Our five year strategy 2020 - 2025
We have published a bold and ambitious strategy for the five years covering 2020-2025. You can read the full document here: Trust five year strategy - 2020-2025 [pdf] 3MB, or watch our short animation:
This builds on our previous strategy, which set a clear vision for us and was ambitious about improving the care we provide. We achieved a great deal in 2015–2020, including maintaining major acute services across two sites, investing £100 million in our infrastructure and integrating our services via place-based health and care services. We enhanced and refreshed our values, including putting more emphasis on Respect as our singular value.
In 2019, we achieved a CQC rating of ‘Good’ and secured further investment of £511 million for a new specialist emergency care hospital. This created the platform for the next stage of our development – described in this strategy. In the next period, we need to address our significant challenges, including clinical sustainability across two sites, workforce shortages and an outdated estate, delivering new facilities and services, and continuing our development of integrated care through community services and with primary care in Sutton and in Surrey Downs.
From early 2020, we have had to quickly adapt as we have managed the challenge of COVID-19. Through this crisis, we have learned a lot about the resilience and commitment of our people but also about the need for flexibility and adaptability in the future. We have reflected this throughout our strategy, including our plans for moving towards recovery, alongside potential further waves or spikes, as well as our ability to handle future pandemics.
This strategy sets the broad direction of travel over the next five years from the perspective of events that have unfolded to date. We may need to refine it and respond dynamically in light of future developments, as our amazing staff have done over the past year. This will include managing the impact that the initial period of COVID-19 has had on those who will have long-term consequences from the virus; those who may have become more frail as a result of having shielded or not accessed routine healthcare that they would have normally benefited from; either because of services having been temporarily diverted towards the immediate COVID-19 response; or, from people being too anxious to access care.
From 2020, our revised mission is to deliver ‘Outstanding care, every day’, building on the progress we have made over the past five years, and setting ourselves an aspiring goal. This puts those who access our services and what matters to them at the centre of what we do. We are committed to working in partnership to address health inequalities.
Commitments and catalysts
We have four commitments to support our mission over the next period:
- We will do all we can to support people to access appropriate care in an appropriate setting (including their own home) by maximizing our integration through community services and with primary care, and developing the district hospital model as set out in Improving Healthcare Together for patients not needing the most acute care but not yet able to return home.
- When people need the most acute care, continue the current major acute services (i.e. emergency departments, acute medical units, critical care, obstetrics and inpatient paediatrics) at both Epsom and St Helier sites until the specialist emergency care hospital is open.
- Implement our commissioners’ decision for consolidating major acute services in a single specialist emergency care hospital at Sutton Hospital.
- Deepen our acute collaboration in South West London, particularly with St George’s University Hospitals NHS Foundation Trust.
In support of all of this, are a range of catalysts which are essential to delivery, including:
- Partnerships – working more closely across the two systems we operate within in south west London and Surrey Heartlands.
- Finance – managing the finances as best we can until we address structural factors.
- Estates – investing in our buildings and supporting Improving Healthcare Together.
- Digital – implementing a new electronic patient record and investing in digital services.
- Environmental sustainability – reducing our impact on the environment.
- Education, research and innovation – being a leading education and research partner.
Our five year strategy 2015 - 2020
Building on our strengths, both Epsom and St Helier hospitals will continue to provide consultant-led, 24/7 A&E, maternity and inpatient paediatric services. In addition, St Helier will provide specialist and emergency care, such as acute surgery, for our most sick patients and Epsom will expand itsrange of planned care. We will work with GPs to provide significantly more care in community settings so that people only come to hospital when it is absolutely necessary.
Our people are central to delivering our mission. Along with greatly improving substantive staffing levels we will seek to engage, empower, develop and equip our teams to perform to their full potential, with clear responsibility and accountability. We will establish an organisational culture that reflects our values and behaviours. We will help and reward all staff who actively wish to come on the change journey with us, supporting them in their education and continuing professional development. We aspire to be a high quality organisation where we are both an 'employer of choice' and a 'provider of choice'.
We will refresh and embed our values to create a ‘one team, one trust’ culture and focus on the delivery of the following five objectives to ensure we provide high quality, compassionate care to all our patients:
Delivering safe and effective care with respect and dignity
Creating a positive experience that meets the expectations of our patients, their families and carers
Providing responsive care that delivers the right treatment, in the right place at the right time
Being financially sustainable
Working in partnership with our patients, commissioners, other health and care providers, local authorities, the voluntary sector, the NHS TDA, NHS England and Monitor in the interests of our patients and a sustainable local health and social care economy.
Our values and these five objectives will be cascaded throughout the organisation and will form the basis for setting objectives for each director, directorate, service and member of staff. We will refine a set of metrics to evaluate our delivery against each objective, which will be consistently measured at service, directorate and trust levels. This will determine the greatest risks to their delivery, which, in turn, will form the basis for our Board Assurance Framework. We will work systematically to mitigate these risks and this will drive the operational focus for the organisation.
