Provide CIC Annual Report 2017-2018

Annual Report 1

Annual Report 2017-2018

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Contents

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A View from the Chairman

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Delivering Our Services to Meet Customer Expectations

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Demonstrating Quality

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Annual Quality Summit

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Being an Employer of Choice

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Recognising Our People

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Making Technology Work

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Being Financially Strong

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Investing in Our Local Communities

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From the Governors

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Volunteering with Provide 2017-2018

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Looking Forward

A View from the Chairman

A View from the Chairman Delivering health and social care services in a financially constrained environment where people are living longer and have growing needs, is becoming increasingly challenging.

Derrick Louis

Yet this is what we are being asked to do on a day by day and year by year basis.

2017-18 was no different and could be argued was even more challenging, especially with the loss of our pre-birth to 19 services. The impact was tough for us but could have been significantly tougher had we not managed the situation with extreme care and foresight. The financial impact was big enough, at around ÂŁ8m, but the fact that so many treasured staff and friends left Provide was our biggest loss.

For many companies of our size, it could have been devastating but we weathered the storm and due to the tireless hard work and dedication of all our staff, we were able to deliver a surplus which is a significant achievement given that savings had to be delivered in all areas.

We have seen significant changes over the past 12 months. We have developed new hubs relocating staff to better equipped and more modern buildings. We have continued to develop the Care Co-ordination Centre and although it has had its difficulties, we are now beginning to see the benefits coming through. Our Child Health Information Service continues to grow and attract national acclaim. Shortly after the end of the financial year we also made our first private company purchase.

Services we deliver cannot stand still and many have seen restructure and reorganisation, including the shift to planned and unplanned teams in our Integrated Care teams. After the end of the financial year, under instruction from Mid Essex CCG, we also successfully managed the closure of our ward at Braintree Community Hospital and started up our Home First service.

We achieved 20 days complaints management turnaround in almost all of our complaints and our Friends and Family Test scores remain up with the best in the country.

Also after the end of 2017/2018 we formed a partnership with Fairhomes and adapted two bungalows in Braintree for supported living for

people with learning disabilities, and we agreed with a developer to build a new health facility in South Woodham Ferrers to house three GP surgeries, as well as our community services.

This will be up and running by May 2019.

We agreed with commissioners in mid Essex to a two-year extension to our Community Services contract, as well as an extension to our Cambridge Wheelchair contract. In addition to the latter, we took on staff from our Approved Repairer company for wheelchair services and now perform this ourselves in Cambridge.

We continue to invest in our staff, particularly to ensure they have access to the best and most appropriate training. In 2017-18 we delivered the Mary Gober programme which all staff will have had access to by the end of this year. The feedback from the many hundreds who have completed it is extremely positive. We continue to invest in technology with 75% of all training and 95% of staff annual leave now booked online. In addition, we invested in updated hardware with new smartphones and laptops to be deployed throughout 2018-19. We have also improved our cyber security and were ready for the new GDPR rules that came into place in May 2018.

We have continued to develop our relationship with Essex County Council and established an Integration Board. We have also continued to play an active part in the Sustainability and Transformation Partnership across mid and south Essex. In doing so we have created a Memorandum of Understanding between ourselves, North East London NHS Foundation Trust (NELFT) and Essex Partnership University NHS Foundation Trust (EPUT) and now have a joint Clinical Director of Operations with NELFT, Stephanie Dawe, after Jane Corser moved back to acute care close to her home.

This was an incredibly busy year with lots of challenges, changes and successes. The Board has remained a constant and we have developed our relationship with Governors even further with joint staff and site visits throughout the year. On all of these visits, I am as always overwhelmed by the amazing support and care we are able to give to the communities we serve. It is an absolute pleasure to me to be able to witness at first hand the excellent services we deliver and I remain incredibly proud to be the Chairman. Thank you all for your hard work and continued commitment.

The Board are as ever, extremely grateful.

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Delivering Our Services to Meet Customer Expectations 8,049 people took the opportunity to provide feedback via the Friends and Family Test (FFT).

Our average FFT rating for 2017-2018 was 97%.

This means that 97% of service users providing feedback via FFT would recommend our services to their friends and family.

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Delivering Our Services to Meet Customer Expectations

Provide encourages feedback from anyone wishing to comment about the services they receive, or from anyone affected by the services we offer.

Provide continually seeks to learn from complaints and to use this feedback to improve the service it delivers to patients and visitors.

Comments, concerns, feedback and complaints form a key part of Provide’s mechanisms for listening, learning and improving the care delivered to patients, families and communities.

Feedback is central to our commitment to deliver safe, effective and person-centred care and is obtained using a variety of approaches. These different approaches allow customers, patients, carers, and visitors to choose the feedback mechanism that best suits their needs. With this in mind, we seek feedback in a number of different ways including in writing, email, telephone, via our website, social media, faceto-face, as well as proactively seeking feedback via questionnaires, surveys and focus groups.

Information for the public is available on the Provide website and there are also posters and banners throughout our hospitals and clinics encouraging people to provide feedback.

All of these feedback mechanisms provide individuals with an opportunity to express concern, receive an apology where appropriate, and is used to inform actions aimed at maximising learning and minimising the potential for reoccurrence. It also allows the Board to

collect a range of quantitative and qualitative data to evaluate our services. Any feedback received is either verbally or formally acknowledged, giving details about the process and the timeframes.

The Customer Services Team ensure that all feedback is recorded in DATIX, our electronic feedback recording system.

Surveys Provide believes the key to excellent patient experience is to deliver a service that is focused on the needs of the client and carer, Provide undertakes an annual programme of surveys ranging from contracted surveys through to evaluation surveys following a service redesign.

