Corporate Objectives 2014/15 2015/16 1. Quality - excel in the delivery of clinical care, safety and patient experience. Objective and key deliverables Timescale Lead director Group reporting into Key Performance Indicator 1.1 Reduce mortality Reduce mortality as reported by HSMR by 5 each year Establish and run the breakthrough collaborative on care of the deteriorating patient Nurse Quality Reduced HSMR by 5 each year. Ensure consistency of fluid management protocols April 2014 onwards Nurse Quality Monthly performance improving on 2013 baseline. Review every death at SDU level September 2014 Medical Director Quality Monthly performance at 100% by Sept 2014 1.2 Reduce harm Reduce harm by ensuring at least 98% of all patient cared for by the Trust receive harm free care as measured by the safety thermometer Roll out falls management pathway June 2014 April 2015 Nurse Quality Roll out pathway. Harm from falls below national average. Regular audit of care bundle pathways e.g Sepsis April 2015 Nurse Quality 95% compliance with all bundles. 1
Develop Medication Safety Steering Group to reduce harm from medication errors June 2014 Medical Director Quality Reduction in harm from 2013 baseline. 1.3 Great patient experience Offer a great patient experience as measured by having a net promoter score of 95 for Friends and Family Test in all areas Implement You said, we did April 2015 Nurse Quality IFFT net promoter score to improve to 95 from baseline of 76. Implement What matters most to me March 2014 April 2015 Nurse Quality Programme starts Improvement in patient survey results in respect of recommendation scores. Deliver Warm Welcome training for frontline staff Nurse Quality Reduction in staff attitude PALs concerns and formal complaints. Deliver published patient centred equality objectives Nurse Diversity Steering Group/Quality Improved patient rating when EDS assessment undertaken. 2
2. People employ, engage, develop and retain the highest calibre dedicated people who are proud to work for Buckinghamshire Healthcare. Objective and key deliverables Timescale Lead director Group reporting into Key Performance Indicator 2.1 Well led and actively engaged staff Ensure our staff are well led and actively engaged in building a strong and sustainable BHT Implement communication and engagement plan June 2014 HR Review our Executive visibility activity and initiatives June 2014 HR Workforce & HR TMC Increase in overall staff engagement score in staff survey. Increase in overall staff engagement score in staff survey. 3
Provide leadership and management development opportunities for all line managers, including medical clinical managers; focussing on core management capabilities and coaching skills HR Workforce & HR Increase in the number of clinical managers on training courses. Increase in overall staff engagement score in staff survey. All staff to have a meaningful two-way discussion through the annual staff appraisal process June 2014 HR Workforce & HR Improvement in appraisal and staff sickness rates. Deliver our staff led equality objectives Strategy Workforce & HR Increase in the number of BME staff band 7 and above. 2.2 Recruit an appropriately skilled, permanent workforce Recruit an appropriately-skilled, permanent workforce Recruit and retain high quality registered qualified nurses and health care assistants up to our optimum staffing levels in all areas of the Trust HR Workforce & HR Registered nurse vacancies below 5% and HCA vacancies below 7% by December 2014. Reduced turnover in these staff groups. Recruit to our full establishment of A&E medical staff HR Emergency Medicine Steering Group 100% recruitment of current vacancies. 4
2.3 Focus on training & development Ensure our workforce are well trained and developed to enable them to deliver safe and compassionate care every time, and upskill clinical leaders to provide effective leadership. Ensure current research is incorporated in the development of all training programmes. HR Workforce & HR Training is evidence based and meets National Standards. Provide preceptorship for all newly qualified band 5 staff. HR Nursing and Midwifery Preceptorship available to all newly qualified Band 5 staff, with 99% pass rates. 5
3. Optimised integration - ensure our full range of services, from community to highly specialised services, are integrated and sustainable Objective and key deliverables Times cale Lead director Group reporting into Key Performance Indicator 3.1 High quality, accessible urgent care 24/7 Develop our urgent care services to ensure access to high quality care 7 days a week 24 hours a day Deliver our reforming urgent care programme incorporating the recommendations of the 2 nd ECIST review focussing on the development of agreed priorities towards 24/7 services including working with partners to improve discharge processes. August 2016 operating Reforming Urgent Care Weekend HSMR Delivery of the 4 hours A&E target Reduction in the number of delayed discharges. Review critical care provision across our 2 acute sites and implement new models of care. June 2014 Surgery Divisional & TMC Review complete March 2016 New configuration introduced. 6
3.2 Preventative, involving and local older people s care Transform our older people s pathway to be more preventative, involving and local Fully develop a sustainable geriatric liaison service within the accident and emergency service. November 2014 Reduction in acute geriatric admissions. Work with primary care and social care to roll-out MAGs (Multi-Agency Groups for high risk patients) to all GP practices April 2015 Full coverage of GP practices using MAGs across Buckinghamshire. Agree strategy for older people and develop a new model of care in line with the Better Care Fund aspirations September 2014 Completed, agreed strategy. Review medical cover to community hospitals to reflect the new model of care New model implemented. 3.3 Focus on dementia and learning disability Promote and develop mental health and learning disability services with a particular focus on dementia Work with Oxford Health to agree mental health service requirements involving community teams and A&E September 2014 Nurse Reduced turnaround times for mental health assessment. Develop the specialist dementia nurse service September 2014 Nurse Reduced time to dementia assessment. 7
