Corporate Objectives 2015/16 Delivery Plan and Monitoring

St George’s Healthcare NHS Trust: the next decade

ST GEORGE’S HEALTHCARE NHS TRUST:THE NEXT DECADE

This document sets out the proposed corporate priorities (in line with the discussions at the Board Strategy Seminar in February 2015), and key actions and milestones that the Trust will take to ensure these are delivered.

The priorities identified by the Board for 2015-16 are:•The strategic plan•Additional capacity•Quality•Financial viability•Workforce and leadership•Research

These are the priority objectives that the Board will oversee delivery of, with quarterly reporting of progress. There are further objectives that need to be delivered in 2015-16, that will be monitored by the relevant Board Sub-Committees, in line with the governance arrangements detailed on the following slide (previously presented to the Board in February 2015).

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Delivery of our 15/16 Annual Plan and Objectives

We will use a number of different mechanisms to ensure that we are able to track progress against the annual objectives. These are:

• Reporting to the Trust Board quarterly on the corporate priorities for 2015-16

• The monthly scorecard for the Trust Board to monitor delivery against quality, finance, workforce and operational targets

• Detailed review of key plans through the relevant Board sub -committees/ EMT:

• Quality and Risk Management: QRC• Workforce and Education: Workforce

Committee• IT: EMT• Estates: EMT• Business Development: Commercial Board • Research: Research Committee • Communications: Trust Board

• Quarterly reviews with the clinical divisions• Clinical Divisions monitoring their own plans at Division and Directorate

levels via DMB and DGB

Governance: Reviewing progress

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Redesign care pathways to keep more people out of hospital 1

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Objective Actions Lead

Q1 Q2 Q3 Q4

Implement the new model of care in community adult health services (CAHS)

Fully operationalise CAHS Post mobilisation evaluationIdentify quality and performance indicators to measure impact of change and monitor service delivery

Director pf Delivery and Improvement/ Divisional Chair CS Division

Complete the redesign of services for frail older people

Continue to work jointly on Frailty Model across both Divisions and link to overall Discharge Improvement programme work. Handover St George’s @ beds (Nightingale) to MC Division.

Work jointly with commissioners via the SRG to identify required frailty provision for local populationIdentify and implement HARI model and OP clinics at the Nelson. Link CAHS into Frailty Model at both prevention of admission and supporting discharge to NHS or social care route

Develop pathway as required

Director pf Delivery and Improvement/ Divisional Chair MC Division

Bid to provide Community Services to the residents of Merton

Submit PQQ Submit ITT if successful at PQQ stage

If identified as preferred provider for services, begin delivery of mobilisation plan

Director of Strategy/ Divisional Chair CS Division

Redesign care pathways to keep more people out of hospital 2

5

Objective Actions Lead

Q1 Q2 Q3 Q4

Support the delivery of the Wandsworth joint health and well being strategy

TBC TBC TBC TBC Director of Strategy/ Divisional Chair CS Division

Develop and implement new models of care and further develop the St. George’s network as per 5YFV

TBC TBC TBC TBC Director of Strategy/ Director of Delivery & Improvement/ Divisional Chair CS Division

Redesign and reconfigure our local hospital services to provide higher quality care 1

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Objective Actions Lead

Q1 Q2 Q3 Q4

Delivering additional capacity in line with clinical need

Nightingale 2nd Floor 20 beds

Cardiology 7 bedsHybrid theatre

SAU 8 bedsCDU3 9 bedsNeurosciences (Thomas Young) 16 bedsNeurosciences (neruo gym) 7 bedsNICU 4 bedsCICU 3 beds

Director of Estates & Facilities/ Director of Delivery and Improvement

Women and Children’s Hospital

Complete enabling work/ actions for the 5th Floor redevelopment

Commence work on the 5th Floor redevelopment

Develop the strategy further with stakeholders

Board approval of OBC for Women and Children’s project

Director of Strategy

Private Patients Unit

Preferred bidder letter signed

Board approval of business case

Finalise service level agreement with HCA

Commence building work

Director of Finance, Performance and Informatics

Renal OBC approved by Trust Board

FBC approved by Trust Board

Enabling works completed Commence PPU building work

Director of Strategy / Director of Finance, Performance & Informatics

Redesign and reconfigure our local hospital services to provide higher quality care 2