The telephone survey for the Waltham Forest and Redbridge wheelchair services was undertaken during July 2017.

Customer engagement Service users are invited to join us for engagement events and are able to give their feedback direct to the service. The events are attended by clinical specialists on hand to listen to the views of our service users and carers.

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Some feedback from the comments made.

You said...

Much too hot in the clinic areas.

We did...

The use of air conditioning was reviewed and is now in place in a number of locations where Provide delivers services.

Springfield Green Clinic

Wonderful food.

Wonderful staff.

Would like more therapy input.

Would like more staff.

Compliments given to kitchen staff.

St Peter’s Hospital

Feedback given to the staff.

St Peter’s Hospital

Therapy and nursing team working together to help with rehab.

St Peter’s Hospital

Staff have reviewed the dependencies of their patients and increased the number of staff in the morning and at night when pressures are greatest.

Halstead Hospital

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Delivering Our Services to Meet Customer Expectations

27 53 16

Complaints by Type

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1 April 2017 - 31 March 2018

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Provide received 218 concerns/ complaints for 2017-2018.

Level 1 (low) Level 2 (Moderate) Level 3 (Severe)

192 26 0

Communication Access to services Care

Equipment (to include provisions of wheelchairs)

Attitude of staff Other

Low in comparison with contacts with service users (435,247) 7

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Compliments It is very rewarding for staff to hear that their efforts have been appreciated by our patients, clients and their families. The figures below show the number of compliments received this year >>>

Thank you to all for giving your time to me and teaching me valuable information that I will use in my future nursing career. Thank you to everyone for being so helpful to me during my placement. I learned so much while on your team and appreciate that each of you made me feel so welcome.

To my mentor [staff name], thank you for making my placement a good one. I will be a better nurse because of it. [Staff names] thank you so much for your time and I’ve learned a lot while paired with you all.

Braintree ICT, August 2017

I feel that I have to write this letter to express my deepest gratitude for the wonderful work the staff at the Lymphoedema clinic carries out.

I have been receiving this treatment for the last 3 years and before this my leg just got bigger and bigger, I can honestly say I would be lost without this service and would like to say a really big thank you to Patricia and all the staff at the clinic.

Thank you for making my life as normal as it can get.

Keep up the good work but hope I don’t see you too soon.

Lymphoedema Service, February 2018

Positive feedback and compliments 2017-2018:

96 177 47 111 4 435 8

Locality and Neighbourhood Services Community Hospitals, Minor Surgery and Out Patient Services

On behalf of my family I wanted to write to thank you and all your staff for the care and compassion shown to my wife when you and your nurses treated her over the last few weeks.

Everyone acted with great respect and dignity and she always felt safe in your hands. Please thank all the nurses who helped us.

Braintree ICT, March 2017

I am writing to express my thanks for the excellent service we have received.

The OT has been absolutely superb.

Not only was she extremely helpful in getting some aids to assist my mother, she was very understanding and her manner when dealing with my mother was particularly kind and considerate.

I cannot thank her enough for all her help. You are all doing a great job.

Community Therapy, April 2017

Specialist Children and Adult Services Primary and Prevention Services Other TOTAL

Thank you for being such a fantastic speech therapist, helping me learn all my sounds and sticking with me. Thank you for helping me throughout the year.

Children’s Speech and Language Therapy, July 2017

Delivering Our Services to Meet Customer Expectations

We as a family would like to thank you for all your help, support and guidance through ours and especially [child’s name] life so far. You and your team have been much appreciated and we will never ever forget what you have done for us.

Children’s Speech and Language, December 2017

I am writing on behalf of my family to give praise and thanks to your wonderful team of district nurses. For months they provided amazing care for my father and we as a family are so grateful for their help and support, especially in the last few weeks before he passed away.

Special mention must be made of [staff name] for arranging extra help with carers and for instigating the hospital bed which increased Dad’s comfort in his final days.

Without your marvellous team we would not have been able to carry out Dad’s wishes of dying in his own home. You should feel proud to have such kind, compassionate, efficient and professional nurses working in the community.

Witham ICT, March 2018

I wanted to take time to provide you with some feedback for the children’s community nursing team, who I currently offer safeguarding supervision for and have also supported following the sad deaths of some children.

The team have always been so engaged in supervision and always motivated to implement changes to support the family units. I have reviewed many of their notes and it is very evident how committed and compassionate they are towards children/ families and built the relationships families need during difficult times. I feel from my observations children are being provided with safe high level care.

One particular case that stands out for me is a case I was recently moved by. The care that the team, particularly [staff name] provided, allowed a young person to have a dignified death at home with his loved ones. You should be really proud of this service.

Children’s Community Nursing, May 2017

Service user called to express her thanks to [staff name] and [staff name] for their excellent care and compassion today.

She cannot praise the service enough and is 100% satisfied with her treatment by the wheelchair service. [staff name] and [staff name] gave her confidence and support and she feels she is going to regain some independence which she is looking forward to.

Cambridge and Peterborough Wheelchair Services, May 2017

Saw nurse [staff name] and she put me at ease with her knowledge. Double checked my symptoms with the senior nurse and I’m so confident now and glad I got it checked. Thought it was something worse. Put my mind at ease.

Essex Sexual Health Service, West, October 2017

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Demonstrating Quality Our approach to quality

Provide quality assurance process

Our focus is to ensure our services are safe, effective, caring, responsive and well-led. To achieve this the Board requires that there are well defined governance systems and processes in place to assure the quality of the services we deliver to our customers. This is at the centre of everything we do. Our Board, in consultation with our staff, have set out a clear statement of our vision and values which underpins our organisation’s culture.

