DGT Strategy 2020 - 2025
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Dartford and Gravesham NHS Trust
Providing outstanding care which is skilled, trusted and kind, every time. Dartford and GraveshamNHS Trust Strategy 2020-2025
Introduction from the Chairman and Chief Executive Officer
Peter Coles Trust Chair
Louise Ashley Chief Executive
It brings us great joy to set the strategic direction for Dartford and Gravesham NHS Trust over the next five years. Despite the challenging global and national context, we have real hope and a strong ambition for providing outstanding care for our patients, and population, as well as an outstanding experience for our colleagues. Our 2014-2019 Trust Strategy served the organisation well for the past five years and so very much has been achieved that stands us in good stead for continuing our journey to outstanding. We have improved patient outcomes, efficiency and productivity of our services as well as the range of local specialist services we provide by working with partners across the NHS, particularly Guy’s and St. Thomas’ NHS Foundation Trust through the GSTT Healthcare Alliance. The latest specialist service that we are excited to be developing is our stroke service which will provide expert care for local stroke patients. The strategy for the next five years is focused on becoming a learning organisation with continuous improvement at the heart of its culture. We will continuously improve the: • quality of care we provide, improving from a ‘Good’ Care Quality Commission rating to ‘Outstanding’; • engagement, sense of belonging and fulfilment of our talented teams; • management of our finances and how we use our estate; • early adoption and roll out of emerging technologies that support new ways of working and give patients greater ability to manage their health; and, • ways we collaborate with our system partners. At Dartford and Gravesham Trust, we have a highly committed, skilled and diverse workforce that provides care and services of a very high quality. This is maintained through our values based interview process, making sure that we are all committed to the same behaviours and expectations.
However, as many others do across the NHS, we struggle to recruit and retain colleagues. This strategy is focused on improving the experience, wellbeing and engagement of all our colleagues to ensure that they feel valued and that they belong, and actively participate in the decision making at the Dartford and Gravesham Trust. To achieve this we are introducing new ways of working to create a culture of continuous improvement enabled by engagement with our patients, carers and our colleagues. For example, we will be introducing Quality Councils within each division to hear from our frontline colleagues. The Council will choose a specific continuous quality improvement issue to work on together with support from senior management. Evidence suggests that this improves colleagues’ ability to have a strong voice and be involved in delivering the changes they want to see. Webelieve that empoweringour colleagues, valuing diversity and promoting equality and inclusion will improve the overall safety and effectiveness of our services and the experience our patients have. To find out more about this and other initiatives to improve the engagement and wellbeing of our colleagues and our approach to continuous improvement, please read our People and Quality strategies. Our context continues to be one of population growth, an aging population and an increase in long term conditions. We will be workingwith our system partners to tackle health inequalities, provide the right care in the right place and proactively support our population in the management of their health. Unfortunately, globally we are also facing an unprecedented infection risk with Covid-19. Whilst we have updated the strategy to factor Covid-19 in, it may impact the implementation. We are excited to be continuing our journey to “Outstanding” through this strategy and look forward to delivering it with our partners and monitoring its delivery over the next five years.
Contents
Introduction from the Chairman and Chief Executive Officer
2
Our vision, values and strategic priorities
4
About the Trust
5-6
Our strategic objectives, outcomes and measures
7
Journey to Outstanding
8
Joy at Work
9
Working smartly within our means
10
Digital First
11
Working Together
12
Continuous quality improvement
13
Our next steps
15
Providing outstanding care which is skilled, trusted and kind, every time.
Our vision
Which we will deliver through...
Our strategic priorities
Journey to outstanding Ensuring patients receive outstanding clinical care, are kept free from harm and are treated with thoughtfulness, skill and respect.
Joy at work Supporting colleagues to be healthy, happy and heard, with a sense of belonging and fulfilment.
Digital first Driving safe, connected and efficient digital innovation to improve care for our patients.
Working together Purposefully collaborating with our partners and communities to make sure the way care is delivered feels joined up and meets the needs of our citizens.
Working smartly within our means Making sure that we do the best for our patients by achieving all of our targets and making the best use of the funding we receive.
Continuous quality improvement To be a learning and
improving culture, using continuous improvement to discover, create and innovate.
