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Precis for Children and Families Services
Integrated Business Plan
As we continue our journey as an independent Trust and progress towards Foundation Trust authorisation in 2013, we are developing our vision and plans as an organisation.
This document provides staff with a summary of these organisational plans and how these relate to Children and Families Services.
If you would like more information please contact Aileen Patterson, Associate Director Children and Families [email protected] or telephone 023 80 53 8708
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Our philosophy is to make things better for our population
master of our own
destiny
Why are we applying for Foundation Trust status?The Department of Health (DH) expects all NHS Trusts to achieve NHS Foundation Trust status on their own, as part of an existing Foundation Trust or in another organisational form. There are a number of benefits for the Trust and for staff in becoming a NHS Foundation Trust.
For the Trust these benefits include:
l Being ‘master of our own destiny’ that is accountable to an independent regulator (Monitor)
l Being able to build up and retain cash surpluses that can then be invested for the benefit of service users and the community we serve. For example, we plan to invest in our infrastructure especially information technology and to provide upfront investment in innovation and transformation
l Being able to keep some of the proceeds of any land sales that can then be re-invested
l Being able to borrow money from commercial sources without DH determination or prioritisation
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Our Vision and StrategySolent NHS Trust was established to manage care in the community, support clients’ independence and self-care by providing integrated physical and mental health and social care services based around GPs and their practice populations. We have particular expertise in providing integrated services to urban communities with complex health and social care needs. Our philosophy is to make things better for our population by taking a service user/family-centred approach which promotes wellness, self-care, recovery and personalisation. Our services enable people to remain safe and well at home with reduced dependency on acute hospital based services. Service users will experience home-based services that are reliable and available 24/7 and are organised with other providers around the care pathway.
The Trust’s strategy is to work closely with clinical commissioning groups and local health and wellbeing boards to lead a whole system change in the delivery of services.
Our goal is to shift the centre of gravity away from acute hospitals by offering clinically appropriate community solutions via a single point of access. The services we provide will be realistic alternatives to acute hospital care, rather than a duplication of services. Admission to acute hospitals will be necessary only for those with clinical acuity that requires the particular skills and infrastructure that only an acute environment can provide.
Long term conditions care pathways will be coordinated and delivered by single clinical multidisciplinary teams using the latest health technology including remote tele-healthcare. Service users will experience services that are better integrated and delivered from ‘one-stop-shops’ in community campuses, ensuring better outcomes for people living with multi morbidities.
All staff, unless they choose to opt out, will automatically become members of the Foundation Trust. Members, who will include service users and the public, will be invited to participate in focus groups and to comment on service changes and developments.
Members will be able to stand for election as a Governor and to vote in these elections, which are planned to take place this summer. There will be five staff Governors elected to the Council of Governors, which is an essential part of the unique governance structure of NHS Foundation Trusts and provides a link between the Trust, its staff and the community it serves. The Council of Governors has a key role in providing advice on the strategic direction of the Trust and the way in which it carries out it’s business. Staff Governors will have the opportunity to meet regularly with the Chairman and members of the Executive Team.
Our vision is to lead the way in local care
Our mission is to provide services in partnership to
deliver better health and local care
At the heart of the Trust is the quality promise:
Patient SafetyPatient Experience
Clinical Effectiveness and Outcomes
Regulation and Assurance
We do no harm Improved satisfaction and patient reported outcomes
Clinical standards and evaluation
Monitoring evidence based practice and clinical outcomes
We will make safety everyone’s highest priority and have a no harm culture ensuring our staff do the right thing for every person, every time
We will improve experience by putting people at the heart of services and listening to people’s views, gathering information about their perceptions and personal experience and using that information to further improve care
We will achieve optimum clinical effectiveness and outcomes by ensuring the application of evidence and best practice is in accordance with NICE guidelines and all other national guidance. We will demonstrate compliance through clinical audit
We will achieve regulatory compliance by ensuring the governance and risk management framework is fit for purpose at all levels, being clear, understandable and seamless whilst supporting continuous quality improvement and meeting the requirements of our regulators and minimising risk
We will improve experience by
putting people at the heart of services
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Delivery of the Trust’s strategic objectives is dependent
on a strong organisational culture focused on delivery
of clinical and business excellence and compliance with
commissioner and regulatory requirements.
The Trust’s Strategic ObjectivesOur strategic objectives set out what we want to achieve as an organisation over the next 5 years:
Strategic Objective 1To provide services which enable improved health outcomes with particular focus on areas of known health inequality
Strategic Objective 2To deliver care pathways that are integrated with local authorities, primary care and other providers
Strategic Objective 3To ensure sustainability of services through clinical and business excellence
Clinical Strategy Children and Families Services
We are developing Clinical Strategies for each of our defining services which underpin delivery of the overarching Strategic Objectives
Adults with long term conditions and elderly with complex needs including Primary Care Services
Adults with mental health conditions and Substance Misuse Services
Children and Families
Health and Wellbeing
Sexual Health Services
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We have also set out our five year quality objectives
These 4 domains are underpinned by 13 high level quality improvement priorities which provide a secure framework by which annual corporate and divisional quality objectives are set and which reflect known and evolving risks.