Our Board monitor and assure quality standards by monitoring, reviewing and evaluating a wide range of quality data and information such as: Bi-monthly quality and safety reports.

Risk Register oversight and management reports.

Specialist reports from all support services in relation to: medicines management, safeguarding, infection prevention, information governance, learning and development, health and safety, service delivery issues and patient experience.

The Board are aware of all serious incidents

What do our customers say?

which occur during the year. They see reports and action plans from incidents and complaints and are able to be assured that appropriate measures are in place to deal with issues when things go wrong.

The Board encourage openness and

A customer recommended the service for: “...Treating them like a valued customer. People had a sense of humour.�

FFT Minor Operations service, December 2017

transparency in all we do and have backed the implementation of our statutory Duty of Candour.

The Board regularly visit different areas across the organisation to see first-hand the quality of the services being delivered and to speak with staff and our customers face-to-face.

The breadth of assurance provided to the Board allows structured discussions at Board meetings and provides detailed insight into the quality of the care being delivered as the norm across services, while recognising the need to improve where things go wrong in an open and transparent manner.

This robust governance framework provides assurance for the Chief Executive, the Chairman, and the Board of Directors, our CQC Registered Manager, and all our staff that the essential standards for quality as set out by the Care Quality Commission are being met in every part of the organisation.

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Demonstrating Quality

Our Quality Assurance Structure Provide Board

Quality & Safety Committee

Audit Committee

Clinical Excellence Group

Customer Feedback Group

Infection Protection Group

Medicines Safety Group

Health & Safety Group

Our Current CQC Rating

Risk Management Review Group

Strategic Safeguarding Group

Learning & Development Group

Workforce Steering Group

Serious Incident Review Group

Annual Quality Account Good

Overall

Finance & Risk Committee

Safe

Good

Effective

Good

Caring

Good

Responsive

Good

Well-led

Good

CQC inspections and ratings of specific services Good

Community Health Services for Adults

Good

Community Health Services for Children, Young People & Families

Good

End of Life Care

Good

Latest inspection: 12-15 December 2016. Report published 8 March 2017.

96

of staff said: “If I see an error, near miss or incident that could hurt staff, patients or customers, either myself or a colleague always report it.�

(Staff Survey 2017-18)

Our Quality Account 2017-18 is published on our staff intranet and the public internet. It has also been published on the NHS Choices website.

Sign up to safety

Community Health Inpatient Services

%

Each year all providers of NHS services are required to publish a report on the quality of the services they deliver. This is called the Quality Account. Our Quality Account aims to provide clear information about the quality of the services we deliver and our plans to improve further with the needs of service users and their families at the centre of all we do.

We are committed to: Putting safety first and reducing avoidable harm.

Continually learning by acting on the feedback from patients and incidents and by constantly measuring and monitoring how safe our services are.

Being open and honest by being transparent with people about their progress, tackling patient safety issues and supporting staff to be candid with patients and their families if something goes wrong.

Collaborating with the wider health, social care and volunteer community to improve the local services that patients use.

Supporting and helping people to understand why things go wrong and how to put them right. Giving staff the time and support to improve and celebrate their progress.

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Clinical strategy The way in which we deliver our clinical services and how our staff interact with our customers is fundamental to the delivery of safe, effective, caring, responsive and well-led services, as defined by the Care Quality Commission and experienced by our customers. At the same time, we live in ever changing times where we need to keep pace with the changing healthcare needs of our population, changing healthcare practices and changing levels of resource.

With this in mind, in 2016 we developed a three year clinical strategy to help us look forward and develop our clinical services, not only to keep us relevant and fit for purpose but also to ensure that the quality of the services we deliver is continually improving. Our clinical strategy priorities are aligned to our organisational vision and values so that our vision and values become real and our customer and staff expectations are met.

In 2017-18 we reached year two of our clinical strategy and we set ourselves a range of new priorities to help us continue our journey of improvement. Below is a summary of what we successfully achieved in year two.

“Staff were amazingincredibly informative, reassuring, worked quickly and efficiently and always made sure I was comfortable.�

(FFT Podiatry Service, November 2017)

Care and compassion

Nurture and empower

We will ensure we have a committed workforce which delivers patient-centred care through relationships based on empathy, respect, and dignity. Our key priority was to build on staff attitude, behaviour and culture change initiatives.

We will nurture a structure that promotes empowerment, fosters a belief in people’s ability to be empowered and acknowledges there is power in the relationships and care provided. Our key priority was for staff to contribute to organisational learning.

We supported staff to undertake the Mary Seacole leadership programme which empowers people to turn their success into consistent team success and to champion compassionate patient care.

The Clinical Professional Forum has been updated to become the Clinical Excellence Group with a focus on debating and reviewing all areas of clinical and professional practice, as well as taking a lead on the clinical audit, policies and clinical research programmes.

Staff undertaking the Mary Seacole programme have developed coaching skills to coach and mentor clinicians in the workplace.

We supported over 150 staff to undertake the Mary Gober training. This training aims to help staff engage positively with customers and colleagues in every interaction so they can provide a better customer experience and improved service delivery.

16 staff were supported to undertake the CMI Management Diploma Programme to support leadership development.

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What do our customers say?

We recruited dedicated Research and Development and Clinical Audit leads.

Training in clinical audit has been developed.

A range of research and clinical audit tools and templates have been developed and published on the intranet.

Demonstrating Quality

A view of our quality assurance At Provide we aim to put quality at the heart of everything we do. We have worked hard to put the right systems and processes in place to enable us to deliver high quality services and measure our performance throughout the year.

