Lancashire Teaching Hospitals. NHS Foundation Trust THE BIG PLAN Excellent care with compassion

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1 Lancashire Teaching Hospitals NHS Foundation Trust THE BIG PLAN Excellent care with compassion

2

3 THE BIG PLAN The NHS is currently facing the biggest challenge in its history. Our population is ageing. People are living for longer with chronic conditions, and our unhealthy lifestyles mean more of us are developing preventable diseases. Hospitals are required to constantly improve quality of care, health outcomes, and access to treatment. And the public is increasingly demanding to be able to access the health services they need, when they need it. At the same time the NHS has to deliver huge savings in a difficult financial climate, and there is a national shortage of nurses, and some specialist doctors. To enable us to address these challenges, ensure we re sustainable for the future, and can balance the books, we have developed a Big Plan. This Big Plan sets out our key goals for the next few years. These goals are milestones in a journey to achieving our strategic aims, whilst ensuring we always provide excellent care with compassion. Karen Partington CHIEF EXECUTIVE 3

4 Lancashire Teaching Hospitals NHS Foundation Trust STRATEGIC AIMS Our strategic aims define our long term ambitions, and describe our core business. Expanding and developing specialised and tertiary services Many complex or less common conditions are best treated by specialist staff who have the opportunity to develop their expertise and experience in centres of excellence which provide the right equipment and facilities. In recent years specialist services have been concentrated in fewer, bigger centres, and many hospitals no longer treat every condition. This way of providing services has improved recovery and survival rates for many illnesses and injury such as stroke, and major trauma. Our aim is to expand the specialised and tertiary services we currently provide, and develop additional services in the future. We will work closely with specialist service commissioners and other local hospitals so that patients can access all the specialist care they need, here in our region. Over the next two years we will be expanding our Critical Care Unit to support the development of specialist services for patients with complex, serious and less common conditions. Delivering local services for Preston, Chorley and South Ribble The population s health and social care Needs has changed significantly in recent times. The population is ageing - the number of people aged 85 years and over will double in the next 15 years. Older people are more likely to require admission to hospital than the general population, and tend to stay in hospital for longer. People are living for longer with chronic conditions such as lung disease, heart disease, asthma and diabetes, and the number of patients with more than one of these conditions is increasing. The need for healthcare is increasing, and the number of patients who require emergency admission to hospital is rising year on year. Our aim is to continue to deliver the highest standards of care for our local communities. We will work with health and social care organisations to make sure the right care is provided, at the right time, in the appropriate setting. More services will be provided in the community and in people s own homes to support people to live well, maintain good health and wellbeing, and recover following a stay in hospital. This will enable hospitals to focus on providing the specialist care only hospitals can. 4

5 The Big Plan To enhance our workforce and our reputation through education, research and innovation In the coming years we will continue to invest in education, research and innovation. Educating our students and staff is vital to growing the right workforce for our future. Investing in innovation and research enables us to develop new drugs and treatment that changes lives. And together these priorities help us attract the very best staff. 5

6 Lancashire Teaching Hospitals NHS Foundation Trust OUR VALUES Our organisational values define the standards of behaviour we expect from staff to ensure we are always providing excellent care with compassion, and working effectively towards achieving our strategic aims: Caring and compassionate Recognising individuality Seeking to involve Team-working Taking personal responsibility 15% reduction in inpatient mortality by % positive patient feedback 98% harm-free care 6

7 The Big Plan Key delivery strategies We have developed five key delivery strategies that set out what we re going to do to achieve our aims. Quality Our quality strategy - Safe, Reliable and Compassionate - describes the standards we need to achieve to make sure every patient receives excellent care with compassion. The strategy was reviewed in 2014 to incorporate recommendations of national reviews including mid Staffordshire, and builds on the outstanding progress we have made in improving quality standards. Our priorities to improve the quality of the care we provide are to : Deliver safe care Provide effective care Improve our patients experience Safe care We are aiming to achieve 98% harm-free care, defined by the absence of pressure ulcers, falls, catheter associated urinary tract infections, and venous thrombo-embolism (blood clots) - and have robust policies and procedures in place to enable this. Our zero tolerance approach to MRSA remains, and we will continue to aim to reduce hospital-acquired C. difficile infections. Effective care We are continuously improving the effectiveness of the care we provide, and are aiming to reduce inpatient mortality by a further 15% by We will continuously review all of our clinical pathways and practice to ensure we comply with guidance from NICE and royal colleges so we know, and patients can be assured, that the care they receive is of the highest quality standards. We will also be improving our clinical coding and recording to make sure our data is accurate, so we can track how we re performing, can identify any trends in health conditions and treatment, and can identify and resolve any issues promptly. Patient experience Patients experiences of care affect their outcomes, overall satisfaction, and confidence in the NHS and in our hospitals, so it is vital we get this right. We already have in place a range of methods to make sure patients and their families can tell us what they think, from the national Friends and Family Test to more detailed local surveys we ask every patient to complete. As important is the feedback we receive from patients and their families every day. All of this valuable data is analysed to identify any trends or emerging issues so we can share good practice across services, and take prompt action if any patient has not had the positive experience they expect and deserve. Patients and families have told us that we could improve communication, information and so this will be a key focus for us. 7

