SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST EXECUTIVE SUMMARY BOARD OF DIRECTORS 30 OCTOBER 2018

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1 SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST EXECUTIVE SUMMARY C BOARD OF DIRECTORS 30 OCTOBER 2018 Subject: Supprting TEG Member: Authrs: Status /19 Crprate Objectives 6 mnth Prgress Reprt Anne Gibbs, Directr f Strategy and Planning Paul Buckley, Deputy Directr f Strategy and Planning Paulette Afflick-Andersn, Strategy and Planning Manager A PURPOSE OF THE REPORT: T present the 6 mnth prgress reprt n the delivery f the Trust s crprate bjectives. KEY POINTS: Intrductin A set f crprate bjectives that mnitr the annual delivery f the Trust s strategic pririties were agreed in May The bjectives are directly linked t the Trust s Operatinal Plan 2018/19 and the strategic pririties within the Trust s Crprate Strategy Making a Difference and supprting strategies. A 6 mnth red, amber, green (RAG) prgress reprt against the delivery f the crprate bjectives is set ut in Appendix 1. Exceptin Reprt The fllwing bjectives are currently rated as Red: T meet the requirements f the Single Oversight Framewrk (SOF) Achieve all relevant quality and perfrmance metrics The Trust is nt meeting all the SOF metrics with pressures remaining in key target areas. These include the Cancer 62 day target, A&E perfrmance and a number f the finance metrics. Recvery plans are in place fr these metrics and are reviewed n a mnthly basis by the Trust Executive Grup (TEG) and the Bard f Directrs thrugh the Integrated Perfrmance Reprt. Directrates wh are nt delivering against the relevant SOF metrics cntinue t be perfrmance managed by the members f TEG as part f the Trust s Perfrmance Management Framewrk. Risks t these plans include lack f successful recruitment and the necessary increased capacity required t meet demand. Ensure all Clinical and Crprate Directrates deliver their agreed financial plans Financial plans delivered At Mnth 5 (M5), nly 15 ut f 38 Directrates were perfrming better than their 2018/19 Year T Date (YTD) Financial Plan prfile. In aggregate the Directrates psitin was almst 3.0m wrse than the YTD Financial plan (in 2017/18 at M5 this underperfrmance was 4.9m). The aggregate underperfrmance against YTD Efficiency plans was 1.7m (19.9%). Prductivity and Efficiency plans achieved At this stage there is a significant risk that in aggregate Directrates will underperfrm against their Efficiency and Financial Plans at utturn. 1

2 The fllwing bjectives are currently rated as Amber: T prgress all the quality reprt bjectives fr 2018/19 Ensure the 13 imprvement gals cvering patient safety, patient experience and effectiveness are achieved within the agreed timescales Of the 13 bjectives fr 2018/19 six were running t time at the end f quarter ne. Of the seven which were f cncern, five are nw back n track and prgressing t time. The remaining tw (Sepsis and Falls) are mnitred by the Trusts Quality Bard, with the next update n prgress due at the Nvember meeting. T prgress the changes required fr delivering seven day services Maintain the achievement f the fur required clinical standards Significant inrads have been made with regards t this. In the Spring Survey 2018, the Trust achieved green acrss all 4 clinical standards. T nte: The Clinical Standard 2 (Patient receiving a senir review in the first 14 hurs f admissin) had imprved frm 40% t 81% making it just belw the 90% threshld and s has been categrised as light green. Taking this int accunt, the number f standards met by the Trust was 3 ut f 4 fr cmpliance. Further wrk t imprve this invlves admitting directrates identifying and describing pathways that are safe and d nt clinically indicate the need fr a senir review. Once categrised, these pathways can be excluded and numbers will imprve even further. Wrk is n-ging with regards t discussing further with NHS England and making this peratinal via Clinical Effectiveness. Prgress acrss all ther clinical standards With regards t the balance f the clinical standards, actins against these depend upn natinal pririties. Wrk with ur system partners t ensure that all patients are discharged frm hspital in a safe and effective manner Reducing number f patients within the Trust that are medically fit fr discharge included thse described as stranded and super stranded The Why Nt Hme, Why Nt Tday Bard has been established acrss the city and is starting t make gd prgress. Unfrtunately, due t capacity cnstraints n the Hme t Assess pathway (due t capacity cnstraints in STIT), reprtable delays cntinue t remain abve the natinal 3.5% target. T develp the use f Mdel Hspital thrughut the Trust and incrprate int the Trust s Perfrmance Management Framewrk (PMF) Utilisatin f Mdel Hspital data in Bard Cmmittees The Trust des nt have rutine use f Mdel Hspital in each relevant Bard cmmittee paper. Next steps will be cnsidered int hw t incrprate this int Bard cmmittee reprting. T deliver the key pririties as set ut in the 5 year capital plan Cmpletin f must d IT schemes There is gd prgress being made against the prtfli as a whle. The majr delivery schemes Renal Infrmatin System, E-Prescribing, STH Telephny are n track as are the IT Infrastructure remediatin prgramme and related infrastructure schemes. There are sme specific challenges resulting in delays being experienced with NHSmail, which is largely deferred int 2019/20. 2

