Darent Valley Hospital - DGT -Trust Strategy

Dartford and Gravesham NHS Trust

Trust Strategy Providing outstanding care which is skilled, trusted and kind, every time

Care with compassion

Respect & dignity

Striving to excel

Professional standards

2020 - 2025

Working together

Foreword

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 staff. Our 2014-19 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 GST 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 which is maintained through our values based interview process, making sure that we are all committed to the same behaviours and expectations. However, we (as many others do across the NHS) struggle to recruit and retain staff. This strategy is focused on improving the experience, wellbeing and engagement of all our staff 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 staff. For example, we will be introducing Quality Councils within each Division to hear from frontline staff. The Council will choose a specific continuous quality improvement issue to work on together with support from senior management. Evidence suggests that this improves staff’s ability to have a strong voice and be involved in delivering the changes they want to see. We believe that empowering our staff, 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 staff 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 working with 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.

Louise Ashley Chief Executive

Peter Coles Trust Chair

Contents

Executive summary

5

About the Trust and our partnerships

7-9

Introduction

10

Our strategic priorities

11-17

Building our strategy Implementing, monitoring delivery and reporting of the strategy and enabling strategies

18-19

Communicating the strategy and progress of its delivery

20

Appendix Trust board key performance indicators

20-23

Executive summary

Our vision: Providing outstanding care which is skilled, trusted and kind, every time

Journey to outstanding Ensuring patients receive outstanding clinical care, are kept free from harm and are treated with thoughtfulness, skill and respect. Digital first Driving safe, connected and efficient digital innovation to improve care for our patients. Joy at work Supporting staff to be healthy, happy and heard, with a sense of belonging and fulfilment. 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. Strategic objectives and outcomes:

Working smartly within our means Making sure that we do the best for our patients by achieving all 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:

Respect & dignity

Care with compassion

Striving to excel

Professional standards

Working together

5

Trust Strategy Summary

6

Trust Strategy Summary

About the Trust and our partnerships

About Dartford and Gravesham NHS Trust and the population we serve Dartford and Gravesham NHS Trust (the Trust) provides services across Darent Valley Hospital in Dartford, Queen Mary’s Hospital in Sidcup, Erith and District Hospital in Bexley and Gravesham Community Hospital in Gravesend, as well as a number of community locations across our population. The Dartford and Gravesham NHS Trust offers a comprehensive range of acute services, with a bed-base of approximately 500, to around 400,000 people in North Kent and South East London. The Dartford and Gravesham NHS Trust is geographically located in the North of Kent with excellent transport links including major motorways and train lines to Kent, London and Europe. Our Planned Care Centre at Queen Mary’s Hospital (a multi-provider hospital site run by Oxleas NHS Foundation Trust) provides a dedicated elective care service for a range of surgical services whilst Darent Valley Hospital (a Private Finance Initiative (PFI) hospital) provides both emergency and elective services, and also hosts a number of other providers offering the best possible local care to our population. Our Demographics The population demographic profile of Bexley and Dartford, Gravesham and Swanley (DGS) is very similar with a younger than national average population which will result in a significant increase in our over 65s in the coming years. • High rates of elderly population growth with comorbidity • High air pollution rates • Variation in deprivation, education & employment • High Obesity rates (children & adults) • High numbers of admissions due to falls & alcohol related • Low breast feeding, lower bowel screening & MMR immunisation rates

Growth and local developments We are in an area of exceptional growth with large housing developments 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. This excludes the City in the East proposed development which will be 22,000+ houses. There are also plans to develop the biggest theme park in the UK nearby which will impact on the transient population that we serve.

Dartford, Gravesham and Swanley Population Growth

Bexley Population Growth

Year

2025

24,000

10,000

2030

37,000

18,000

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Trust Strategy Summary

About the Trust and our partnerships

Our partnerships in Kent and Medway and our commissioners The success of our strategy is dependent on excellent partnership working with both local and national partners, including our community. Integrated Care System The Dartford and Gravesham NHS Trust is a member of the Kent and Medway Integrated Care System (ICS). Our Kent and Medway Integrated Care System 5 year delivery plan has informed this strategy, and the strategic objectives are: 1. Improving care quality and patient experience 2. Increased focus on population health and prevention 3. Driving financial balance, efficiency and productivity 4. Transformation of our workforce and infrastructure 5. A new integrated care system and delivery model These have been informed by our population health needs, public engagement and the system challenges. A comprehensive programme of work to deliver these continues to be delivered by all partners in the Integrated Care System. To aid this, there will be a single strategic commissioner from 2020. Integrated Care Partnership – Dartford, Gravesham and Swanley ICP The Dartford, Gravesham and Swanley Integrated Care Partnership is developing a collaborative alliance approach to improve the populations’ health and well-being, reduce health inequalities and proactively support service users with integrated service delivery and personalised care. The priorities are: Focus on prevention and population health management; new relationship between local people and services; connecting people to community assets and resources; building resilient communities; working with local government and voluntary sector re the wider determinants of health; and, leveraging person and population level data. Prevention and population

