Dartford and Gravesham NHS Trust Strategy 2020-2025

Dartford and Gravesham NHS Trust

Dartford and Gravesham NHS Trust Strategy 2020-2025 Providing outstanding care which is skilled, trusted and kind, every time.

Introduction

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 2014-19 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 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 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 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 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’s 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 objectives

4

Who are we

6

Our partnerships

7-8

Our strategic objectives, outcomes and measures

10-16

Our next steps

18

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

Our vision

Which we will deliver through... Our strategic objectives

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

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.

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 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

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Trust Strategy Summary

Who are we

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

Our partnerships

We directly serve the Dartford, Gravesham and Swanley community and are part of a number of other local and regional relationships including the Kent and Medway Integrated Care System. 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. Kent and Medway Integrated Care System (ICS) The Dartford and GraveshamNHS Trust is a member of the Kent andMedway IC S. Our Kent andMedway Integrated Care System 5 year delivery plan has informed the development of this strategy. The strategic objectives of the ICS are:

Dartford, Gravesham and Swanley Integrated Care Partnership (ICP) The Dartford, Gravesham and Swanley ICP is developing a collaborative alliance approach to improve the populations health and wellbeing, reduce health inequalities and proactively support service users with integrated service delivery and personalised care. The priorities of the ICP are:

Improving care quality and patient experience

Increased focus on population health and prevention

Driving financial balance, efficiency and productivity

Prevention and population

Transformation of our workforce and infrastructure A new integrated care system and delivery model The development of these objectives was informed by our population health needs, public engagement and the system challenges.

Integrated Services

Care in the community

Managing complex needs

More information on these priorities can be found in the DGS ICP Five Year Plan.

NKPS

A joint collaboration between Medway NHS Foundation Trust, Dartford and Gravesham NHS Trust and North Kent Pathology Services 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. Together the Trusts in Kent and Medway continue to explore how best to collaborate on the provision of effective and efficient pathology services.

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Trust Strategy Summary

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 ICS which is made up of five providers and six local authorities collectively serves a diverse population of 2 million people. The three primary aims of the ICS are:

Helping people to lead healthier and longer lives

Improving access and quality of care for everyone

Oxleas NHS Foundation Trust Oxleas NHS Foundation Trust operates the Queen Mary’s Hospital site in Sidcup, and Dartford and Gravesham NHS Trust is the main acute provider there, providing elective care, diagnostics and outpatient services. Both Kings 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. GSTT Healthcare Alliance Dartford and Gravesham NHS Trust is the founding member of the GSTT Healthcare Alliance allowing patients and colleagues 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, source clinical expertise, and jointly develop improvements that benefit a wider range of patients and colleagues, 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.

Making the most efficient use of NHS funding

The

Trust’s

focus

is

on

the

health population. Within the South East London ICS, there are borough specific Local Care Partnerships. Oxleas NHS Foundation Trust serves the population of Bexley and provides a number of health 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-centered 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. of the Bexley

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Trust Strategy Summary

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Trust Strategy Summary

Our strategic objectives

Six strategic objectives 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 objectives are short statements, they directly relate to more comprehensive objectives which then flow through to detailed activities and planning. Our strategic objectives 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

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Trust Strategy Summary

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 • Proportion of clinical incidents that cause harm to under 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 colleagues 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

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Trust Strategy Summary

Joy at Work

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

Outcomes

3. Heard Our colleagues 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).

2. Healthy We will provide holistic health and wellbeing support to all colleagues, to promote healthy living and provide emotional support during challenging times.

1. Happy We will support and develop our colleagues, 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.

Measures • Reduce vacancy rate • Reduce the number of colleagues 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 colleagues to have an annual appraisal • Representation of Black, Asian and Minority Ethnic (BAME) colleagues at senior level to increase in line with WRES target

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Trust Strategy Summary

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.

2. Eliminate unnecessary variation in our processes by putting in place standard operating models.

3. Ensure we have an evidenced-based process for assessing value for money and sustainability.

4. Ensure we have effective financial reporting and the associated systems for understanding and improving performance.

Measures • Income and expenditure performance • Development and delivery of our Cost Improvement Programme • Delivery of our Capital programme • Referral to Treatment (RTT) pathway performance • Sustained and improved performance against our constitutional targets • Improving and sustained utilisation of our theatres capacity • Declining number of services showing as outliers on Model Hospital

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Trust Strategy Summary

Digital first

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

Outcomes

3. Efficient Improve efficiency for

2. Connected Digitally enabling patients and clinicians to better manage care.

1. 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 • Increase in the update of Cyber Security Training • Data Protection Impact Assessment completion and approval • Increase in the ratio of outpatient appointments undertaken virtually • Performance against adoption, implementation and roll out of Robotic Process Automation (RPA)

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Trust Strategy Summary

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

3. Continuing to collaborate with GSTT Healthcare Alliance to share and adopt best practice.

2. Working with system partners, we will

1. We will contribute leadership to our local community

optimise service delivery to maximise the value of the NHS for the wider health economy.

and partnership and collaborate within the systems in which we operate.Dartford and Gravesham Trust is the best place to work.

Measures • Progress of developing DGT as an Anchor Organisation • Progress of the development of the Integrated Care Partnership • Development of the Integrated Care Partnership Financial Systems and Accountability • Continued development of the GSTT Healthcare Alliance

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Trust Strategy Summary

Continuous quality improvement

To continue enhancing our learning and improving culture, using continuous improvement to discover, create and innovate.

Outcomes

3. A strong and positive culture of

1. Continuous improvement purposely linked with our strategic priorities

2. Achieving CQC rating of Outstanding

continuous improvement reported across the organisation

Measures • Creation of new Divisional and themed Quality Councils • Launch of the CQI Academy • Implementation and numbers of colleagues trained in continuous quality improvement methodology • Improvement in colleagues surveys which confirm their ability to be involved in making improvements in their areas

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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 objectives have been developed jointly with members of colleagues across the Trust from 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 everyday will support us in achieving our six strategic objectives and achieving our Journey to Outstanding. The aims that we have set ourselves for the next five years are much more than words to us. We commit to realising them through a number of measures:

• 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 objectives on a year by year basis • The strategic objectives will be incorporated into our business and financial planning • Our reporting at all levels fromward to Board will be aligned to the strategic objectives so we can identify how we are progressing. • Wewill 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.

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Trust Strategy Summary

Dartford and Gravesham NHS Trust

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