Stephanie Dawe Executive Clinical & Operations Director

Overall we have performed well over the past year and we have actively worked to improve on our service performance and delivery throughout the year as a result of learning from incidents and customer feedback.

In the past year all our staff have worked tirelessly and enthusiastically to ensure high standards of care have been experienced by our customers. We are very proud of our staff and what they have achieved and I would like to thank all of them for their hard work, professionalism and dedication.

Innovation

Competence

To ensure we have an organisational culture that drives innovation which balances cost and healthcare quality. Our key priority was to develop digital innovation in care and utilise technology for virtual consultations.

To ensure staff are equipped with the skills, knowledge, attitudes, values and abilities for effective competent practice. Our key priority was to review roles to support integration and practice development.

A Digital Strategy Working Group has been developed with the support of the IT team to explore how technology can be utilised to improve service delivery and the quality of the patient experience.

The children’s team now email care plans and reports to families to ensure they have prompt access to their information and it improves data safety.

The ESD service are utilising iPads with therapy apps to provide remote consultations and encourage service users to maximise their therapy programme.

Our staff conference, called the Quality Summit, in October delivered a packed agenda on best practice in record keeping.

We have contributed to a national working group seeking to develop bespoke apprenticeship training for Community Nurses.

Workforce planning has been established to explore how a new Associate Nurse role can support the delivery of safe, effective and caring services.

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Annual Quality Summit 101 staff attended the 2017 Quality Summit which took place on Friday 13 October 2017 at Colchester Football Stadium. The day was focused on the importance of record keeping and was targeted at both clinical and non-clinical staff.

As a learning organisation we identified that a common theme arising from our complaints and incidents was poor record keeping. Therefore we felt it was important to dedicate our entire Quality Summit to this one key topic.

Welcome

What did you see?

The event was opened by our Chairman, Derrick Louis, who gave everyone a very warm welcome and an endorsement from the Board for the day’s programme.

The Clinical Quality Team delivered a thoughtprovoking session to demonstrate that despite witnessing an event first hand, it is easy to forget the details if you do not make a record of it as soon as possible after the event. This reinforced the importance of ensuring clinical records are updated at the time a clinical intervention takes place to ensure it is accurate, factual and timely.

Let’s set the record straight!

Our Executive Clinical and Operations Director, Jane Corser, gave a very detailed presentation to ‘set the record straight’ by giving an overview of the origins of good record keeping and why good record keeping is important in Provide, not least because we have professional and legal obligations to keep good records but also to ensure safe, effective care and good continuity of care for our customers.

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The Datix game This session delivered by the Quality and Safety Team Data Analyst demonstrated through a fun and interactive game what happens to a Datix incident once it has been reported.

Annual Quality Summit

Record keeping - what is good record keeping and why is it important?

The whole of the afternoon was dedicated to our key note speaker, Andrew Andrews MBE. Andrew is a lawyer by profession and a respected legal advisor, whose practice is and has been in the public service.

Andrew is an established and recognised legal trainer within health and social care.

His current responsibilities comprise of: Director at Bond Solon, Chief Child and Adults at Risk of Harm Officer and Medico-Legal Advisor for St John Ambulance, Visiting Lecturer Royal College of Psychiatrists, Chairman of One in Four (charity which supports survivors of abuse) and Trustee & Legal Advisor of the Florence Nightingale Foundation.

What did our staff say?

“Excellent speaker, able to captivate audience.

Lots of valid points that make me question my documentation.”

(Staff feedback form re Bond Solon Presentation)

Andrew has served as Legal Adviser and Director of Legal Services for several health authorities. Andrew has also served as a member of a Multicentre Research and Ethics Committee and was Vice Chairman of a Local Research and Ethics Committee. He is increasingly called upon to serve and chair inquiries at both a local and national level into all aspects of health care.

Andrew gave an insightful presentation highlighting the importance of good record keeping and how it can be the best line of defence should an incident occur and we have to answer to a court or professional body. Andrew’s interesting presentation included amusing anecdotes and some memorable quotes taken from actual patient records.

All staff attending the day received a goody bag and throughout the day they had the opportunity to win various raffle prizes.

During breaks staff were able to view various posters in the exhibition area and were able to drop in to get their annual flu vaccination if they needed it.

The day was a great success and was well evaluated by attendees.

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Being an Employer of Choice We recognise that our workforce are our most valuable asset, so we have continued to invest in education and development to support the delivery of high quality care to everyone.

Mandatory training Our Fitness to Practice programme continues to support our commitment to delivering safe and effective care and this year, staff completed 97% of all their mandatory training requirements. We consistently exceeded our contractual performance target of 90% for the whole year. As part of rolling out the self-service function of our Electronic Staff Record, our staff now make 95% of all their training bookings using the new online system.

100% of our new starters continue to complete a comprehensive induction programme within their first week of employment with us. We are continuously reviewing our induction and onboarding process have developed a number of customised elearning programmes for our staff, as well as a range of video and online updates for clinical and core mandatory training programmes.

Apprenticeship Levy Since the introduction of the national Apprenticeship Levy system in 2017, Provide has been working hard to access Apprenticeship Levy funding, to support and develop staff.

While the new system has thrown up challenges in terms of processes, the eligibility criteria is now much wider and so more of our staff will benefit from this funding. Over the past year we have supported 30 staff to undertake development programmes using the Apprenticeship Levy. Nine of these were new apprentices recruited into apprenticeship posts. The remainder of our

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apprenticeship training is being undertaken by existing staff in a wide variety of areas, including everything from nursing and clinical support, to customer service, business administration and HR-based qualifications. We have already recruited three of our new apprentices into permanent posts in the organisation. “I was first employed by Provide last November where I was given the opportunity to complete a Level 3 HR Support Apprenticeship. When I first started with Provide I was shy and had no confidence in myself and the tasks I was completing.