The principal challenges that we face in order to deliver our vision are:
The need to strengthen staffing in key service areas - we will tackle this through a proactive and creative recruitment strategy, by valuing our staff and improving their working lives, and through role and service redesign.
Variability in the delivery of clinical care, which increases risk and potential harm for our patients. We will work together to instil the culture of ‘one team, one trust’ and work to consistent, evidence-based operating practices across all our services and sites.
Poor estates - the quality of the St Helier estate, in particular, is unacceptable. We will tackle this by agreeing a five-year investment plan for our estate at both sites and developing a long term plan to deliver first class facilities for our patients as part of the on-going work across SW London.
Finance – in order to develop new models of care, invest in quality and innovation, and tackle our poor estate, we will need to create a recurrent surplus each year. This requires us to become more efficient, remove unnecessary duplication and reduce our overhead costs.
Corporate objectives – 2015-2016
Objective 1: Delivering safe and effective care
1. Hospital Standardised Mortality Ratio (HSMR) – maintain an HSMR within the top quartile for acute trusts throughout 2015/16.
2. Ensure adherence to best practice standards to reduce incidents of avoidable harm, in particular infection prevention and control, pressure ulcers, falls and venous thromboembolism (VTE) assessments.
3. Achieving an overall good or outstanding rating in the Care Quality Commission (CQC) Chief Inspector of Hospitals’ inspection which is anticipated during 2015/16.
4. Increase our substantively employed clinical workforce by 200+ whole time equivalents (WTEs) by end 2015/16 compared to 2014/15 outturn with a corresponding reduction in agency spend.
5. Achieving 95%+ staff having had an appraisal and completed their statutory and mandatory training.
6. Invest £2.5m to improve the quality of care by increasing access to consultant delivered care and increasing the range of services available overnight and at weekends to reduce variability of care.
7. Identify, plan and execute necessary steps to maintain key services (including maternity, children’s services and accident and emergency) at both sites that are affordable and meet required quality standards.
8. Enhance leadership within the trust, in particular by progressing board development, appointing Associate Medical Directors to lead on Education, Research Development and Innovation and Quality, and developing clinical leaders in the directorates.
9. Develop and implement a ‘one team, one trust’ programme to deliver internal (cross site) and external integration and support the on-going transformation of our services in line with best practice.
Objective 2: Creating a positive patient experience
10. ‘Patient first’ is established as our primary patient experience improvement initiative across the trust with 50% of staff having completed the programme by the end of 2015/16. Evidence continuous change and improvement as a result of the programme.
11. Make a demonstrable impact on improving our existing estate, through investing at least £9m in estates and facilities and reducing the critical backlog maintenance by 25%.
12. Complaints and Serious Incidents (SIs) – have put in place a new complaints and SI policy and responded to 90% of complaints within the time agreed with the complainant. We will maintain a low number of complaints that are referred to the Ombudsman.
13. Improve engagement with patients over their experience by strengthening patient feedback mechanisms and increase our patient Friends and Family Test (FFT) response rate in line with national guidance and best practice.
14. Improve staff engagement and motivation, which will be demonstrated by having at least 50% of our staff survey responses rated above average.
15. Develop a long term estate plan (beyond five years) to deliver first class facilities for our patients.
Objective 3: Providing responsive care
16. Successfully deliver and maintain key operational performance standards, in particular for Accident and Emergency (A&E), Cancer, and Referral to Treatment (RTT).
17. Commissioning for Quality and Innovation (CQUINs) – achieve 90%+ of patient-focused CQUINs that we agree with our commissioners.
18. Improve accessibility and integration of services with a focus in 2015/16 on cardiology, embryology and community services.
19. Increase access and choice for those who wish to use private patient services by further developing Northey Suite.
Objective 4 : Being financially sustainable
20. Deliver our agreed 2015/16 financial plan to make a small surplus including delivery of our Quality Assured Cost Improvement Plan (QCIP) commitments.
Objective 5 : Working in partnerships
21. Working with the Sutton, Merton and Surrey Downs clinical commissioning groups (CCGs) and other stakeholders to support the delivery of the Better Care Fund and other key programmes they have for improving care for their patients.
22. Actively participating in the south west London acute provider collaboration and agreeing a series of actions that improve integration of care across south west London.
23. Being a leading partner in a new joint venture with the other care providers working in the Epsom area to deliver a new model of care for older people.
24. Further developing the South West London Elective Orthopaedic Centre (SWLEOC) services to agree a new partnership agreement and develop a 3-year strategy to expand the service.
25. Further develop our renal services to agree a 5-year strategy for the development of renal services across south west London and Surrey.
Our corporate objectives
- Delivering safe and effective care with respect and dignity
- Creating a positive experience that meets the expectations of our patients, their families and carers
- Providing responsive care that delivers the right treatment, in the right place at the right time
- Being financially sustainable
- Working in partnership
- Ensuring we have highly engaged, patient centred and skilled teams that are well-led.