Solent NHS Trust Quality Objectives 2012-17
1 Achieve NHSLA Level 2 (2014/5) and level 3 (2017)
2 Maintain CQC compliance for all 26 standards supported by the Solent NHS Trust ‘s Getting the Basics Right Programme and No Needless Harm initiatives on-going from 2012
3 Reach the top quartile of national patient surveys and benchmarks relevant to the organisation by agreed milestones by 2015
4 Reach the top quartile of the staff survey for agreed milestones by 2015
5 Achieve the top quartile scoring for the High Impact Actions by 2013
6 Achieve ‘green’ ratings across all Quality Risk Profile categories by 2013
7 Achieve top quartile rating in mental health surveys and Care Programme Approach by 2015
8 Be recognised nationally as a leading community and mental health research organisation by 2017
9 Board to Floor processes seen as part of every executive and non-executive member of the organisation’s responsibility on-going from 2012
10 Strengthen the culture of innovation across the organisation by encouraging new ideas and rewarding those individuals, services and organisations that adopt best practice from 2012
11 Quality Impact Assessments undertaken for all change programmes to assess impact on safety and delivery on-going from 2012
12 Deliver on the NHS Outcomes Framework domains
13 Deliver on the NHS Mandate and Constitution principles
Dental Services
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Priorities for Children and Families Services include:
1. Providing services which enable improved health outcomes with particular focus on areas of known health inequality
l Delivery of Baby Talk and Every Child a Talker programmes
l Health reviews undertaken by Specialist Nurses at school entry and key transitions
l Embed revised model of CAMHS services in Southampton
l Improve models, access and waiting times in paediatric therapy services
l Expand core Health Visitor services in Southampton and Portsmouth by doubling the number of qualified health visitors
l Expand Family Nurse Partnership (FNP) in Portsmouth and Southampton to reach more teenage parents
l Develop a plan to roll out the You’re Welcome preparation and application to achieve accreditation in all services
2. Delivering care pathways that are integrated with local authorities, primary care and other providers
l Contribute to the delivery of a multi-agency Children and Young People’s Development Service (CYPDS) in Southampton and integrated services for children with complex health needs and disability in Portsmouth
l Provide strategic leadership by identifying Solent lead manager for multi-agency CYPDS steering group
l Consult and plan for pooled health and Local Authority staff in an integrated Child Development Centre in St Mary’s Community Hospital
The clinical strategy to develop Children and Families services includes:
l Delivering a range of services that work together to prevent ill health,
provide early help, targeted care and support and specialist community
care for the most vulnerable children, young people and families
l Implementing Health Visiting Call to Action programme and delivering
the Healthy Child Programme
l Embedding Common Assessment Framework processes in all services
for children
l Achieving You’re Welcome accreditation for all Solent NHS Trust services
working with adolescents
l Supporting the move towards personalisation, particularly for children
with complex needs and disabilities
l Having a key partnership role in Southampton Children and Young
People Development Service (CYPDS) and in the development of an
integrated model in Portsmouth for children with complex health needs
and disability
l Working with parents to deliver care to ill children and those with
complex health needs and disability in their homes and other community
settings and empowering children and young people in self-care
l Delivering services which contribute significantly to the whole system
requirement to reduce avoidable hospital admissions
l Retaining core business and expanding into new geographical areas
The key elements of the clinical strategy for Children and Families Services are summarised below.
Children and Families Services
Solent NHS Trust provides services to meet the physical, mental and psychological needs of children and young people aged 0-19 years. Services are delivered across three care pathways – Universal, Targeted and Specialist according to clinical need. Each of the care pathways encompasses elements of prevention, planned care and urgent care.
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3. To ensure sustainability of services through clinical and business excellence
l Embed Common Assessment Framework processes in all services for children
l Identify a Solent champion for Common Assessment Framework
l Second a health visitor to the multi-agency Joint Action Team in Portsmouth to support embedding CAF
l Evaluate Children’s Outreach Assessment Team (COAST) pilots in Southampton and Hampshire and expand the model into Southampton and Hampshire
l Explore opportunities to develop role of advanced paediatric nurse specialist working in primary care and Emergency Departments.