Integrated services

NKPS A joint collaboration between Medway NHS Foundation Trust, Dartford and Gravesham NHS Trust and North Kent Pathology Service (which launched in 2016) is the first joint pathology service in Kent and Medway. Elements of the pathology provision in Kent are centralised at Maidstone and Tunbridge Wells NHS Trust, with which North Kent Pathology Service has an excellent relationship. Together the Trusts in Kent and Medway continue to explore how best to collaborate on the provision of effective and efficient pathology services. NHS England/NHS Improvement regional team NHS England/NHS Improvement commission specialist services from the Trust and we work closely with the NHS England/NHS Improvement regional team regarding our governance and performance. NHS England/NHS Improvement provide a range of support that we regularly access, including support to our Emergency Department pathways, and we will be continuing to work with NHS England/NHS Improvement on responding to the challenges and operational changes that have emerged due to COVID-19. There are a series of workstreams that underpin this, and there is a governance system in place to oversee the successful delivery of the plans. For further information, see the Integrated Care Plan Five Year Plan. Planning and redesigning services with input from our residents & service users; integrating services around patients; urgent care that is integrated with primary, community, mental health and social care; reduction in emergency or unplanned interventions; and, the hospital will deliver only the services required in a hospital setting. Greater coordination of care; more services in the home and in community settings; integrated, multi-disciplinary community teams, linking hospital specialists to community-based care; greater use of technology to deliver care remotely; and, using social prescribing, community navigation and other tools to enable self care and self management. Care in the community increasing management of complex health needs in the community, offsetting some of the need for increasing the number of hospital beds; providing capacity to meet population needs; and, inpatient care only for those who need intensive or complex care. Managing complex needs

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Trust Strategy Summary

About the Trust and our partnerships

Our partnerships in South East London and beyond Integrated Care Systems The Dartford and Gravesham NHS Trust is an associate member of the South East London Integrated Care System called ‘Our Healthier South East London’. Alongside the newly formed single commissioner, the Integrated Care System, which is made up of five providers and six local authorities, collectively serves a diverse population of two million people. The three primary aims of the Integrated Care Systems are: 1. Helping people to lead healthier and longer lives 2. Improving access and quality of care for everyone 3. Making the most efficient use of NHS funding To do this, there are a series of programmes: • Community-based care • Cancer care • Planned care • Urgent and emergency care • Care of children and young people • Maternity care • Mental health care • Specialised services • Transforming care • Digital • Workforce • Estates • Finance (including procurement) The Trust’s focus is on the health of the Bexley population. Bexley Local Care Partnership Within the South East London Integrated Care System, there are borough specific Local Care Partnerships. The Oxleas NHS Foundation Trust serves the population of Bexley and provides a number of health care services at both Queen Mary’s Hospital in Sidcup, and Erith and District hospital in Erith. The vision is that Bexley will have a ‘place-based’ system of care, in which a range of partners

work together to provide person-centred care in a proactive and integrated way. This means organisations working in close partnership, sharing information to fully understand the needs of the population, and collaborating to manage the common resources available. The new, place-based system of care will be: • Person centred • Joined up • Unique to Bexley Oxleas NHS Foundation Trust Oxleas NHS Foundation Trust operates the Queen Mary’s Hospital site in Sidcup, and we are the main acute provider there, providing elective care, diagnostics and outpatient services. Both King’s College Hospital NHS Foundation Trust and Guy’s and St.Thomas’ NHS Foundation Trust operate at Queen Mary’s Hospital, providing services to the population of Bexley. We have a hard and soft facilities management contract with Oxleas NHS Foundation Trust, and we pay rent to use the facilities. The Oxleas NHS Foundation Trust has been providing services from QueenMary’s Hospital since 2013 and is committed to continuing to do so, to not only provide a more local service for Bexley patients, but also to maximise the use of clinically appropriate NHS estate that can support operational changes in the wake of the COVID-19 pandemic. GST Healthcare Alliance Dartford and Gravesham Trust is the founding member of the GST Healthcare Alliance allowing patients and staff to benefit from the skills and expertise at Guy’s and St. Thomas’ NHS Foundation Trust. Networks We continue to work in partnership with other clinical and administrative teams to harness skills and expertise across networks. Networks provide an opportunity to share pathways and policies, scarce clinical expertise, and jointly develop improvements that benefit a wider range of patients and staff, as well as making the best use of NHS resources. In particular, we work closely as part of the Kent and Medway Cancer Alliance and the Kent and Medway Local Maternity System to introduce the changes to these services.

