough level, and Cheshire and Merseyside and Greater Manchester systemwide strategies. Following engagement across the organisation, and reflecting on the external environment in which we operate, we have developed six strategic priorities for the next three years. These priorities reflect our aspirations over a threeyear period and will be underpinned by a more detailed annual operating plan which sets out the actions we will take during each year of the strategy to achieve our objectivies.
13 Our strategic priorities for 2018-2021 are: 1 We will deliver quality, safe and efficient services with a highly skilled and motivated workforce. 4 We will engage with our communities and staff to deliver services differently. 2 We will deliver whole person care through targeted growth. 5 We will play an active role in place-based care systems to maintain a whole person care focus and high clinical standards. 3 We will retain our values and culture. 6 We will grow and develop the Trust at scale, being seen as an equal partner in any system-wide collaboration.
14 How it all fits together focus and high clinical standards. maintain a whole person care We will grow and develop the Trust at place-based care systems to scale, being seen as an equal partner We will play an active role in in any system-wide collaboration. Commitment Our values Communication Delivering commitments We deliver on our strategy Listening and learning Care Trust purpose We will take a lead in improving the wellbeing of our communities in order to make a positive difference throughout people s lives Feedback and contribution Quality and excellence Compassion Dignity and respect We will deliver quality, safe and efficient services with a highly skilled and motivated workforce. Competence We will deliver whole person care through targeted growth. We will engage with our communities and staff to deliver services differently. Courage We will retain our values and culture.
15 For each of our strategic priorities, we have explained what success will look like by 2021...
16 1 We will deliver quality, safe and efficient services with a highly skilled and motivated workforce. What this means By 2021, we will: It is essential we deliver efficient and effective services to the communities we serve. Within the changing health and social care system it will become increasingly important for us to work in partnership with local authorities, acute hospitals, third sector partners and others to ensure our services reflect the needs of the local communities and services go beyond the traditional boundaries of care and support. Key to our future success will be ensuring we remain financially viable. This means we need to deliver on all our financial responsibilities and are as efficient as we can be in how we deliver and manage services. This could mean we deliver services in different ways in the future. We know a key challenge going forward will be making sure we have the right workforce with the right skills available. As well as ensuring we recruit the right workforce, it is essential we are able to retain our workforce. Through the redesign of pathways, deliver services which make a positive quality and financial contribution to the organisation, the localities in which we operate, and support whole person care delivery. Have maintained an NHS Improvement segmentation of at least two throughout the strategy lifetime in order to deliver the best possible care. Have maintained or improved our Care Quality Commission core services ratings of Good. Through digital technology, 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 achieved the aims of our Quality Strategy in order to deliver safe and effective services. Have achieved the aims of our People Strategy in order to support our workforce to deliver the best possible care.
17 2 We will deliver whole person care through targeted growth. What this means To achieve our ambition of whole person care being delivered in all the boroughs in which we operate, we will need to develop and win new services. It may not be possible or appropriate for us to deliver all services in all boroughs, so there will be occasions when we will work with partners through strong clinically-led pathways to achieve our ambition of whole person care delivery. By 2021, we will: Have developed integrated physical and mental health pathways, either as a sole provider or working in partnership, in each of our boroughs.
18 We will retain our values and culture. 3 What this means We have a firm commitment to the culture and values we have developed and embedded over the last five years. Our values aim to ensure we recruit and retain the best staff; create the best environment for our staff; and ensure our staff have the skills, motivation and focus to continue to deliver the best possible care and support we can. A key priority throughout the lifetime of the strategy will be to ensure our workforce and those we support are engaged in discussions and changes which will take place during the next three years. By 2021, we will: Deliver safe, effective and recovery-focused services which enable individuals to live their life well. Through effective engagement, have maintained staff motivation and brought staff with us on the journey of change. Be seen as an employer of choice.
19 4 We will engage with our communities and staff to deliver services differently. What this means Delivery of health and social care services in the same way they have always been delivered is not an option in the future. People are living longer and demand on services is growing. At the same time, resources available to deliver services remain broadly static. It will be essential for health and care organisations to find new ways of working together to support effective and different delivery of new and existing services. This could involve new partnerships to deliver services differently. We will need to engage with and educate the communities and people we serve to develop and deliver preventative services and support more effective self-care. By 2021, we will: Through our clinical transformation programmes, be delivering, where appropriate, core pathways in partnership with local communities and through a range of organisations. Have significantly increased the role of prevention within our service offers. Have expanded the focus on supported self-management in an individual s journey. Have significantly increased the number of people employed in peer support worker roles in our organisation.
20 5 We 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 2021, we will: Working at a borough level in the communities we operate is really important to make sure services reflect local need. We are committed to working with a wide range of stakeholders to make sure physical and mental health services delivered by us and our partners are joined up and there is the best use of resources available. In each borough, place-based care systems are being developed which bring together providers and commissioners to make decisions about what services are needed in each area and how they are delivered to best meet local need. Although we are delivering services across different local areas and in different communities, we want to make sure the services we provide are delivered to the same high standard. To do this, our clinical networks will continue to focus on start well, live well and age well, ensuring consistently high standards wherever services are accessed. Be playing a full and active part in the place-based systems in the boroughs in which we operate. Through our clinical networks, have ensured consistently high clinical standards across our boroughs.
21 6 We will grow and develop the Trust at scale, being seen as an equal partner in any system-wide collaboration. What this means By 2021, we will: Since 2016, the three mental health and community trusts in Cheshire and Merseyside (us, Mersey Care NHS Foundation Trust and Cheshire and Wirral Partnership NHS Foundation Trust) have been working together to bid for and deliver new services in partnership. Similarly, we have been working with Pennine Care NHS Foundation Trust and Greater Manchester Mental Health NHS Foundation Trust to seek opportunities to deliver services jointly at scale across Greater Manchester. Sometimes, delivering services across a larger geography as an individual trust or with other trusts makes sense due to the specialist nature of services. Working in this way helps to make sure specialist services are available with a strong clinical model and the right specialist practitioners. We will continue working together to reduce duplication and have a standardised approach to service provision, ensuring, regardless of where services are accessed, there is a consistency in their delivery. Be an active partner in Greater Manchester and Cheshire and Merseyside care systems, working with partners to deliver integrated physical and mental health care.
22 Our enablers Quality Strategy 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. Financial Strategy Our Strategy 2018-2021 People Strategy Digital Strategy Estates Strategy
23 Monitoring delivery Alongside our strategy, we will develop annual operating plans setting out our detailed objectives for each year to help us achieve our overall strategy by 2021. Progression towards delivering our annual objectives 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: communications@nwbh.nhs.uk Call us: 01925 664 002 Write to us: Communications Hollins Park House Hollins Lane Winwick Warrington WA2 8WA Follow us on Twitter: @NWBoroughsNHS Like us on Facebook: /NWBoroughsNHS Supporting our communities to live life well