7

Objective Actions Lead

Q1 Q2 Q3 Q4

Implement all Merton CCG requirements at the Nelson Health Centre

Begin service delivery and negotiate additional service developments to be included at the site; set up redesign groups; implement cardiology redesign

Scope out and agree redesign for respiratory, gastroenterology and ophthalmology services

Implement phase 1 changes; identify additional redesign areas for year 2

Implement final year 1 redesign changes

Director of Delivery and Improvement/ Director of Strategy/ Divisional Chair CS Division

Continue to work closely with the SW London Collaborative Commissioning Programme and take a leadership role in the Acute Provider and Out of Hospital projects

Delivery of the Acute Providers proposal for future provision of acute services to the SWLCC Board

Trust Board to approve the outcomes of the proposal

Communication with key stakeholders

Plan for implementation

Implementation CEO/ Director of Strategy

Consolidate and expand our key specialist services

8

Objective Actions Lead

Q1 Q2 Q3 Q4

Cardiology expansion TBC TBC TBC TBC Director of Strategy / Divisional Chair MC Division

Deliver redesigned cancer services in partnership with MacMillan

Programme Board to agree the priorities for delivery in 2015-16 from long-list

TBC TBC TBC Director of Strategy / Medical Director

Neurosciences Expansion Additional physical capacity delivered

Professor of Neurology in post

Appointment of senior lecturer in neurosurgery Deliver activity target – TBC by Sean Briggs

Director of Delivery and Improvement/ Divisional Chair STNC Division

Develop and implement a rehabilitation strategy

Establish a 6 bedded spinal rehabilitation service in partnership with the Royal National Orthopaedic Hospital, Stanmore

Establish Divisional Rehabilitation Strategy Group

Cohort existing spinal beds together as pilot

Evaluation of pilot spinal unit and report to commissioners

Decision by commissioners re. support for 6 bedded unit

Director of Delivery and Improvement/ Director of Strategy

Provide excellent and innovative education to improve patient safety, experience and outcomes

9

Objective Actions Lead

Q1 Q2 Q3 Q4

Implement the Trust components of the joint education strategy with SGUL once approved

Joint education strategy to be approved

TBC in line with joint strategy

TBC TBC Director of HR and OD/ Medical Director

Further develop the commercial education workstream

TBC TBC TBC TBC Director of HR and OD/ Medical Director

Drive research and innovation through our clinical services

10

Objective Actions Lead

Q1 Q2 Q3 Q4

Continue to increase the number of patients recruited into NIHR studies

TBC TBC TBC TBC Medical Director

Ensure the Trust is in a position to make a successful bid for NIHR Clinical Research Facility funding

Establish Steering Group

Steering Group to approve action plan

Implementation of action plan

Medical Director

Increase collaborations between SGUL Institutes and Trust clinical directorates through the development of further CAGs:CardiologyNeurosciences

Establish steering group to oversee operational delivery of Cardiology CAG

CAG Chief of Cardiology appointed

Cardiology CAG fully operationalNeurosciences CAG established

Director of Strategy

Increase underlying recruitment trends on NIHR commercial recruitment from 2014/15 recruitment year by 5%

TBC TBC TBC TBC Medical Director

Develop additional commercial income streams

NIPT testing for Down’s Syndrome in place

Commercial strategy approved

Director of Strategy

Improve productivity, the environment and systems to enable excellent care 1

11

Objective Actions Lead

Q1 Q2 Q3 Q4

Implement electronic document management and electronic referral system for all new out-patient registrations at St. George’s

Complete recruitment to in house scanning bureau

All newly registered outpatient records scanned for St. George's campus activityAll GP referrals triaged electronicallyChoose and book referrals incorporated in the electronic triage system

Tertiary referrals incorporated into the electronic triage system

Director of Finance, Performance and Informatics

Complete the deployment of electronic prescribing, drug administration and clinical documentation to inpatients, theatres and the emergency department on the St. George’s Hospital site

Complete exit from the BT contract for Cerner services

Identify, agree and enable approach to delivery of new maternity reporting requirements