Our values
4
Trust Strategy Summary
About the Trust
We are proud to provide excellent local services to people in North Kent and South East London. Geographically located in the north of Kent, Dartford and Gravesham NHS Trust provides services in Gravesham Community Hospital in Gravesend as well as a number of community locations across our population. The Trust offers a comprehensive range of acute services, with a bed-base of c500, to around 400,000 people in North Kent and South East London. Darent Valley Hospital has inpatient beds and specialities that include day-care surgery, general surgery, trauma and orthopaedics, cardiology, maternity and general medicine. Since October 2013, the Trust has provided a number of services at Queen Mary’s Hospital, Sidcup, and Radiology at Erith and District Hospital. The services provided by the Trust at Queen Mary’s Hospital (QMH) include elective inpatient and day surgery and outpatient services in general surgery, urology, orthopaedics, gynaecology, medicine and paediatrics, in addition to diagnostics and therapies. We are in an area of exceptional growth with large housing developments underway and planned across the communities we serve. Our population is set to grow by 35,000 within 5 years and by 55,000 within 10 years. There are also plans to develop the biggest theme park in the UK nearby which will impact the transient population that we serve. Our 3,500 exceptionally talented and motivated staff are working to build a clinically-led organisation that provides outstanding care which is skilled, trusted and kind, every time. This is us.
Our Partnerships We directly serve the Dartford, Gravesham and Swanley communities and are part of a number of other local and regional relationships. We acknowledge that we are part of a larger healthcare economy with important responsibilities and opportunities for our role as a committed partner and collaborator in the system. Our strategy has been informed by the national and local context and the roles that we have. A joint collaboration between Dartford and Gravesham NHS Trust, Medway NHS Foundation Trust and the North Kent Pathology Service is the first joint pathology service in Kent and Medway. Elements of the service are centralised at Maidstone and Tunbridge Wells NHS Trust and we continue to work together on the provision of effective and efficient pathology services.
Dartford, Gravesham and Swanley predicted population growth
Bexley predicted population growth
Year
2025
24,000
10,000
2030
37,000
18,000
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Trust Strategy Summary
About the Trust
It is clear that we will need to do more to improve population health and tackle inequalities in the future. To do this, we will need to work with our partners across the Kent and Medway and South East London Integrated Care Systems and locally with the Dartford, Gravesham and Swanley Integrated Care Partnership. We will also need to work even more closely with our partners and networks, such as the GSTT Healthcare Alliance and the Kent and Medway Cancer Alliance to jointly develop improvements that benefit a wider range of patients and colleagues, as well as make the best use of NHS resources. Our charity, and fundraising partners, are also important to us, our patients, their families and carers. We will continue to work closely with the Valley Hospital Charity raising money for cutting-edge equipment, pioneering treatment and improving the working environment and wellbeing of our people.
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Trust Strategy Summary
Our strategic priorities
Six strategic priorites are outlined and these are underpinned and closely linked to our Quality, People, Clinical, Digital and Estates strategies. These strategies have been shaped by the impact of Covid-19 on the Dartford and Gravesham NHS Trust, and the national and local vision set out in the NHS Long Term Plan, NHS People Plan and Kent and Medway Integrated Care Strategy five year strategic delivery plan. The overall purpose of this strategy is to ensure that Dartford and Gravesham Trust is able to “provide outstanding care, which is skilled, trusted & kind, every time”. It provides us with a framework through which improvements in the services we offer to patients can be focused and measured for the planning, implementation, evaluation and reporting of our journey to achieving a CQC rating of “Outstanding”. Dartford and Gravesham NHS Trust’s vision and goals from 2020 to 2025. While the strategic priorites are short statements, they directly relate to more comprehensive objectives which then flow through to detailed activities and planning. Our strategic priorites are not just words but part of a larger strategic framework which will effect real change in our services. Our Trust strategy is the overarching organisational strategy that describes the
Journey to outstanding
Joy at Work
Digital first
Working together
Working smartly within our means
Continuous quality improvement
7
Trust Strategy Summary
Our strategic priorities
Journey to outstanding
Ensuring that patients receive outstanding clinical care, are kept free from harm and are treated with thoughtfulness, skill and respect.
Outcomes
Through working with our partners, patients will only access our hospital for acute care and we will support them back to their ‘best bed’, i.e. the one that they call “home”, as soon as possible.
Our patients will have confidence and trust in the effectiveness and safety of the care they receive in our hospital comparable to, or better than, any elsewhere.
The care and services we provide will be of the best possible quality, based in evidence and supported with appropriate resources.
Our patients will feel respected and will experience kindness and compassion, every time.
Measures of success
• Mortality rate at the national average • Year on year reduction of incidents that cause harm • Length of stay for elective and non- elective care at the national average
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Trust Strategy Summary
Our strategic priorities
Supporting colleagues to be happy, healthy and heard, with a sense of belonging and fulfillment. Joy at Work
Outcomes
Happy We will support and develop our staff, creating talented people for our organisation. Our colleagues will consistently report improved fulfilment at work, leading to local, regional and national recognition that the Dartford and Gravesham Trust is the best place to work.