Before I had begun the apprenticeship work, I had undertaken several training days and attended different meetings for me to better understand what HR is about and what my colleagues and managers do on a day-to-day basis.

Once my college work had commenced I was able to reflect what I have already learnt and to use it in answering questions for my assignments which made me become more confident in myself and the tasks I was completing. Eight months on, I’m now almost half way into my apprenticeship and achieving my targets.�

Feedback from one of our apprentices: Sophia Bayliss, HR Apprentice During 2017, we also celebrated the graduation of our first four work-based learning graduate nurses. This two-year fast track Nursing Degree Programme at the University of Essex is for experienced healthcare support staff and is an alternative route to becoming a Registered Nurse, allowing them to earn as they learn. The staff had previously worked in our community nursing teams as healthcare support workers and were our first staff to complete the programme. They are now all working as Registered Nurses in our community nursing teams.

Another five healthcare support workers are due to

Being an Employer of Choice

start their Registered Nursing Higher Apprenticeship Programme at the University of Essex.

We are also part of a system-wide mid & south Essex partnership group, supporting the introduction of the new Nursing Associate role into our clinical services. This will be a two-year work based learning programme and is aimed at bridging the gap between a healthcare support worker role and a Registered Nurse.

Mary Gober To support us moving to being recognised as an outstanding organisation, we rolled out a new customer service programme based on the well-known and internationally acclaimed Mary Gober training which helps to equip all our staff with enhanced communication skills and behaviours to deliver outstanding and people-focused customer services.

Some feedback from the training included: “Empowering training, due to focus on ‘what I can do’”

Leadership and management With Health Education England funding support, six of our staff are completing a District Nurse training programme with Anglia Ruskin University. This training will support the delivery of responsive, high quality health care to people in their own homes and communities by our community nursing teams.

As part of our behaviour change strategy and vision to provide a range of outstanding services which care, nurture and empower individuals to live better lives, 24 of our managers completed an Institute of Leadership & Management (ILM) diploma programme which included the delivery of a behaviour change project within their area of work. These included developing new approaches to improve the way we deliver care directly to communities and individuals, as well as within our systems and processes in our administration and corporate teams.

“This excellent training reiterated to me the value of customer service and how vital it is for Provide’s future.”

“Very informative and engaging from the beginning to the end.”

“The training exceeded my expectations.”

“I am supporting people on the phone all day and this training will really have a good impact on my team and the people I support.”

“Made me think about first responses and how my thoughts and feelings impact my responses.”

Health and wellbeing courses As part of our healthand wellbeing strategy, 20 staff completed a meditation course from April to October.

Feedback from these staff indicate that the majority of them are still practising meditation regularly and have experienced both physical and mental health benefits.

Health coaching 137 staff have also completed health coaching training to develop essential skills and an understanding of health coaching methodologies, This enables staff to use these in everyday conversations with our customers to support self-management and a sustainable change for improved health and wellbeing.

Provide Annual Conference We held another successful annual staff conference in May 2017 at Chelmsford City Racecourse. The conference theme was Integration and joint presentations about models of integrated care were delivered by Provide and managers from Essex County Council Social Care.

Provide staff delivered 12 workshops at the event, sharing their experiences of integrated working and an exhibition area included a range of information stands, including sustainability, diabetes, health champions, dementia, continence, and COPD. Some feedback from the day included: “Very relevant in the current culture of health and social care provision and the vision to implement for the future.”

“Relevant topic to my changing nursing role in the Integrated Discharge Team.”

“Well organised, good speakers that were interesting to everyone.”

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Recruitment This year the Provide Workforce Steering Group has focused on understanding how recruitment and retention can be maximised.

Roll out of our values-based recruitment training has continued with 11 courses being delivered in 2017-18 and all new managers undertaking the course as part of their training. Early indications are that this is enabling better recruitment decisions and supporting our retention.

We continue to work to streamline our recruitment processes to ensure that this is efficient for both prospective employees and our services. Feedback on our recruitment process by applicants using NHS Jobs consistently places us above the national average. We were also successfully accredited as a ‘Disability Confident’ employer in recognition of our ability to recognise and maximise the talents disabled people can bring to our workplace.

In 2017-18 all new employees assessed at the end of their probationary period were confirmed in post, which indicates that our recruitment processes are successful in securing employees that share our values and meet our high expectations. Our absence rates have continued to decrease over the year and are some of the best amongst community providers nationally.

Whilst there remain challenges to recruiting nationally and locally to some positions, we have generally been able to recruit to key roles and to maintain turnover through voluntary resignations at around 14%.

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Being an Employer of Choice

Technology

Health and wellbeing

During the year we have continued to develop our Electronic Staff Record (ESR) System. 75% of our training and development opportunities were booked through the Employee Self-Service function of ESR this year and 2017-18 also saw us successfully embedding access to online payslips. No paper payslips were generated and this has not only supported our sustainability agenda by saving on printing and postage, but has enabled staff to receive pay advice two days earlier. Additionally, we have improved the access and training available to staff to our Easypay Claim system enabling staff to claim expenses and additional hours in a secure, efficient system, further reducing our use of paper-based systems with 99% of all claims now being electronic. In the early part of 2018 we continued to increase system functionality by using ESR to request and authorise annual leave. 95% of our employees used the system to request annual leave in this way, enabling managers to have real time access to the leave booked by their team. This has streamlined systems and delivered improved information for service planning.