l Through the Health Visitor and Specialist Nurse services ensure all families are offered follow up advice and support following frequent Emergency Department attendances
l Develop business case to expand Occupational Therapy services for a wider group of children’s needs, e.g. sensory integration for autism and Attention Deficit Hyperactive Disorder assessments
l Improve waiting times for access to paediatric therapy services
Supporting StrategiesAlongside the clinical strategies, we have explained how other areas of the Trust’s business will help us achieve our plans. These include:
Research and Development including Primary Care Services
Estates
Information Management Technology (IMT)
Market Development
Workforce and Organisational Development
Increase the scope of research activity, the number of patients recruited into research, and the number of staff that are engaged with research and service evaluation activity. A particular focus will be placed on attracting commercial and National Institute for Health Research funding
Consolidate the incorporation of best evidence and evaluation findings into service delivery and be at the forefront of evidence based translational innovative care and practice. This will involve dovetailing health intelligence and information across research, evaluation and audit to inform outcomes and quality improvements
Involve patients and the public in research and evaluation so that they can work in partnership to develop projects that will benefit our population and improve our service delivery
Broaden and strengthen collaboration and partnerships with relevant organisations
Reinforce and streamline management and governance processes, ensuring that Solent NHS Trust meets national targets and attracts the best quality research. There will be support for staff to engage in the best standards of research, evaluation and audit, via access to training and other resources
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Research and Development
It is our plan that Solent NHS Trust will be recognised as a leading community and mental health research organisation and will be a leader in the involvement of service users and the public in research. Over the next five years, research and service evaluation activity will be embedded into services in a cycle of continuous improvement, to transform and deliver innovative, effective high quality care.
To achieve this aim the Research and Service Evaluation Strategy embraces five key goals:
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Workforce and Organisational Development (OD)
We aspire to be the local healthcare employer of choice, an organisation with learning at its core, providing the best workplace experience and quite simply a great place to work. Our staff are our greatest asset and we will strive to enable them to feel valued, involved and proud, creating a culture which ensures excellent services, excellence in all that we do. How we recruit, retain and develop the right people with the right skills at the right time will be a critical success factor in delivering business and clinical excellence.
Our Workforce & OD Strategy is designed to respond to the challenges of the changing environment, our organisational strategic objectives and our ambitious transformation agenda.
Key themes within the strategy are to strengthen the culture of the organisation, develop organisational capability and build organisational capacity to ensure operational effectiveness aligned to delivery of our strategic objectives. Greater emphasis and investment has been placed on creating a more effective clinical leadership infrastructure and ensuring that accountability for service development and governance is jointly owned at service leadership level.
Estates
A significant proportion of the facilities from which Solent NHS Trust provides services transferred to the Trust in April 2013. Facilities Management staff have also transferred to Solent NHS Trust.
Across the estate there are issues of underutilisation and buildings that are not fit for purpose. The Estates strategy therefore aims to improve utilisation so that the number of properties being fully utilised increases from 70% to 80%. Capital investment has also been identified to improve the overall condition of the estate both in terms of physical condition and also functional suitability and quality.
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Information Management Technology (IMT)
Although our use of tele-health is leading edge, our IT systems are not. Significant capital investment is planned to enhance our care record and performance monitoring capabilities. This includes
l A single domain for Solent NHS Trust
l Procure an integrated network across Hampshire to support shared patient pathways and facilitate organisational change
l Maximise recent investments by expanding:
o Voice over internet protocol (VOIP) communications links between Portsmouth & Southampton converging with IT network
o Investment in virtualised environments – rolling out desktop virtual desktop infrasture (VDI)
l Refocus the clinical applications strategy to include shared community/primary care systems to encourage greater engagement between primary and community services
l Build a new business intelligence infrastructure to replace the existing data warehouses and introduce new contract monitoring and performance management systems to improve reporting capability within the organisation
l Develop a fully scoped and costed mobile working strategy for administrative and clinical staff that supports clinicians on the front-line and increases productivity.
Market Development
Our market development strategy sets out the significant changes in the NHS and economy that will impact on Solent NHS Trust’s market position.
l The changes to the commissioning environment with clinical commissioning groups, services moving to be commissioned by local authorities and the development of the National Commissioning Board
l The challenging economic climate reducing commissioning budgets
l The increasing competitive environment with increasing competition from private and third sector organisations
To respond to these changes our market development strategy focuses on areas where the Trust is clearly differentiated from other providers::
Focused on urban areas where there are complex health and social needs
Integrated with social care
Delivery fully aligned to practice populations
Organised with other providers around care pathways
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The market development strategy has two parallel themes:
Firstly, securing our position as the provider of choice for locality teams in cities and supporting the shift of service provision away from acute hospitals and into patient’s homes and the community.
Secondly, the development of specialised services, such as substance misuse, specialist dentistry and sexual health, across a wider geography.
For children and families services this means:
l Focus on admissions avoidance and single point of referral for general paediatrics
l Develop the community offer in partnership with University Hospitals Southampton NHS FT and Portsmouth Hospitals NHS Trust.
l Expand to wider geography in Hampshire and West Sussex.
Working with parents to deliver care to ill children and those
with complex health needs and disability in their homes and
other community settings and empowering children and young
people in self-care
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November 2012. Designed by NHS Creative – SLA34085
www.solent.nhs.uk
To become a member of Solent NHS Trust, please visit www.solent.nhs.uk/membership
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