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Trust Strategy Summary

Introduction

Our Trust strategy is the overarching organisational strategy that describes the Dartford and Gravesham NHS Trust’s vision and goals from 2020 to 2025.

The key objectives/outcomes for each strategic priority are included in the strategy. We want to ensure that our integrated performance reporting is well aligned to delivering our strategy, and that our ability to measure improvement is more effective. The strategy will inform the annual objectives for each of the five years which, in turn, influence the objectives of each Division, service and individual in the Trust. A set of Board Key Performance Indicators are proposed alongside the Trust and system-wide transformation and improvement programmes/activities that will support the delivery of these outcomes. Our staff are our most valuable asset and they are key to the successful delivery of this strategy. We are therefore keen to show our commitment to them through a comprehensive wellbeing offer, introducing greater shared governance and the development of Continuous Quality Improvement, which will provide them with the skills, capability and capacity to deliver the strategy.

Six strategic priorities 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”. Working closely with our partners, on both a local and national level, is vital to the successful implementation of our strategy. Together with our local partners, we will ensure that patients receive outstanding and trusted care in the right place, by teams that are highly skilled and are passionate about providing excellent patient-centred care. We will work with national partners including Public Health England, NHS England and NHS Improvement, to rapidly implement recommendations to ensure the ongoing safety of our patients and staff, particularly in light of the COVID-19 outbreak in 2020.

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Trust Strategy Summary

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

Working smartly within our means

Making sure that we do the best for our patients by achieving all our targets and making the best use of the funding we receive

Digital first Driving safe, connected and efficient digital innovation to improve care for our patients

Joy at work Supporting staff to be healthy, happy and heard, with a sense of belonging and fulfilment

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

Continuous quality improvement To be a learning and improving

culture, using continuous improvement to discover, create and innovate

Each of the strategic priorities has a named lead Executive Director, a Trust Board sub-committee that it will oversee delivery, a set of outcomes, programmes that seek to deliver the outcomes and key performance indicators that will be monitored and reported.

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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:

1. 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. Lead: Chief Operating Officer / Director of Operations Delivery programme: a. Urgent and Emergency Care Programme b. Flow Programme c. Discharge Programme d. Patient Experience and engagement quality priority e. Effective Care quality priority Timescale: 2020 onwards 3. Our patients will feel respected and will experience kindness and compassion, every time. Lead: Chief Nurse Delivery programme: a. Patient experience and engagement quality priority Timescale: 2020 onwards

2. 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. Lead: Medical Director Delivery programme: a. Clinical Variation programme b. Children’s Board c. Getting it right first time d. Patient experience and engagement quality priority

e. Effective Care quality priority f: Harm Free Care quality priority g: Reduce Mortality quality priority Timescale: 2020 onwards

4. The care and services we provide will be of the best possible quality, based in evidence and supported with appropriate resources. Lead: Chief Nurse Delivery programme: a. Getting it right first time / clinical variation programme b. Patient experience and engagement quality priority c. Effective Care quality priority d. Harm Free Care quality priority e. Culture of Excellence quality priority Timescale: 2020 onwards

Executive Lead: Medical Director and Chief Nurse Lead Executive Committee: Quality and Safety

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Trust Strategy Summary

Our strategic priorities

Joy at work

Supporting staff to be happy, healthy and heard, with a sense of belonging and fulfilment.

