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A summary version
Integrated Business Plan
to 2017
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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 you with a summary of these organisational plans and how these relate to our clinical services.
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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.
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
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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
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 are also able to stand for election as a
Governor and to vote in elections. There will be 25
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 its business.
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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 five 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
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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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We have also set out our five year quality objectives
These four 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
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Clinical strategyWe are developing clinical strategies for each of our defining services.
These underpin delivery of the overarching strategic objectives
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Adults with long term conditions and elderly with complex needs including Primary Care Services
Adults with mental health conditions and Substance Misuse Services
Child and Family
Health and Wellbeing
Sexual Health Services
Dental Services
Adults with long term conditions and elderly with complex needs including Primary Care Services
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In line with commissioner intentions, the clinical strategy required to
develop the locality model for adult services includes:
l Delivery of gateway services including single point of referral and single
point of access
l Common assessment framework implementation
l Expansion of adult / frail elderly case finding to eventually reach the top
5% population
l More support for service users to manage their own care with tele-
health support
l More support for GPs to manage within primary care
l Better alignment to primary care so that GPs feel much more supported
by named staff in their locality teams working into the practices
l Development of case management capability for Long Term Conditions
through partnership working with secondary care
l Improved capacity 24/7 rapid response and virtual wards including end
of life care
l Expansion of step up/ down/ flexi beds to support timely discharge from
acute hospitals and avoid admission
l Improved integrated working with social services
l Development of long terms condition services in locality hubs
Adults with long term conditions and elderly with complex needs including Primary Care ServicesSolent NHS Trust provides locality based integrated health and social care services providing a combination of Community Nursing, Rehabilitation and Reablement case management, rapid response, and virtual wards. Care is based on a pathway around the patient, using evidence based practice and national guidelines.
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Priorities for Adult Services include:
1. To lead the delivery of integrated health and social care locality services including the new model for community rehabilitation beds and virtual wards.
l Services will be co-located with social care partners where possible
l Community Physiotherapy, Occupational Therapy, Podiatry and Speech and Language Therapy will be aligned into health and social care locality teams
l Older People’s Mental Health Services will be fully integrated into health and social care locality teams
l Locality teams will be aligned to practice populations
2. To expand Single Point of Access to cover access to all Adult Services, including unscheduled and scheduled care services, to act as a conduit to commence care and treatment, 24/7.
l The Single Point of Access will connect with 111 and Out of Hours services helping to prevent crisis situations
3. To deliver integrated long term conditions outpatients and primary care provision within localities to promote flexibility and choice.
l Six long terms conditions ‘one-stop-shop’ hubs in Southampton and Portsmouth will cater for long term conditions and co-morbidities
l Speech and Language Therapy, Podiatry, Musculoskeletal, Diabetes, Chronic Obstructive Pulmonary Disorder (COPD), Cardiac and Neuro Outpatient Services will be provided in these hubs which will eventually include diagnostic services
l Diabetic patients will have swift access to Podiatry Services
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l Community neurology services will expand into the localities to support people with very complex health needs
l Respiratory services including pulmonary rehabilitation services will be developed to support admission avoidance working in partnership with acute services and primary care
l The community early supportive discharge model for stroke will be replicated across Solent and expanded
4. Admission avoidance through the provision of community based alternatives to hospital admission, increased capacity in our unscheduled care services, and increased clinical confidence in community based models of care.