3 The utlk fr PACS remains challenging with elements f the cntract remaining t be implemented. There als remains a significant challenge with delivery f Digital Dictatin due t late signature f the cntract. Prgress apprved Westn Park Hspital (WPH) refurbishment schemes and apprval f the Full Business Case fr the verall scheme The Trust is prgressing a range f schemes t develp WPH. These include a linked walkway between WPH and RHH; a develpment f an interim utpatients department in a cnverted facility n the 4th flr f WPH; the refurbishment wrks t the brachytherapy suite; and the upgrade f the pharmacy aseptic unit. The Trust is awaiting feedback frm the submissin via the sics t the Department f Health n the prpsal t develp a new utpatient department. Wrk n the Full Business Case is nging and will be cmpleted nce a decisin has been reached by the Department f Health. Hyper Acute Strke Unit develpment Design and planning wrk is in prgress fr an interim slutin t develp H and N flr at the Ryal Hallamshire Hspital. Wrks are scheduled t start in Nvember 2018 and be cmpleted fr the end f the financial year. Subject t the full business case apprval, the wrk t create the permanent HASU n L flr t facilitate the recnfiguratin f services acrss Suth Yrkshire is scheduled t start in April Nrthern General Hspital Radilgy department refurbishment An utline business case was presented t the Capital Investment Team in September This was apprved t cmmence the detailed design and planning stage t infrm a full business case. The prpsed scheme has fur phases, which aim t cmmence at the end f and cmplete in July T ensure access t the available Prvider Sustainability Funding T meet the financial cntrl ttal as agreed with NHS Imprvement The frecast t NHS Imprvement (NHSI) remains that the Trust will meet its Financial Cntrl Ttal. Hwever the Trust 2018/19 Financial Plan is set at 4.2m belw it Cntrl Ttal and the Trust has failed t deliver against the A&E PSF target fr Q1 and Q2. The Trust must therefre exceed it Financial Plan by at least 4.2m.The current apprach is t: Minimise the adverse directrate psitin against the Financial Plan Accumulate sufficient cntingencies t ffset the directrate psitin and deliver the financial plan r better. Maximise ne-ff gains and cntingencies sufficient t bridge the gap between the Financial Plan and the Cntrl Ttal The current frecast is t achieve this, althugh there are cnsiderable risks t manage which include: Delivery f Activity/Efficiency/Financial Plans Cntract Issues, e.g. QIPP, receipt f Winter Funding, CQUIN, etc. Service, Wrkfrce and Financial (including pay awards) Pressures. Receipt f Prvider Sustainability Funding. Cntinue t drive efficiency and sustainability prgramme thrugh the Making it Better prgramme All wrkstreams t deliver against agreed plans The aggregate underperfrmance against YTD Efficiency plans at M5 was 1.7m (19.9%). The frecast utturn underperfrmance is 8.5%. At this stage sme f the wrk streams are under-delivering in terms f bth YTD and frecast utturn. 3