8 Lancashire Teaching Hospitals NHS Foundation Trust Clinical services Developing clinical services, and in particular expanding our specialities is critical to making sure our communities can access the treatment they need, and that we can continue to provide care for future generations. We have recently been designated as a regional Major Vascular Centre, and will be building a new operating theatre and recruiting specialist staff to make sure patients with complex and serious circulatory system conditions receive the very best care. As the regional Neurosciences Centre we will be further developing our neurosurgery service, and investing in expanding neuro-rehabilitation care. In 2013 we were designated the Major Trauma Centre for Lancashire and South Cumbria, and our new CT scanner will be installed in 2014 which will make sure patients with life and limb threatening injuries can receive prompt diagnosis and treatment. Over the next two years we will be expanding our Critical Care Unit to support the development of specialist services for patients with complex, serious and less common conditions. Our midwifery unit at Chorley and South Ribble Hospital was refurbished in 2013, and a new midwifery unit opened at Royal Preston Hospital in We have made significant investments in expanding our midwifery workforce, and will be building a new obstetrics operating theatre. 8

9 The Big Plan Operational effectiveness Making sure our hospitals run efficiently is critical to providing excellent care with compassion, whilst ensuring we manage our finances so we can remain viable, and are able to invest for the future. Our key priority in the coming year is to work with health and social care organisations to improve urgent care services. A new urgent care centre at Chorley and South Ribble Hospital will provide access to GPs and other health professionals, for less serious illness and injury, 24 hours a day, seven days a week helping local patients to get the care they need, when they need it. We will also be working with our partners to improve services for elderly people and patients with long term conditions, to enable them to keep well and maintain their independence in their own homes and community settings. Together these two developments will help reduce urgent admissions to hospital, and reduce the amount of time elderly people and patients with long term conditions stay in hospital. This will enable hospitals to focus on providing the specialist care only hospitals can provide, and make sure people receive timely treatment. We are participating in a national pilot to develop seven day services and integrating this way of working is a key focus for the future. Seven day services will provide quicker access to treatment, and ensure the quality of care is consistent for every patient, all the time. Future savings plans include improving our procurement practice, recruiting more permanent staff so we can reduce use of more expensive agency workers, rigorous budget management within services, and engaging staff in identifying more efficient ways of working. We will also invest now to save later, such as implementing the case note digitisation scheme which is vital to delivering an electronic patient record in the future, and which will also reduce cost in the longer term. IT The Department of Health requires all hospitals to produce a paperless patient record by 2018, and between now and then we ll be investing in developing our electronic patient system to ensure we can achieve this. We will also be looking at all of our patient administration systems, such as operating theatre management and outpatient booking processes, to ensure we are working effectively and managing our capacity to make sure patients can access timely and appropriate treatment. The financial challenge We along with other health services across the country have worked hard to deliver the significant savings required by the Department of Health over the past three years. Making savings is increasingly challenging, as both the need for and cost of healthcare grows every year. We are absolutely committed to making changes that do not reduce the quality of the care we provide. We have already implemented a wide range of measures to reduce costs and improve productivity, and identifying further opportunities to save money, whilst maintaining or improving patient care, is increasingly challenging. 9

10 Lancashire Teaching Hospitals NHS Foundation Trust Organisational development and workforce Our Organisational Development and Workforce Strategy aims to help us ensure that we have the right number of people, with the right skills, knowledge and experience, doing the right job, to help us ensure we are always providing excellent care with compassion. We are developing a talent management programme to ensure we are identifying and supporting our rising stars, and we will continue to deliver our national award-winning leadership development curriculum, helping us to grow our leaders for the future. The recent national staff survey highlighted that our staff are increasingly feeling satisfied with their jobs, feel they are supported to deliver quality care, and feel engaged, and we will be building on this in the years ahead. Making sure we have the right number of the right roles across our services is crucial to being able to provide the quality of care patients expect and deserve. We have recently invested 3m in additional nursing posts, and will continue to more staff and nurses in particular in the next two years, to make sure we always have the right resources to maintain the highest standards of care at all times. We will increase the number of nurses on the wards and we ll continue to review staffing levels on an ongoing basis to make sure the staff numbers and mix is right, and that we can respond flexibly to any changes in demand. This will help us reduce our use of agency nurses and other temporary staff so we can maintain a continuity of service, invest in developing the best permanent workforce, and reduce the amount we spend. We will be implementing a widening access programme to support the development of the workforce for the future by engaging with young people during their education and giving them opportunities to work in our hospitals. We aim to be a leader in healthcare education, and in the next two years plan to launch a student-funded nursing degree course with a local university, to ensure sustainability of the nursing workforce for the future. We are also aiming to increase the number of medical students we educate. We recognise the importance of supporting our staff to stay fit and healthy, and are investing in a range of health and well-being opportunities to promote wellness, and reduce sickness absence. We are committed to driving innovation in healthcare, to develop new drugs and treatment that enable people to live better for longer. We have developed an innovation pathway to assess and progress ground-breaking ideas which will be a key factor in driving pioneering advances i n the future. Last year alone we were involved in more than 200 research studies, and recruited more than 1500 patients to clinical trials, which makes us one of the most research-active hospitals in the country. We will be increasing our research capability and capacity in the next two years to enable us to become a research and innovation leader nationally and globally. EXCITING TIMES AHEAD In we will be launching the Your Hospitals Your Health programme, which is a major review of our clinical services and hospital estate, to enable us to respond to the challenges we are facing, continue to provide the highest standards of care and services, and make sure we re fit for the future. This is a challenging period for the NHS, as demand increases whilst budgets are restricted. But we think this presents us with a fantastic opportunity to work differently, innovate, and change. We are confident that we have the right approach, and a skilled, motivated and committed workforce in place to enable us to continue to provide excellent care with compassion for this and future generations. 10

11 The Big Plan

12 Our full Annual Plan is available on our website For further information or alternative formats contact : Communication Department Office of the Chief Executive Lancashire Teaching Hospitals NHS Foundation Trust Royal Preston Hospital Sharoe Green Lane Fulwood Preston Lancashire PR2 9HT Telephone :

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