The Working Well Group and Wellbeing Champions have continued to deliver a number of wellbeing projects for staff this year. These have included seated massage, meditation, hydration challenges, pamper days and a number of sporting initiatives.

10 employees were trained as Mental Health First Aiders during the year and are now available across Provide sites to talk to people who may be showing signs of stress or other mental health issues and signpost them to sources of help and support.

Staff survey In November 2017 we launched our annual staff survey.

This is the third time that we have run the survey using our own systems, achieving a response rate of 50%. This year a greater percentage of our staff indicated that they would recommend Provide as a place to work and as a place for a friend or family member to receive care, compared to staff in NHS Community Trusts and all NHS Trusts.

The staff survey is an important tool to enable Provide to gather and respond to the feedback from our teams. The feedback has been used to inform a range of projects and has been considered by our Workforce Strategy Group in order that a targeted action plan can be implemented to make continuous improvements.

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P r o v i d e

A n n u a l

R e p o r t

2 0 1 7 - 2 0 1 8

Every year the outstanding achievements of Provide’s health and care staff, as well as the volunteers who work with them, are recognised at an annual staff awards ceremony. This year it was held on 28 March 2018 at Newland Hall in Chelmsford and 140 people attended.

Recognising Our People

The main categories for the awards and winners were:

Care and Compassion Award Children’s Community Nursing Team (Service) Nicola Radovic, Assessment Nurse, ESDAAR (Individual)

Outstanding Leader Award Sophia Flint, Community Matron

Outstanding Volunteer Award Jane Rice, Pulmonary Rehab Class, St Peter’s Hospital

Outstanding Service Award Children’s Community Nursing Service Outstanding Service Award

Outstanding Employee Award Michelle Kulik, Business Co-ordinator Carol Selby, Administrative Assistant, Child Health Information Service

Sustainability Award Essex Child Health Information Systems Team

Behaviour Change Award

Behaviour Change Award (Gold) - Therese Williams

Therese Williams, Project: Electronic triage through SystmOne (Gold) Sophie Flint, Project: Red to Green (Silver) Stephanie Rivett, Project: Paper Reduction Awareness Campaign (Bronze)

This year we also presented Highly Commended Awards in the following categories to recognise the hard work and commitment of these individuals:

Sustainability Award Emma Schmid

Outstanding Leader Award Ruth Barlow and Julia Tseayo

Sustainability Award - Emma Schmid

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In addition, 46 members of staff received Educational Achievement Awards and 13 members of staff received Long Service Awards, for over 25 years of service to Provide and the wider NHS and care services.

Recognising our People

Speaking about the awards, Provide’s Chairman, Derrick Louis said:

“These awards are a special occasion when we can publically recognise the successes of our staff and teams and acknowledge staff who have achieved national recognition through research and study. It is a fantastic event to celebrate the exceptional teams and individuals who have gone above and beyond what is required of them to provide an excellent level of service.

There was an exceptional response for our Care and Compassion Award with patients, carers and their families nominating services and individuals they feel deserve to be recognised for their hard work and inspiring efforts.

Many entries demonstrated how caring, compassionate and valued our staff are and I was proud to hear about the support shown by our staff to patients, often at difficult times for families.”

Care and Compassion Award

WINNER

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P r o v i d e

A n n u a l

R e p o r t

2 0 1 7 - 2 0 1 8

Making Technology Work

2017-18 was another busy year for the Technology Team in which improvements were made in a variety of areas. ‘ISO27001:2013 Information Security Management’, an internationally recognised standard was achieved, further enhancing the reputation of the department and improving how we protect and secure our data. Cyber Essentials Plus was also maintained for another year.

Both accreditations helped with a year-long project to be ready for the General Data Protection Regulations (GDPR) and was achieved in advance of the 25 May 2018 deadline. This has included introducing Data Protection Impact Assessments (DPIA), improving the way we map our data flows, appointing a Data Protection Officer (Richard Bradley), and much more.

We have introduced the Provide App store which is accessible from our new Android mobiles which will be distributed to staff in 2018. The mobiles are secured with a new Mobile Device Management tool that will also allow a greater level of remote support.

There has been a focus on self-service and efficiency for our systems. We have introduced self-service password tools for our e-Roster, smartcards and Active Directory accounts, and lots more can be done through our Service Desk Portal.

E-roster has been expanded to new services, our Community Hospital wards now use SystmOne and SystmOnline is available to all our SystmOne services.

Richard Bradley, Gateway Assure

We have worked with digital partners to plan how we further improve our services and this has focused largely on ensuring we have a resilient and robust infrastructure on which to build from. As part of this we have replaced many of our switches and introduced new next generation firewalls, an important part of protecting us from cyber crime. The planning work has been taking place for new technology to support the CCC and these plans will be realised in 2018-19 when we will introduce WebChat, email queuing and social media integration, giving a greater number of channels through which service users can contact us.

We have also been working with the University of Essex on a Knowledge Transfer Partnership to consider how artificial intelligence and machine learning can be used to improve our services. We have had a project approved over three years that will see the partnership develop tools that help us to help our service users.

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Technology

ISO 27001 REGISTERED This document certifies that the information security management systems of

PROVIDE (CIC) 900 The Crescent, Colchester Business Park, Colchester, Essex CO4 9YQ have been assessed and approved by QMS International Ltd to the following information security management systems, standards and guidelines:-

ISO 27001 : 2013 The approved information security management systems apply to the following:THE PROVISION OF IT AND DATA SERVICES AT PROVIDE (CIC) HQ.