Map and redesign end of life care for patients with dementia September 2014 April 2015 Nurse Mapped process complete Implement new pathway. 8
4. Efficiency - be a highly effective, sustainable Foundation Trust through maximising efficiency, productivity and cost effectiveness. Objective and key deliverables Timescale Lead director Group reporting into Key Performance Indicator 4.1 Focus on technology and estates Optimise the use of our estate and technological developments to facilitate high quality, responsive and cost effective service delivery Develop a clinical strategy and supporting estate plan for Wycombe Hospital maximising the benefit of clinical adjacencies and ensuring the use of the best estate for clinical services. Identify a development partner to deliver the estates plan. September 2014 Strategy and Business Development TMC Delivery of outline plan Tender process for development partner commenced. 9
Develop and implement a plan for Amersham Hospital as a centre of elderly care identifying and working with a partner organisation to maximise the use of the estate. Plan development Strategy and Business Development TMC Agreed plan. Partner secured Implementation March 2016 New model implemented. Identify an IT solution and develop mobile technology to support ACHTs, community midwives and other staff. Release and develop estate supported by the new ways of working e.g. Oakridge centre and other community sites. Strategy and Business Development Property Services Director CMG, ACHT review team Increase in ACHT and other community teams productivity. Estate rationalisation. Implement the new patient administration systems by undertaking the tender process June 2014 Finance Programme through to TMC Successful tender process. Award contract and Implement new systems 4.2 Promote and develop our services to realise new opportunities October 2015 Implementation plan in place. Promote and develop our services, in particular our centres of excellence, based on robust service line management Develop cost effective and sustainable stroke services to enable all stroke patients in South Buckinghamshire to receive their care at the Wycombe stroke unit. Medicine board Increase in stroke activity. Develop cost effective and sustainable cardiology services to provide a service locally for all Bucks patients and repatriate from neighbouring hospitals Medicine board Increase in cardiology activity and market share. 10
Increase the number of Bucks residents who are able to receive their operation at the Wycombe Treatment Centre Surgery Divisional Increase in surgical market share. Develop our neuro rehabilitation service to treat patients who live outside of Buckinghamshire Increase in non-bucks income. Return to profitable SLR Develop a strategy for private patient development, with particular focus on Spinal March 2016 Finance TMC Delivery of income target. Increase in Spinal private patient income. 4.3 Cost efficient & effective quality improvement Maximise our cost efficiency and effectiveness through delivery of our quality improvement strategy Deliver our cost improvement plan in full March 2016 Finance Cost Improvement Finance and Performance Delivery of planned outturn position. 11
Deliver our reforming elective care programme incorporating the recommendations of the external review focussing on improving the patient experience of outpatients and the elective pathway and ensuring delivery of our elective access targets. Reforming Elective Care Achievement of 18 week access target. Improved patient satisfaction in outpatients. Reduction in number of rearranged appointments. 12
5. External collaboration - work effectively across organisations and with our communities to ensure the best outcomes for patients and to influence the national agenda. Objective and key deliverables Timescale Lead director Group reporting into Key Performance Indicator 5.1 Community hospitals as hubs with strong community teams Working with our partners in health and social care as well as the local populations, develop community hospitals as local hubs of care supported by proactive, effective and efficient Adult Community Health Teams Implement a joint programme of work with commissioners and social care to develop a plan for each community hospital. Engage with local communities, and consult formally as necessary, around developing a sustainable future for their community hospitals September 2014 September 2015 March 2016 Strategy and Business Development Health economy programme board Plan agreed with commissioners Full proposal developed and agreed with local communities New model fully implemented Reduction in emergency admissions. March 2016 13
Review the provision of radiology services at community hospitals to ensure a proactive and sustainable service Strategy and Business Development Medicine & TMC Review completed, and plan developed for future service. 5.2 Transform the interface between health and social care Using the Better Care Fund as a driver, we will work with partners to transform the interface between health and social care Working with social care to streamline reablement and intermediate care services to improve better access for patients Strategy and Business Development Health economy programme board and TMC Reduced waiting time for reablement services. Implement the outcomes of the ACHT review Increased number of contacts per WTE. Working with commissioners, primary care and social care, develop crisis and out of hours services to provide alternatives to accident and emergency. Strategy and Business Development Health economy programme board and TMC Reduced A&E attendances out of hours. 5.3 Further develop children s services Work closely with social care, education and primary care to further develop our children s services Work with our commissioners to review and develop the school nursing service Working across divisions, redesign the surgical pathway for children to incorporate principles of the national service framework Nurse Specialist Services Divisional Nurse Specialist Services Divisional BHT retains the school nursing service. Introduction of children s operating lists. 14
Work with commissioners to develop the paediatric urgent care pathway and develop alternatives to A&E for children and their families Nurse Specialist Services Divisional Reduction in emergency attendances admissions (or hold to baseline). 15