4 T prgress the implicatin f the Bimedical Research Centre Bid in partnership with the University f Sheffield MRI PET facility cmpleted and peratinal The riginal prject timeline was delayed due t the cmplexity f the design and planning stage. A final decisin t prceed with the wrks was agreed by the University f Sheffield at the end f September The Trust is nw finalising the cntractual arrangement with the University f Sheffield. The revised start n site fr the cntractr is Nvember 2018 and n this basis the facility will becme peratinal in February Crprate Objective Changes There is a prpsed change t tw crprate bjectives as currently written. Strategic Aim 5 Deliver excellent research, educatin and innvatin Establish the new Clinical Research and Innvatin Office (CRIO) Revisin t the descriptin f the bjective relating t the review f the Trust s research infrastructure adjusting this t undertake rather than cmplete the review f the Trust s research infrastructure and adjusting the deadline frm December 2018 t. Cntinue t imprve the vlume f patients recruited t NIHR research studies Change t the descriptin t better reflect the true bjective, adjusting this t - maintain vlume f patients recruited t NIHR research studies. T maintain the psitin f ne f NIHR YH CRN s tp 10 NHS rganisatins fr recruitment vlumes. Next Steps A final review f the prgress against the delivery f the crprate bjectives will be presented t the TEG and the Bard in April During this final review prcess, a new set f crprate bjectives will be develped fr 2019/20 fr cnsideratin and apprval. As part f this prcess crprate bjectives will be mre clsely aligned t the Bard s Assurance Framewrk. IMPLICATIONS 2 : AIM OF THE STHFT CORPORATE STRATEGY TICK AS APPROPRIATE 1 Deliver the Best Clinical Outcmes 2 Prvide Patient Centred Services 3 Emply Caring and Cared fr Staff 4 Spend Public Mney Wisely 5 Deliver Excellent Research, Educatin & Innvatin RECOMMENDATION(S): The Bard is asked t: a) Apprve the prgress made in delivering the crprate bjectives fr 2018/19. APPROVAL PROCESS: Meeting Date Apprved Y/N Trust Executive Grup 17 Octber 2018 Y Bard f Directrs 30 Octber

5 APPENDIX 1-CORPORATE OBJECTIVES 2018/19 Crprate Objective Executive Lead(s) Actins / Measure(s) f Success Timescale 6-mnth RAG Prgress Strategic Aim - 1 Deliver the best clinical utcmes Wrk with the Cancer Alliance and imprve early diagnsis, develp service pathways and imprve utcmes fr cancer patients T prgress all the quality reprt bjectives fr 2018/19 T imprve ur apprach t investigatins, learning frm incidents, deaths and reducing verall harm Directr f Strategy & Planning Meet the requirements within Achieving Wrld Class Cancer Outcmes Imprve cmpliance with cancer waiting time targets in partnership with the Cancer Alliance. Implementatin rapid assessment and diagnstic pathways fr lung, prstate and clrectal cancers, Develp the 28 day Faster Diagnsis Standard fr implementatin in April Supprt the rllut f Faecal Immunchemical Test (FIT) All breast, prstate and clrectal cancer patients shuld have access t stratified fllw up pathways f care. Medical Directr / Ensure the 13 imprvement gals cvering patient Chief Nurse safety, patient experience and effectiveness are achieved within the agreed timescales Medical Directr Imprve the turnarund time fr respnding t incidents Minimise the risk f Never Events Reduce avidable harm frm falls and pressure ulcers Implementatin f e-prescribing t all clinical areas December 2018 T respnd t the Care Quality Cmmissin (CQC) and NHS Imprvement (NHSI) reviews f Trust services Trust Executive Grup Maintain areas rated as Outstanding and identify areas needing develpment t achieve Outstanding, acrss all ther dmains Develp an actin plan setting ut all must d actins, all shuld d actins and actin where agreed. 5