Original Approval:

30 January 2018

Current Certificate:

30 January 2018

Certificate Expiry:

29 January 2023

Certificate Number:

278342018

On behalf of QMS International Ltd

This Certificate remains valid while the holder maintains their management system in accordance with the published standard. To check the validity and status of this certificate please email certificates@qmsuk.com This Certificate is the property of QMS International Ltd and must be returned in the event of cancellation

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P r o v i d e

A n n u a l

Being Financially Strong

R e p o r t

2 0 1 7 - 2 0 1 8

3%

9%

3% 25%

11% Analysis of income 1 April 2017 - 31 March 2018

48%

6%

20% NHS Mid Essex CCG Local Authority NHS England Other CCGs Braintree Hospital

21%

Other NHS Other

In the year ended 31 March 2018, Provide received ÂŁ60.1m of income for the services it delivers. Just under half (49%) of this income was received from Mid Essex CCG for the main community health services in mid Essex. At ÂŁ29.6m, this is slightly more than we received in the previous year and represents a higher proportion of our overall income.

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41%

Analysis of Non Pay Costs 1 April 2017 - 31 March 2018

1% 1%

1% 16%

Being Financially Strong

10%

A further £5.2m was paid to us for services at Braintree Community Hospital under a separate agreement with Mid Essex CCG.

3%

Analysis of pay costs 1 April 2017 - 31 March 2018

41%

21% Nurses and Healthcare Assistants Therapists and Scientists Admin and Clerical Senior Management and the Board Doctors

Supplies Establishment expenses Premises

19%

Charitable donations Miscellaneous Corporation Tax Services provded by other organisations

We do not receive all of our money from this one CCG though, and the 11% we receive from other CCGs (£6.4m) demonstrates success in marketing our services outside of mid Essex. We also received 20% of our income from Essex County Council (£11.9m) and 6% from NHS England (£3.3m).

We spent £59.2m to provide our services, leaving a surplus of £0.9m (before tax). It is important that we make a surplus of income against expenditure as this provides the cash necessary to manage the business. In the longer term, we will reinvest all of our surpluses back into our community.

Our costs were split between pay (£32.4m) and nonpay (£26.8m). The biggest staff group are nurses and healthcare assistants, with this staff group costing £13.6m in the year. Admin and clerical staff cost £8m in the year, and our third largest group of staff were therapists (£6.7m).

The rest of our staff costs were spent on management (£3.1m) and doctors (£1.1m).

The £26.6m of non-pay costs include supplies of £5.9m, premises costs (including rent, electricity, gas, water, insurances, refuse collection, and so on) of £4.2m, as well as establishment expenses (for example printing and stationery, postage, telephone rental, travel expenses, etc) of £5.0m. We also paid around £11.2m for services provided by organisations like Mid Essex Hospital Trust, Serco and our partners who deliver parts of the sexual health pathway (Colchester Hospital University NHS Foundation Trust and Essex Partnership University NHS Foundation Trust). The remaining non-pay costs relate to miscellaneous charges, such as depreciation. We also made charitable donations of £0.1m.

The overall financial performance was excellent, and in making a surplus, Provide delivered the savings requirements set by commissioners in our contracts.

Making non-recurrent surpluses and non-recurrent charitable donations does not remove the on-going need to make recurrent savings, and our NHS and Local Authority commissioners will continue to ask us to show that we are using taxpayers’ money effectively and efficiently.

All staff have shown that they are able to rise to the challenge of delivering savings and controlling costs.

This puts us in a good position as an organisation as we continue to contract with the NHS and Local Authority commissioners.

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P r o v i d e

A n n u a l

R e p o r t

2 0 1 7 - 2 0 1 8

Investing in Our Local Communities Provide Foundation Our partnership with Essex Community Foundation (ECF) means that we can effectively invest funds into voluntary, community and charitable organisations whose work complements our own. As a Community Interest Company, Provide is committed to reinvest a part of its surpluses back into the communities that it serves. Having established the Provide Foundation with ECF we can do this in the most efficient and effective way and will be awarding grants year-on-year to support the voluntary sector where we provide services.

Dementia Adventure

There are many community schemes and projects making great strides to improve the health and wellbeing of people in mid Essex and beyond, and through the grants from the Provide Foundation, we can help them continue and expand their work.

In 2017-2018, 14 community projects run by voluntary and community groups were given a major cash boost with grants totalling £88,905 from the Provide Foundation. There was a top award of £20,000 which was presented to Dementia Adventure, and 13 organisations received grants and donations ranging from £4,000 to £10,000.We have also invested a further £50,000 in the Provide Foundation fund in 2017-2018.

Maldon & Dengie Stroke Association

A full list of grants made is as follows: CARA – Centre for Action on Rape and Abuse £5,000 Contact the Elderly £5,000 Essex Respite and Care Association £4,976 Kids Inspire £5,000

Maldon Community Voluntary Service

Headway Essex £5,000 BOSP – Brighter Opportunities through Support Play £4,929 St John Ambulance £4,000 Families in Focus (Essex) £5,000 Support for Sight £5,000 Dementia Adventure £20,000 Maldon & Dengie Stroke Association £10,000 Maldon Community Voluntary Service £5,000 Remap £5,000 RCCE – Community Agents £5,000 RCCE – Community Agents

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Investing in Our Local Communities & Giving Month

Fundraising activities In addition to the work we do with ECF, our Governors are responsible for agreeing additional grants and charitable donations through two separate mechanisms. The Governors approve grants to local communities based upon requests from members of our organisation. They also approve sponsorship matching where members undertake their own fundraising efforts on behalf of local and national charities. In 2017 – 2018, the Governors approved a total of £22,287 to many different charities and voluntary sector groups, including the following:

Cancer Research Chelmsford CVS Children’s Liver Disease Foundation CRY Cystic Fibrosis Trust

£175 £2,000 £142 £1,000 £500

Daniel McGauley

£1,000

Daniel O’Shea

£1,000

Daniel Robinson & Sons

£1,000

Diabetes UK

£1,000

Earls Colne Baptist Church

£2,000

Lavender House

£1,000

Mayor’s Charity

£3,000

MS Society

£500

Our chosen charities In 2017 – 2018, Provide also asked its members to agree two specific charities that we should donate money to based upon the fundraising efforts of our staff. The two charities chosen by staff were Little Haven’s Hospice and the Essex and Hertfordshire Air Ambulance Trust.