Medical Device integrationRiO Mobile working deployed in Battersea

Completion of nursing whiteboards deployment

Complete electronic clinical documentation, e-prescribing and drug administration to wards, theatres, and emergency department on St. George's campus

Cerner Code upgrade live

Director of Finance, Performance and Informatics

Improve productivity, the environment and systems to enable excellent care 2

12

Objective Actions Lead

Q1 Q2 Q3 Q4

Develop and implement an Outpatient Strategy

Establish OP Strategy Board

Agree the optimal service model including delivery of OP flow and process

Agree model of care and 5 year strategy

Director of Strategy / Divisional Chair CWDTCC Division

Ensure each Division has a prioritised programme of local and national clinical audit activity which is registered with the Clinical Audit Team

TBC TBC TBC TBC Chief Nurse(QIP)

Introduction of a new dementia and delirium team and dementia leads

TBC TBC TBC TBC Chief Nurse(QIP)

Provide transparency on outcomes by publishing consultant level activity data, clinical quality measures and survival rates from all nationally agreed audits

TBC TBC TBC TBC Medical Director (QIP)

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Objective Actions Lead

Q1 Q2 Q3 Q4

Roll out the Friends and Family Test to day surgery, outpatients and community services

Successful roll out to OP and Day Surgery. Reports to PEC, EMT and Board

Roll out to community services

All areas are compliant with FFT rollout and reports updated to every QRC and PEC

Chief Nurse(QIP)

Prevent deterioration through a focus on acting quickly for patients who have sepsis

Resuscitation data to identify areas where cardiac: peri arrest rate highAudit of NEWS in electronic notesLink with the ITU outreach team to identify teams requiring additional supportHarm free training includes SBAR escalation and handovers

Circulation of SBAR pads in clinical areasFeedback of NEWS audit results

Chief Nurse (QIP)

Introduction of a medication safety thermometer

Finalise work with pilot areasFacilitation with each clinical team to identify the most significant harms in their areasHarm Free trainingDevelop monthly feedback to ward areas in a user friendly and consistent format.

Roll out within one Division.Pilot feedback mechanisms with clinical teams. Provide patient information through video and written comms.

Roll out across remaining Divisions Develop monthly feedback to ward areas in a user friendly and consistent format.

Evaluate harm reduction and further actions needed

Chief Nurse (QIP)

Improve productivity, the environment and systems to enable excellent care 3

Develop a highly skilled and engaged workforce championing our values 1

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Objective Actions Lead

Q1 Q2 Q3 Q4

Implement an organisational development programme that supports the Divisional governance review findings

Work with divisions to identify effective team working and where there is a need for team support.

Identify a coherent programme of team support that can be delivered by workforce and development department , including LiAise manager, staff support unit, HRMs and leadership development team.

Where required identify and commission external programmes of support.

Evaluation of programme

Director of HR and OD/ Director of Corporate Affairs

Develop leadership behaviours to deliver high quality

Establish an agreed St George’s leadership styleDevelop timescale, scope and cost of programme

Secure process for accreditation and assessmentAgree content of programmeCommence tender for programme provider

Establish programme of delivery

Evaluate programme delivered to date

Director of HR and OD

Developing a flexible workforce who can work across boundaries

TBC TBC TBC TBC Director of HR and OD

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Objective Actions Lead

Q1 Q2 Q3 Q4

Ensure the right number of skilled members of staff are available to provide the best possible quality of care

Ensure implementation of care certificate for all new HCAs

Review the opportunity to set up a learning zone facility and identify any actions required

Review preceptor programmeReview induction programmeReview current activity and develop a learning and development plan based on contribution from professional leaders, annual business plans, and needs assessment drawn from appraisals.

Director of HR and OD

Develop a highly skilled and engaged workforce championing our values 2

Securing financial viability

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Objective Actions Lead

Q1 Q2 Q3 Q4

Ensure that tariff payments agreed with commissioners optimise income to the organisation

Director of Finance, Performance and Informatics

Delivery of the CIP programme Director of Finance, Performance and Informatics

Complete review of the existing IBP and LTFM. Implementation of the recommendations will be overseen by the Service Review Board

CEO

Refresh the current Trust strategy to determine whether the strategy remains appropriate in the current external environment; and/or whether the objectives to deliver the strategy remain appropriate

Director of Strategy