6 Crprate Objective Executive Lead(s) Measure(s) f Success Timescale 6-mnth RAG Prgress Strategic Aim - 2 Prvide patient centred services T ensure patients are satisfied with the services they receive in key areas acrss the Trust and are invlved in decisin making T prgress the changes required fr delivering seven day services Wrk with ur system partners t ensure all patients are discharged frm hspital in a safe and effective manner T develp the use f Mdel Hspital thrughut the Trust and incrprate int the Trust s Perfrmance Management Framewrk T actively participate in, and lead where apprpriate, the system wide develpments required within the Accuntable Care Partnership (ACP) and prpsed Integrated Care System T meet the requirements f the Single Oversight Framewrk Chief Nurse T remain abve the natinal average and peers fr patient satisfactin measures Increased scale f patient engagement and demnstrable patient invlvement in decisin making prcesses Medical Directr Maintain the achievement f the fur required clinical standards Officer Officer Chief Executive / Medical Directr / Officer / Directr f Strategy and Planning Officer Prgress acrss all ther clinical standards Reducing number f patients within the Trust that are medically fit fr discharge included thse described as stranded and super stranded Implement the actins utlined within the Lcal System Review Revised Integrated Perfrmance Reprt fr Bard and Directrate Dashbards Utilisatin f Mdel Hspital data in Bard Cmmittees Implementatin f the new gvernance arrangements underpinning the new system wide wrking Demnstrable prgress within each f the ACP wrk prgrammes Demnstrable engagement in the Integrated Care System wrk prgrammes Actin plan in place and prgress made with the utcme f the Sustainable Hspital Services Review Achieve all relevant quality and perfrmance metrics Ensure mnitring against segment 1 r 2 September 2018 Octber 2018 Octber

7 Crprate Objective Executive Lead(s) Measure(s) f Success Timescale 6-mnth RAG Prgress Strategic Aim - 3 Emply caring and cared fr staff T implement the Trust s Peple Strategy Directr f Human Resurces & Staff Develpment / Chief Operating Officer Peple Strategy frmally launched including a mnitring dashbard Prgress made in meeting the Wrkfrce Race Equality Standards and Wrkfrce Disability Standards September 2018 Imprved Friends and Family Test results in all Directrates T implement Key Perfrmance Indicatrs fr imprved rganisatinal HR perfrmance Directr f Human Resurces & Staff Develpment Reductin in Agency spend Staff retentin ver 80% Sickness absence imprvement Year n year imprvement in Staff Survey Results, T imprve recruitment and retentin f staff Medical Directr / Chief Nurse / Directr f Human Resurces & Staff Develpment Implementatin f targeted slutins by staff grup t reduce vacancy rates 7

8 Crprate Objective Executive Lead(s) Measure(s) f Success Timescale 6-mnth RAG Prgress Strategic Aim - 4 Spend public mney wisely Ensure all Clinical and Crprate Directrates deliver their agreed financial plans T deliver the key pririties as set ut in the 5 year capital plan T ensure access t the available Prvider Sustainability Funding Directr f Finance Financial plans delivered Directr f Finance / Directr f Strategy & Planning Directr f Finance / Officer Prductivity and Efficiency plans achieved Prgress A Flr and Nrthern General theatre refurbishment prgramme Prgress refurbishment f RHH main lifts Cmpletin f must d IT schemes Prgress apprved WPH refurbishment schemes and apprval f the Full Business Case fr the verall scheme Hyper Acute Strke Unit develpment Nrthern General Hspital Radilgy department refurbishment T meet the financial cntrl ttal as agreed with NHS Imprvement December 2018 Cntinue t drive efficiency and sustainability prgramme thrugh the Making it Better prgramme Directr f Finance All wrkstreams t deliver against agreed plans Systematic reviews are cmpleted within agreed timescales 8

9 Crprate Objective Executive Lead(s) Measure(s) f Success Timescale 6-mnth RAG Prgress Strategic Aim - 5 Deliver excellent research, educatin and innvatin Establish the new Clinical Research and Innvatin Office (CRIO) Medical Directr Develpment f the Clinical Research Patient and Public Invlvement (PPI) Strategy Cmplete the review f the Trust s research infrastructure and implement revised gvernance arrangements Develpment f the Innvatin Strategy December 2018 T prgress the implementatin f the Bimedical Research Centre Bid in partnership with The University f Sheffield Cntinue t imprve vlume f patients recruited t NIHR research studies T actively participate in the Sheffield City Regin innvatins Medical Directr Medical Directr Chief Executive MRI-PET facility cmpleted and peratinal Prgress against each f the research themes T maintain the psitin f ne f NIHR s tp 10 NHS rganisatins fr recruitment vlumes Increased invlvement f patients in all parts f the research prcess and f individuals that are harder t reach Implement a plan fr maximising the pprtunities arising within the Life Sciences Industrial Strategy Octber