l We will work in partnership with partner community services to develop pull system from acute hospital to reduce length of stay
l Increase levels of case management of all vulnerable at risk patients
l Increase use of the Minor Injuries Unit and improve access to diagnostics to support the appropriate diversion of activity from acute provider Emergency Departments
l Ensure that the Home Enteral Nutrition Service is fully implemented
l In partnership with acute trusts develop more elderly rehabilitation and step up beds into community
l Provide hydration IVI therapy and administration of IVI antibiotics
l Increase close collaborative working with social services to effect timely discharge of patients and improved links with community initiatives e.g. virtual wards
l Further enhance ‘at risk foot’ pathway
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5. Frail elderly/ long term conditions community care
l Promote and extend the Common Assessment Framework and case-coordination of frail elderly patients and those with long term conditions
l Prioritise caseloads through risk stratification with primary care to ensure we focus on those patients who have urgent needs and require support
l All patients referred following a fall, or with a history of falls, will have a personal management plan to reduce further incidents where possible
l Improve integration between Older People’s Mental Health (OPMH) Services (Southern Health) and Frail Elderly Services (Solent NHS Trust) in Southampton
6. End of life and palliative care in partnership with primary care
l To work with primary care to ensure all End of Life patients are on Gold Standards Framework
l All palliative care patients will be on the Liverpool Care Pathway
l Achieve preferred place of death for all patients through Advance Care Plans
7. Older People’s Mental Health
l Create step down beds at The Limes to help reduce length of stay in acute hospital
l Relocate long term patients to nursing homes once their episode of treatment is complete and their ongoing needs require this level of support
l Reduce anti-psychotic medication
l Further develop the dementia pathway
l Further develop in-reach into acute trusts to reduce length of stay
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8. Clients with a learning disability (Section 75)
l Develop the service with Portsmouth City Council to ensure better integrated working
l Increase access to main stream general medical services, for health checks and screening
l Improve service integration in Southampton
l Further develop acute trust in-reach support
l Develop offender support
9. Telehealthcare and technology
l All case-managed patients and those with long term conditions will be offered Telehealth
l Increase use of Telehealth for patient symptom recognition and self-management
l Teleconferencing to be introduced with housebound patients
l Assistive technology (e.g. environmental controls) offered where there is an identified need
l Telehealth alerts to be monitored by the Single Point of Access (SPA) to ensure effective staff response to urgent need
10. Primary care and offender health
l Develop our strategy for expanding primary care provision across the cities
l Further develop our primary care provision to ensure effective pathway working with the prison service and acute trusts
l Ensure effective management of frail elderly and those with long term conditions through risk stratification, single assessment process and robust pathways across our practices
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Adults with mental health conditions and Substance
Misuse Services
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The clinical strategy to develop Adult Mental Health Services includes:
l Preventing the emergence or escalation of mental health or substance misuse problems by active health promotion and early intervention in the community where possible
l Ensuring early detection and ongoing treatment of physical health problems in vulnerable groups by ensuring that all our patients are screened to ensure that a physical health check has been undertaken by their GP
l Enabling all those who are able and eligible to access a personalised budget by ensuring that this is built into the care programme approach core assessment process for all patients
l Ensuring that services are meeting people’s personal goals in a way that suits them
l Maximising the number of people selecting Solent NHS Trust as their provider of choice in the service areas that the Trust is wishing to maintain or grow by improving overall patient experience in the service
l Ensuring that people using Solent NHS Trust services report that we have helped them to live the life they want by embedding recovery-based practice in the service and using patient-reported outcomes to measure success
l Delivering a year on year increase in people using services, successfully returning to work and education
l Ensuring Solent NHS Trust takes an active part in the Time to Change campaign and embeds anti-discriminatory practice within all its services by identifying champions across the service, both patients and staff, to drive through local changes needed
l Ensuring that people’s mental health needs can be addressed by pathways of care that begin at a common Trust-wide single point of access
Adults with mental health conditions and Substance Misuse ServicesSolent NHS Trust’s Mental Health Services are highly rated by service users and deliver good outcomes with an average length of stay well below the national average.
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l Bringing the parts of people’s care together without them noticing the joins
l Embedding standardised evidence care pathways across all services, to support the implementation of Payment by Results, Service Line Reporting and Patient Level Information and Costing System (PLICS) by developing Integrated Care Pathways for all the Care Clusters and begin producing outcomes that demonstrate benefits for patients
l Delivering services at overall below tariff cost, whilst delivering specified clinical and commissioner outcomes by adopting a transformation based approach to service redesign that combines cost reduction with quality improvement as we are currently doing in Community Services
l Taking advantage of growth opportunities and expanding services into new geographical areas and markets where appropriate by developing and executing a coherent growth strategy that outlines the areas we want to grow in and clearly outlines the benefits from a business and patient perspective
delivering a year on year increase in people using
services, successfully returning to work
and education
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l Implement an ‘open referral’ system – directly and through SPA – to allow GPs and other health professionals fast access to advice and assessment, including specialist advice and assessment by a psychiatrist, where required
l Named individuals will be linked to GPs within the ‘front-gate’ pathway – provided by the community recovery teams
l Self referral (already possible through Talking Change and Headspace), will be extended to the whole population by incorporating Adult Mental Health and substance misuse into the Solent SPA
l The Specialist Intensive Community Services (Portsmouth City) will offer an extended hours service, with increased capacity for the most vulnerable young people and those disengaged from services
l Talking Change services will create a single Step 2 and 3 assessment and treatment model, combining IAPT and counselling services. This will allow increases in the volume of Step 2 interventions carried out (by 33%) and decrease the waiting time to first contact
l All people entering a mental health Care Programme Approach pathway will be offered a physical health check on assessment. Physical health issues will be recorded on care plans with reviews at least every 12 months
l The Physical Health Care Matron role will be revised to ensure that all people admitted to inpatient facilities have appropriate physical health screening on admission and are capably dealt with if they develop physical health problems during their stay
l Blood borne virus screening will be undertaken for all at risk substance misusing clients
Priorities for Adult Mental Health Services include:1. Safeguarding wellbeing
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2. Personalisation and choice
l Completion of the Personal Health Budget pilot with targets agreed with local commissioners
3. Recovery, responsibility and tackling stigma
l All service users who are care co-ordinated for more than six months in a general community team, or any inpatient setting, will be offered either Recovery Star or WRAP as part of their care planning process
l Recovery leads in Mental Health and Substance Misuse Services will be appointed to develop partnerships with housing , education and employments partners and educate staff and raise expectations about recovery among service users and the wider community
l The Trust will join the Time to Change campaign
4. Pathways
l Crisis Resolution and Home Treatment (including AMH psychiatric access) and liaison psychiatry to transfer front end call handling to SPA
5. Outcomes and value
l The outputs of service user surveys and stakeholder reviews will be evaluated with service user and clinical reference groups – selecting measures for quality accounts and local improvement plans
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Substance Misuse Services
Solent NHS Trust currently provides Substance Misuse Services to adults in Portsmouth City, across Hampshire County and runs a Young People’s Service in Southampton City.