Outcomes:

1. Happy We will support and develop our staff, creating talented people for our organisation. Our staff 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. Lead: Chief People Officer Delivery programme: a. Recruitment and Retention programme b. Education and Training programme c. Opportunities through partnerships (Integrated Care Partnership, ICS, GST Healthcare Alliance) d. Workforce design Timescale: 2020 - 2022 3. Heard Our staff will work in an open and transparent culture in which they are treated with equality, dignity and respect and are listened to through active involvement in decision making (shared governance). Lead: Director of Improvement & Chief People Officer Delivery programme: a. Shared governance programme (Quality Councils) b. Equality, diversity and inclusion programme & Council c. Partnership working with JCC and LNC

2. Healthy We will provide holistic health and wellbeing support to all staff, to promote healthy living and provide emotional support during challenging times. Lead: Director of Wellbeing Delivery programme: a. Wellbeing programme b. Occupational Health programme for fit and healthy staff (including mental health)

c. Celebration of diversity d. Community engagement Timescale: 2020 onwards

d. Freedom to speak up Timescale: 2020 - 2021

Executive Lead: Chief People Officer Lead Executive Committee: Workforce

13

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:

1. Deliver our agreed financial and operational trajectories through effective and efficient ways of working, including with our partners. Lead: Chief Operating Officer Delivery programme: a. Quality innovation b. Productivity and prevention programmes c. A&E delivery board

2. Eliminate unnecessary variation in our processes by putting in place standard operating models. Lead: Chief Operating Officer Delivery programme: a. Trust Leadership team governance b. Theatre productivity c. Outpatient transformation d. E-noting and e-prescribing & medicines administration e. K&M stroke review Timescale: 2021-22 4. Ensure we have effective financial reporting and the associated systems for understanding and improving performance. Lead: Chief Finance Officer Delivery programme: a. Performance management framework b. Earned autonomy c. Effective Care quality priority d. Finance charter Timescale: 2021

3. Ensure we have an evidenced-based process for assessing value for money and sustainability. Lead: Chief Finance Officer Delivery programme: a. Service line reporting, patient level information and costing system

b. Use of resources assessment c. Smart procurement processes Timescale: 2021

Executive Lead: Chief Finance Officer and Chief Operating Officer Lead Executive Committee: Finance

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Trust Strategy Summary

Our strategic priorities

Digital first

Driving safe, connected and efficient digital innovation to improve care for our patients.

Outcomes:

1. Safe Clinical information can be safely and digitally accessible wherever needed Lead: Director of Digital Transformation Delivery programme: a. General Data Protection Regulation (GDPR) b. QIA for all programmes c. Information Governance Toolkit d. Clinical safety standards

2. Connected Digitally enabling patients and clinicians to better manage care Lead: Director of Digital Transformation Delivery programme: a. Patient portal b. Digital maternity c. Self-management of long-term conditions Timescale: 2020 onwards

e. Kent and Medway care record f. Enhanced business intelligence Timescale: Every year

3. Efficient Improve efficiency for staff, so they can focus on patients and increasing productivity, as a result of digital innovation. Lead: Director of Digital Transformation Delivery programme: a. Artificial Intelligence b. Electronic Patient Record – paperless at the point of care c. E-prescribing and medicine administration d. Electronic inpatient e-Noting e. Wearable devices

f. Kent and Medway care record g. Remote and virtual working Timescale: 2020 onwards

Executive Lead: Director of improvement Lead Executive Committee: Quality and Safety

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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:

1. We will contribute leadership to our local community and partnership and collaborate within the systems in which we operate. Lead: Chief Executive Officer Delivery programme: a. DGS ICP development programme b. SEL ICP collaboration c. Community engagement – local and district councils, faith groups, as well as the community and voluntary sector Timescale: 2020 onwards 2. Working with system partners, we will optimise service delivery to maximise the value of the NHS for the wider health economy. Lead: Chief Financial Officer Delivery programme: a. ICP development programme b. Establishing an effective governance and function of the ICP Timescale: 2020 onwards 3. Continuing to collaborate with GST Healthcare Alliance to share and adopt best practice. Lead: Director of Improvement Delivery programme: a. Guy’s and St Thomas’ Healthcare Alliance Timescale: 2020 onwards

Executive Lead: Executive Directors Lead Executive Committee: Trust Board

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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:

1. Continuous improvement purposely linked with our strategic priorities Lead: Director of improvement Delivery programme: a. Continuous Quality Improvement programme b. Shared governance programme c. A culture of excellence quality priority Timescale: 2021

2. Achieving CQC rating of Outstanding Lead: Chief Nurse

Delivery programme: a. Quality priorities b. Positive patient experience c. Harm-free care d. Effective care e. A culture of excellence f. Reduce mortality Timescale: 2022

3. A strong and positive culture of continuous improvement reported across the organisation Lead: Director of improvement Delivery programme: a. Continuous Quality Improvement programme b. Shared governance programme c. A culture of excellence quality priority Timescale: 2022 onwards

Executive Lead: Director of improvement Lead Executive Committee: Quality and Safety

