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Trust undertakes a range of initiatives to promote a culture change for enhancing patient care, improving staff engagement, thereby motivating them to deliver better care

CATEGORY:
HSJ Awards 2018/ Trust of The Year
AWARD:
Winner

Challenge

    • Create a culture change and enhance staff engagement to deliver better patient care

Action

    • Established in partnership a Sexual Assault Referral Centre for young victims
    • Established the 3Sixty Care Partnership, introducing clinical pharmacists and facilitating same day access to paediatric nurses
    • Introduced Freedom to Speak Up programme and Leadership Matters training programme
    • Developed Moving Ahead project to remove health inequalities in black minority ethnic communities
    • Redesigned the mental health crisis pathway, reducing acute admissions

Result

    • Improved staff engagement score from 3.85 to 3.91
    • Increased recommendation as a place to work from 57% in Q3 2016 to 73% in Q4 2017
    • Received 25,089 reviews through iWantGreatCare feedback system in 2017/18
    • Resulted in 93.89% users recommending services to friends and family
    • Saved £800,000 in acute admissions and achieved green award for reducing carbon emissions by 24%

Outline:

We are a Provider Trust who want to support change and growth locally and on a national scale.

After narrowly missing out on HSJ NHS Provider Trust of the year 2017, we are rising to our challenges and achieving our goals of;

• Demonstrably changing cultures to influence care

• Delivering practical, future focused innovations that are change lives

• Being financially robust in a challenged climate

• Delivering our targets for partnership working Highlights and outcomes: (see PDF) • Significant gains in staff engagement and #1 Trust of our type for staff recommendation as a place to work

• Reported growth in recognition and engagement with our mission, vision, values and behaviours through our 54321 roadmap campaign

• Chief Executive, who has now taken the lead for the local STP, placed in HSJ Top 15 CE’s.

• Contributing to reduction in acute admissions through our partnership focused mental health crisis pathway redesign

• Opening a new rTMS facility for treatment resistant depression

• National focus for our innovation with Body Worn Cameras from media, RCN and NHS England

• Achieved our financial targets

• Taking a key leadership roles in the local STP

• Achieved Diversity and Inclusion partner status with NHS Employers

Ambition:

Our goals are embodied in our strategy DIGBQ we have addressed our challenges through robustly focusing on:

Developing in Partnership: We committed to pushing ahead to ensure we deliver new models of care and overcome partnership challenges. At a resourcing risk to our Trust, we supported our Chief Executive taking leadership of Northamptonshire STP.

Innovation: We set goals to change pathways of care through enabling innovation and improving efficiency, united by a focus on engagement in research.

Growing our staff capability Raising staff engagement to improve our patient outcomes remains a priority. In October staff and stakeholders joined us to refresh our strategy at 5 countywide events. Leaders of best practice, including Professor Michael West (Kings Fund) joined us to expand our collective thinking and unite our focus.

Building a sustainable organisation We were clear we wanted to maintain financial stability in a difficult local landscape which includes the nationally observed financial challenges of Northamptonshire County Council. Our momentum is strong in this area.

Quality and safety Our continued goal is to enhance quality care and patient experience by listening to and acting on feedback and further strengthen our diversity focus in 2018 to reduce health inequalities.

Outcome:

Key highlights:

D

• Collaborated with partners to deliver a new Sexual Assault Referral Centre for young victims

• Put clinical pharmacists and same day access to paediatric nurses into general practice.

• Strengthened our diversity focus, making strong links with national leaders. Now one of 40 NHS Diversity and Inclusion partners with NHS Employers. (See PDF).

I

• National firsts - new facility for the use of cutting edge rTMS treatment, increasing capacity to treat private and NHS patients

G

• Despite a highly pressurised climate for staff, our overall engagement score increased from 3.85 to 3.91 out of 5.

• Recommendation as a place to work increased from 57% in Q3 2016 to 73% in Q4 2017 – achieving the top score nationally for Trusts of our type.

B

• We not only met our financial targets but exceeded our control total.

• Reduced agency costs and increased permanent staff.

• Received all our core Sustainability and Transformation Fund (STF) funding and became eligible to receive Incentive and Bonus STF funding.

Q

• Received 25,089 reviews in 2017/18 through our feedback system iWantGreatCare. 93.89% would recommend our services to friends and family, and we were rated of 4.81 out of 5 for overall experience.

Spread:

Significant evidence of the spread of our work through 2017/18 includes: (see PDF)

• Our Chief Executive now a board member of NHS Providers

• Redesign of the mental health crisis pathway with service users, local authorities and third sector, now being used as a case study by NHS England

• Empowered our principle of distributed leadership through involving key thought leaders in our leadership matters staff and stakeholder conferences.

• Our crisis house delivered £800,000 savings in acute admissions, model is now being scaled to include a second house for the county

• Shortlisted for CIPD award for our Leadership Matters and behaviours programme distributed leadership

• Findings of our trial of body worn cameras on mental health wards shared with NHS England, received national focus, the subject of RCN annual congress and shortlisted for a Patient Safety award

• Development of strong relationships with the NHS England WRES team, working closely with Yvonne Coghill to share best practice.

• Shortlisted for a Global Equality and Inclusion award for our work to remove health inequalities in the BME community

Value:

• Achieved financial control total with surplus, secured STP funding and bonus funding

• Secured new custody healthcare contracts 2018-2023

• Met our regulatory requirements under NHSI’s Risk Assessment Framework and Single Oversight Framework

• Exceeded planned score of 2 against NHS Improvement’s ‘Use of Resources’ metrics achieving a rating of ‘1’ by year end

• Reduction in agency costs and increase in recruitment of permanent staff bringing our vacancy rate to under 10%

• Further developed partnerships to improve value, learning, population health and integrated care provision:

• Our partnership with 27 GP surgeries, the 3Sixty Care Partnership, saw the introduction of pharmacists and same day access to paediatric nurses. Further work being progressed to bring same day access to Physiotherapy at GP surgeries

• Provided a new sexual assault referral centre for young victims in partnership with Nottingham University Hospitals Trust, Northamptonshire police and Police and Crime Commissioner

• Green award – reducing our carbon emissions by 24% 2017/18

Involvement:

Our co-production focus is at the core of all we do. Our involvees are our equal partners and co-creators.

Activities this year included:

• Staff working group submitted and achieved award of the Workplace wellbeing charter.

• Strengthening partnership working with trade unions

• Freedom to Speak Up programme and introduction of local FTSU champions

• Nationally recognised Leadership Matters training programme

• Shaping Our Future Together events to co-produce Trust strategy 2018-2023

• Achieved wave 2 funding for our vital perinatal mental health services, working closely with CCG and patients to shape our submission.

• Involvement strategy developed using all feedback mechanisms.

• Co-produced redesign of Mental Health Crisis pathway with patients, carers, local authorities and Mind improving outcomes

• New Recovery College supporting individuals with experience of mental health difficulties to become experts in their own self-care. Courses co-produced and co- delivered by people with lived experience of mental health difficulties

• Patient involvement groups developed in community bed unit. Model will be rolled out across the other services in 2018/19

• Moving Ahead project to remove health inequalities in BME communities -community engagement programme with Northamptonshire Carers, Total Voice and Mind

• Sharing of best practice with National bodies - NHSE case studies: Crisis House and Individual Placement Support