The Portsmouth Service has recently been remodelled and retendered and Solent NHS Trust was successful in retaining services by providing the Medical Assessment and Clinical Intervention element of the new model, which is a ‘hub and spoke’ model with a number of key partners working from a central hub. This model has a strong emphasis on partnership working across 2-3 key bases within the City.
The Hampshire service is delivered as part of the ‘Hampshire Operational Model for Effective Recovery’ model (HOMER). This is an integrated recovery orientated model designed to meet the needs of individual service users, their families and carers and the wider communities across Hampshire.
The two differing models reflect different commissioning approaches.
Throughout 2013–2017, Solent NHS Trust will focus on fully embedding both the new Portsmouth and the existing Hampshire models and identify more varied employer partners as additional work placements become required and continuously evaluate what works well to enable people with substance misuse problems enter into recovery and develop their recovery capital.
This will put Solent NHS Trust in a strong position to gain the confidence of Commissioners to reward an extension to current contracts, raise credibility for future tenders by achieving high performance nationally and utilise and build on strengths from current partnerships.
raise expectations about recovery among service users and the
wider community
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Child and Family Services
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The clinical strategy to develop Child and Family 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
Child and Family ServicesSolent 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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Priorities for Child and Family 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
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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
Improve waiting times for access to paediatric therapy services
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Health and Wellbeing Services
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Our health and wellbeing vision is to achieve the best health outcomes for
patients and staff by working in partnership with public health, primary
care, social care, the acute sector and other stakeholders to deliver
improved outcomes, improve wellbeing and tackle health inequalities
focused on six core principles:
l Improving access and tackling health inequalities
l Focusing on individual client needs
l Providing services which promote healthy lifestyles and enable improved
health outcomes
l Ensuring the environment in which we operate is fit for purpose, safe,
secure and conducive to the delivery of high quality services
l Ensuring our workforce is happy, healthy and here
l Improving integration and partnership working with primary care, the
acute sector, local authorities and other stakeholders
Health and Wellbeing ServicesFor adults and older people, Solent NHS Trust provide a wide range of services to improve health and wellbeing, from our sexual health screening and treatment services, through supporting people with substance misuse issues, and delivering smoking cessation and healthy living interventions. In all the care we provide we aim to make every contact count, in order to improve health as well as simply treat illness.
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The clinical strategy for health and wellbeing identifies priorities for development including
Priority area Action
Access and health inequalities
Increase access to services for client groups with the highest needs, through marketing of services and engaging with targeted communities
Increase access and referrals to children’s centres of families with poorest health and highest income poverty
Increase knowledge of benefits and increase referral and signposting to Citizen’s Advice Bureau, Social Services and other benefits advice and support services
Develop better integrated pathways to prevent people ‘falling out of the system’, both adult and child services and working with Social Services and other relevant agencies
Induction of new staff to include Trust’s objective to reduce inequalities
Client focus Responsibility for every healthcare professional to make ‘every contact count’ by developing simple health inequalities interventions
Promote Solent Health Improvement Training Programme to a wider audience, including community groups which can access groups the NHS traditionally finds hard to reach
Lifestyle and outcomes
Increase the number of referrals to smoking cessation services
Reduce numbers of people overweight by referring to Health Trainers, physical activity services and healthy eating programmes
Reduce levels of alcohol harm by increasing the number of referrals to alcohol services and Health Trainers through delivering alcohol brief interventions
Environment Implement the Solent NHS Trust Estate Strategy
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Priority Area Action
Healthy workforce
Develop Workforce Wellbeing Strategy to promote culture of ‘Happy, Healthy and Here’ and achieve the following outcomes:
• promoting health and wellbeing at work
• improving access to health and wellbeing whilst as work
• achieve a reduction in the days lost due to sickness absence to <3%
• achieve Investors in People Health & Wellbeing accreditation
Partnerships Work with commissioners, primary care and other stakeholders to re-design care pathways to include interventions that improve health and wellbeing and reduce health inequalities
Develop working relationships with community groups and other partners and provide training, where appropriate, to improve access to hard to reach groups
Key services to link with Hampshire Fire and Rescue service to target key areas for free support on fire and safety measures
Monitoring and evaluation
Service managers to develop service relevant KPI’s and to identify SMART ways to monitor and evaluate progress towards achieving outcomes in improving access and reducing inequalities.