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Trust Strategy Summary

Building our strategy

Implementing, monitoring delivery and reporting of the strategy and enabling strategies

• Positive patient experience • Harm-free care • Effective care • Culture of Excellence Journey to Outstanding Continuous Quality Improvement Quality

Implementing the Trust Strategy through programmes of work to deliver the specific outcomes and the enabling strategies . Programmes of work to deliver the strategic priorities: • The Trust improvement and transformation programmes, as well as other Trust strategic activities, have been mapped to each of the strategic priorities to align existing and future resources to the programmes, with the greatest impact on the delivery of the strategy and to measure impact more effectively. • There is a named delivery lead for each of the outcomes that will act as the senior responsible officer for the delivery of that outcome. The lead will receive regular progress updates from each supporting programme. Enabling strategies: The delivery of the Trust Strategy is enabled by the following strategies. Each of these strategies can be found on the Trust intranet and website. Each strategy supports our journey to Outstanding, as well as at least one other strategic priority. Each enabling strategy includes a set of key performance indicators to support the Trust Board, and its sub-committees, to monitor the delivery of both the strategies and the Trust strategic priorities.

• Happy • Healthy • Heard Joy at work People

• Specialist services • Children and young people • Integration and pathways • Excellence Journey to Outstanding Working together Clinical

Digital

• Paperless at the point of care • Enhanced business intelligence

• Technology enabled care (e.g. wearables) • Artificial Intelligence Supported Workforce Journey to Outstanding Joy at work Digital first Working smartly within our means Working together • Right capacity in the right place • Effective use of clinical space • Maintain high standard of estate and provide greater VFM • Delivering the Sustainability Agenda Journey to Outstanding Working smartly within our means Estates

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Trust Strategy Summary

Building our strategy

Reporting and monitoring the delivery of the strategy The reporting process is summarised below. The integrated performance report will continue to be received on a monthly basis to the Finance Committee and Board. It will be structured to align with the six strategic priorities and the national, compliance and performance standards that require exception based reporting to and oversight/scrutiny from the Trust Board. Reporting against strategic priorities will improve the alignment and awareness of the wide range of programmes that the Trust is delivering, both internally and with our system partners in the ICP and ICS, as these will no longer report in isolation but instead report against the relevant objective and strategic priority.

Statistical process control charts Statistical process control charts are an essential quality tool for data collection and analysis of the impact interventions as they allow for comparison to past years’ performances, illustrating the impact of the current interventions. In doing so, they demonstrate when a variation in performance has occurred, allowing an informed decision to be made to either take new action or to continue with current processes. This form of reporting will enable the Board to be able to measure the level of progress being made towards delivering the strategic priorities. An example chart shows the upper control limit and lower control limit set by previous years’ performances, and the data plotting of this year’s performance.

TABLE??

TABLE

Board Assurance Framework (BAF) TheBoardAssurance Framework is akeymechanism used by the Board to describe and manage the risks to delivering the Trust’s strategic priorities. The Board Assurance Framework will therefore be structured into the strategic priorities from April 2020 and risks will be articulated and scored in relation to the 2020-2025 strategic priorities.

1. Named Lead for the outcomewill receive regular updates from each of the programme leads 2. Lead Executive Director for the strategic priority will receive regular updates from the named lead 3. Trust Board Sub-Commitee will review all KPIs for the relevant objectives 4. Trust Board will monitor the progress against delivery of the Trust strategy with an aggravated RAG rating and will receive KPI updates on an exemption basis

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Trust Strategy Summary

Communicating the strategy

Communicating the strategy and process of its delivery The communication of the Trust Strategy will include a roadshow led by the CEO and Executive Team. These will be open to all staff and will be located across Darent Valley Hospital, Queen Mary’s Hospital, Erith & District Hospital and Gravesham Community Hospital on different days of the week, and at different times of the day, including early morning and late evening to give as many staff the opportunity to attend as possible. The CEO has a weekly blog and podcast which is sent to the whole organisation providing updates and progress against the Trust strategy. Blogs Starting from April 2020 across the Trust, this is a day free from all Trust meetings where all staff, including the Senior Leadership Team, will be out and about listening and talking with staff. This will be an opportunity for individuals to either meet with leaders in a set place (times to be publicised), or to stop them and talk to them. The feedback from Feedback Fridays will be pulled together and ‘You said, we did’ reports sent out monthly. Feedback Fridays In addition, there will be:

Members of TLT will communicate to all staff via social media such as Twitter and Instagram. Social Media