Heard Our staff will work in an open and transparent culture in which they are treated with equality, dignity and respect. All staff are listened to through active involvement in decision making (shared governance).
Healthy We will provide holistic health and wellbeing support to all staff, to promote healthy living and provide emotional support during challenging times.
Measures of success
• Lower vacancy and turnover rates • Workforce demographics reflective of our local communities • Staff survey results confirm we support our staff to be happy, healthy and heard
9
Trust Strategy Summary
Our strategic priorities
Working smartly within our means
Making sure that we do the best for our patients by achieving all of our targets, and making the best use of available resources.
Outcomes
Deliver our agreed financial and operational trajectories through effective and efficient ways of working, including with our partners.
Eliminate unnecessary variation in our processes by putting in place standard operating models.
Ensure we have an evidence-based process for assessing value for money and sustainability.
Ensure we have effective financial reporting and the associated systems for understanding and improving performance.
Measures of success
• Sustained delivery of the financial plan • Year on year reduction in the number of services showing as outliers on Model Hospital • Collaborative work with partners to ensure the best use of resources
10
Trust Strategy Summary
Our strategic priorities
Digital first
Driving safe, connected and efficient digital innovation to improve care for our patients.
Outcomes
Efficient Improve efficiency for
Connected Digitally enabling patients and clinicians to better manage care.
Safe Clinical information can be safely and digitally accessible wherever needed.
colleagues, so they can focus on patients and increasing productivity, as a result of digital innovation.
Measures of success
• Robotic Process Automation (RPA) programme performance • An improvement in our Digital Maturity Index Score • Cyber Security Training uptake
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Trust Strategy Summary
Our strategic priorities
Working together
Purposefully collaborating with our partners and communities to make sure the way care is delivered feels joined up and meets the needs of our citizens.
Outcomes
Working with system partners, we will optimise service delivery to maximise the value of the NHS for the wider health economy.
We will contribute leadership to our local community and partnership and collaborate within the systems in which we operate. Dartford and Gravesham Trust is the best place to work.
Continuing to collaborate with GSTT Healthcare Alliance to share and adopt best practice.
Measures of success
• Develop and begin implementing our Anchor Organisation strategy • Evidence of working collaboratively with health and care partners to redesign pathways of care • Development of the Dartford, Gravesham and Swanley Integrated Care Partnership
12
Trust Strategy Summary
Our strategic priorities
Continuous quality improvement
To continue enhancing our learning and improving culture, using continuous improvement to discover, create and innovate.
Outcomes
A strong and positive culture of continuous improvement reported across the organisation.
Continuous improvement purposely linked with our strategic priorities.
Achieving CQC rating of Outstanding.
Measures of success
• Implementation of Divisional and themed Quality Councils • Implementation and number of colleagues trained in continuous quality improvement methodology • Year on year improvement in the number of colleagues confirming their ability to be involved in making improvements in their area
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Trust Strategy Summary
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Trust Strategy Summary
Our next steps
The development of this strategy follows many conversations with our colleagues, partners, volunteers, patients, families and their carers. The strategic priorities have been developed jointly withmembers of colleagues across the Trust fromour frontline clinical and non-clinical colleagues, to middle and senior management. This document is only the beginning of the development of the strategy. The actions we take every day will support us in achieving our six strategic priorities and achieving our Journey to Outstanding. The aims that we have set ourselves for the next five years are much more than just words to us. How will we launch our strategy and translate vision into action? • This strategy will be supported by a detailed implementation plan which will outline the key activities, programmes and projects that will need to be undertaken to realise the strategic priorities on a year-by-year basis. • The strategic priorities will be incorporated into our business and financial planning. • Our reporting at all levels from ward to board will be aligned to the strategic priorities so we can identify how we are progressing. • We will only undertake projects and initiatives that will help us to achieve our objectives. • Our performance as a Trust, as a division, as a team, as individuals will be judged by our success in delivering these objectives in line with our core values. • We will continue to listen and engage with patients and staff about our strategy through existing forums and meetwings, so it becomes an integral part of decision making and day to day service delivery.
How will we monitor implementation and impact? • Progress against our strategic priorities across the enabling strategies will be reported through the governance of our Trust Board and its sub-committees. • Each year the Trust Board will conduct an annual strategy review which will focus on key performance measures of success, and provide an opportunity for strategic commitments to be reaffirmed and delivery priorities for the year ahead defined.
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Trust Strategy Summary
Dartford and Gravesham NHS Trust
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the communications team by emailing dgn-tr.communications@nhs.net
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