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Sexual Health Services
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The clinical strategy to develop Sexual Health Services aims to achieve the best health outcomes for patients and staff by working in partnership with Public Health, primary care, social care, the acute sector and other stakeholders to deliver improved outcomes, improve wellbeing and tackle health inequalities by:
l Increasing awareness and education to improve the public perception of sexual health services, reduce stigma and increase uptake
l Improving access to integrated sexual health services in primary care settings, secondary schools, colleges, universities and other community settings
l Delivering services which improve clinical outcomes
l Providing a regional Sexual Assault Referral Centre offering expertise to a wider area
l Achieving You’re Welcome accreditation for all health services working with adolescents to ensure effective transition to adulthood
l Working with a greater variety of stakeholders and being recognised for our expertise, delivering training and support to, primary care, secondary care, education and social care in order to deliver improved clinical outcomes
l Building on our established national reputation through research and membership of national sexual health professional organisations
l Ensuring all service users have influenced the design and delivery of services
Sexual Health ServicesSolent NHS Trust’s Sexual Health Services are delivered through consultant-led integrated hubs, providing specialist (Level 3) services across Hampshire and nurse-led spoke clinics sited in major towns which deliver a broad range of integrated genito-urinary medicine and contraceptive and sexual health services (Levels 1-3). Young people’s drop-in clinics, outreach and health promotion services target populations with the highest risk of sexual ill-health.
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Priorities for Sexual Health Services include:
1. Providing services which enable improved outcomes with particular focus on known health inequality
l Promote local Sexual Health Services effectively and facilitate convenient and timely access to integrated sexual healthcare for all
l Deliver a ‘one-stop-shop’ approach to Sexual Health Service provision, including Quick Check, ensuring that patients have access to a range of sexually transmitted infection (STI), contraception and reproductive health services
l Reduce the number of appointments that patients require to have their needs met
l Introduce self-triage in all open access clinics
l Provide integrated services for STI screening, diagnosis and treatment with services for contraception and reproductive health and provide targeted sexual health promotion and partner notification
l Provide targeted outreach for vulnerable people
l Develop a single Chlamydia Screening Programme across Hampshire, Portsmouth and Southampton and improve the uptake of Chlamydia screening for 15-24 year olds in all sexual health and community settings
l Provide evidence based behaviour change interventions tailored to meet the specific needs of target groups/individuals
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2. Delivering care pathways that are integrated with local authorities, primary care and other providers
l Improve access to contraception services (including long acting reversible contraception), including for young people, across a broader range of settings
l Contraception to be available as part of all STI and termination of pregnancy care pathways
l Provide targeted outreach to all under 19s following termination of pregnancy
l Develop user-focused services, referral pathways and networks between health and local authorities and specialist HIV voluntary sector and social care services
l Maximize existing workforce skills and expertise by achieving 90% dual trained nurses within three years
l Reduce service duplication with other providers and focus on provision of level 3 services
l Provide training to level 1 and 2 providers
3. Ensuring sustainability of services through clinical and business excellence
l Reduce admissions to acute care by providing specialist HIV care in the community through HIV specialist nurse outreach and direct access to specialist HIV clinicians
l Improve access to high quality services within local areas through a network of hub and spoke venues, other appropriate community venues and outreach services with six days a week access.
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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
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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 and 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 require substantial development. 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 The procurement of 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 and 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
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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 Adult Services this means:
l Complete the virtual wards, case management and early supportive discharge offer to significantly impact on admissions and discharges
l Move the management of long term conditions out of acute trusts; focus on falls, pulmonary, cardiac, diabetes, specialist palliative care and dementia
l Develop a major focus on neurological rehabilitation services including post trauma rehabilitation
l Look at opportunities to support the military including veteran health
l Provide more services integrated with social care
l Ensure specialist services are retained under Any Qualified Provider
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For Adult Mental Health and Substance Misuse Services this means:
l Becoming the main provider in Southampton
l Expanding services into Dorset and West Sussex
l Selling capacity outside the geographical area
For Child and Family 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
For Sexual Health Services this means:
l Ensuring effective delivery of services in Hampshire
l Looking for further expansion – possibly into Dorset
If you would like more information please contact Sarah Austin, Director of Strategy on 023 8060 8919 or via email [email protected]
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