Furthermore, the Trust is adopting greater shared governance to better engage and empower frontline staff to develop and deliver their quality improvement ideas. Each Division will have a Quality Council, with volunteer members that engage with frontline staff to listen to their ideas, and drive quality improvements within the Division. The ideas generated by the Quality Councils will be aligned to the strategic priorities, and progress reported to the Trust Leadership Team via the Divisional leadership. For further information see the Quality Strategy section of this document. Divisions will also earn greater levels of financial and performance autonomy based on the performance, actions, mitigations and assurance presented to the Trust Leadership Team. There will continue to be a quarterly Celebrating Success event where all staff are welcome to come and chat with members of the TLT. This will also be an opportunity for staff to present posters and displays of the excellent work they have been undertaking. Celebrating Success Events There will be listening posts across both hospitals and a virtual one on Adagio (our Trust Intranet) where staff can complete a card outlining a suggestion, a comment or concern. The feedback from these will be included in the monthly ‘you said, we did’ feedback. Listening Posts There will be a quarterly front line forum for all staff from grades 1-4 where staff, who otherwise often do not get the opportunity can come and enjoy a cuppa and a chat with the CEO. CEO front line Forum

Trust Leadership Team (TLT)

Each Wednesday for four weeks, the Trust Leadership Team will meet, and these sessions will be divided into: • Quality, Workforce and Education; • Finance and Transformation;

• Performance; • and, Strategy

After each weekly meeting, a member will write a summary of everything that was discussed during the session, and there will be an opportunity for staff to post comments.

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Trust Strategy Summary

Appendix Trust board key performance indicators

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Trust Strategy Summary

Trust board key performance indicators

Delivering our strategy How are we doing?

Journey to Outstanding

Joy at work

Aggregated KPIs • Reduce vacancy rate

Aggregated KPIs • Proportion of clinical incidents that cause harm to <5% • Mortality score to be at national average • LOS overall, for elective and non-elective care, to benchmark at national average • GIRFT with top 3 priorities addressed for 50% of GIRFT programmes • Recruitment of patients or staff into research projects with 10% more recruits based on 2019-2020 data • Ensuring the voice of our patients is used to drive to our learning and design of services RAG rating: out of 7 KPIs failing to achieve or

• Reduce the number of staff voluntarily leaving the Trust within their first year by at least 25% based on 2019/2020 data • Improve flexibility based on 2020/2021 performance • Reduce the number of leavers citing promotion or work life balance for their reason for leaving, by at least 25% based on 2019/2020 data • 85% of all staff to have an annual appraisal • Representation of Black, Asian and Minority Ethnic (BAME) staff at senior level to increase in line with WRES target RAG rating: 3 out of 7 KPIs failing to achieve or Quantitative evidence on (forming part of bi-monthly deep dive): • Developing a Children and young people strategy • Developing a new UEC and Accident & Emergency model which supports patients back to their best beds in a timely manner • Increasing utilisation of Queen Mary’s Hospital as an elective centre • Improving the mental health and wellbeing of our staff 2 or more KPIs showing statistically significant trigger, or more than 1 major quality indicator off track e.g. vacancy rate

2 or more KPIs showing statistically significant trigger, or 1 major quality indicator off track number of SIs

Working smartly within our means

Aggregated KPIs RAG rating: 3 out of 7 KPIs failing to achieve or

2 or more KPIs showing statistically significant trigger, or 1 major quality indicator off track number of SIs

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Trust Strategy Summary

Trust board key performance indicators

Delivering our strategy How are we doing?

Working together

Digital first

Aggregated KPIs RAG rating: 3 out of 7 KPI’s failing to achieve or 2 or more KPI’s showing

Aggregated KPIs RAG rating: 3 out of 7 KPI’s failing to achieve or

2 or more KPI’s showing statistically significant trigger or 1 major quality indicator off track number of SI’s

statistically significant trigger or 1 major quality indicator off track number of SI’s

Continuous quality improvement

Aggregated KPIs RAG rating: 3 out of 7 KPI’s failing to achieve or 2 or more KPI’s showing

statistically significant trigger or 1 major quality indicator off track number of SI’s

Quantitative evidence on (forming part of bi-monthly deep dive): • Improve corporate productivity metrics based on last UoR data • Delivery of the digital priorities • Progress of the of the ICP leadership priority • Progress on the CQI strategy and development of the Academy

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Trust Strategy Summary

Dartford and Gravesham NHS Trust

If you have any questions or comments about this or any other guides please contact a member of the communications team by emailing xxxxxxxxx@xxxxx