In September, we launched an initiative to promote fundraising by teams within the organisation and agreed to split the money raised between the two chosen charities.

Efforts to raise money included:

NCDS

£1,000

Our Charity Golf Day in September

St Helena Hospice

£1,270

A Christmas Jumper day

Starlight Children’s Foundation

£1,000

The Café, St Peter’s Hospital

£2,000

Raffle and guess the weight of the cake at our Corporate Christmas Party

United Engineers Ladies Festival

£1,000

Cake baking A staff quiz night Christmas gifts sale On the basis of all of the money raised and with a matching amount donated by Provide, we were able to donate a total of £5,097 to each of the charities.

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P r o v i d e

A n n u a l

R e p o r t

2 0 1 7 - 2 0 1 8

From the Governors The Council of Governors have continued to work on behalf of you, the members, and are happy to share some of the activities carried out in which they have been involved for 2017-18.

The Governors have worked with the Board to represent the members’ views and ensure that these are communicated and taken into consideration when decisions about the organisation are being made.

Again, this year the Governors and Board have worked together to refresh the corporate strategy and agreed the changes required to move the organisation forward.

The Governors continue to be represented at all Board meetings and are actively involved in the decisions being made. The Chair of Governors is a Board member and takes part in all Board activities. A guest Governor is invited to attend every monthly Board meeting.

The Governors have also agreed that the Non-Executive Directors coming to the end of their current term will remain for a further term, maintaining the stability of the Board overall.

The Council of Governors meet every two months and discuss the issues raised with us to communicate to the Board and we value your engagement.

Coffee mornings have been held at various bases for members to drop in for a chat and share any ideas.

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These mornings will continue in line with future open door sessions being hosted by the Chief Executive and the Executive Clinical and Operations Director.

We continue to visit services with Board members to support staff and to take back to the Board ideas that are discussed. We see this as a positive way of meeting with you and we always value the opinions and thoughts of you all.

This year has seen an increase in the number of successful requests for charity match funding from members with over ÂŁ10,000 donated. The Governors have formally agreed the criteria with a maximum of ÂŁ1,000 available to members that meet the criteria.

We again celebrated Employee Ownership Day by delivering cakes to all bases to be enjoyed by all members.

We are very proud to represent the organisation and all of its members and to represent your views to the Board, ultimately helping to support the delivery of our services to the communities we serve.

From the Governors

Nisha Desai ines armacy & Medic Ph Head of t en m ge na Ma

Claire Aldridge Care Call Services Manager

Mike Fair Head of Safety & Resilience

Ian Martin Head of Contracts & Commercial Finance

Karen Dresse r Admin Team Le ader

Carol Gerrard Clinical System s Manager

Amy Jackson PMO Co-Ordinator

Jayne Pe Head of Q den (Chair) uality & S afety Ellen van Gemmert (Vice Chair) Health Development Manager

Helen Mulle m Head of Safe guarding ie Rivett Stephan Co-ordinator rt o p p iness Su

Helen McRorie Child Health Team Leader

Cheryl Ellis IC Respite Carer, EP ce ite Servi Children’s Resp

Heather Joslin Urgent Care Lead, ESDAAR

arnall Nicola Y gist & u ic A diolo Paediatr rvice Lead ENT Se

Sian Webster-Hirst Child Health Administrative Assistant

Bus

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P r o v i d e

A n n u a l

R e p o r t

2 0 1 7 - 2 0 1 8

Volunteering with Provide 2017-2018 The Provide volunteer service was started three years ago and although the total number of active volunteers remains consistent (between 75-85), the number of hours completed has increased each year. This year’s volunteering hours increased by 61.6%, from 3,830 hours to 6,190 hours.

When the service was being developed, the volunteer roles were mainly ward based. As the organisation becomes increasingly aware of the value that volunteers offer, the variety of roles has widened. With the opening of the Care Co-ordination Centre and the centralisation of administrative staff away from the front line, volunteers have been placed to interface with the public and support clinical staff. They signpost service users and encourage the completion of Friends and Family feedback cards.

One of the service goals for 2017-18 was to look at capturing a wider range of feedback, which included measuring the level of experience of clinicians and also the views of the service users. This resulted in an overall positive view with 73.3% of clinicians who utilised volunteers within their service reporting a positive effect for the service and 86.7% were likely to recommend the service. Feedback from the inpatient service users showed 84.2% were aware of the volunteer presence, with 81% satisfaction for those who participated in activities provided. Our volunteers rated their overall experience of working with Provide as 28.6% satisfactory and 53.4% excellent.

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Volunteering with Provide 2017-2018

Highlights of 2017-2018 In April 2017 the Pop-Up Shop opened in St Peter’s Hospital in partnership with The Café, providing inpatient service users the opportunity to buy toiletries, sweets and newspapers. This has been a lifeline for some patients who do not have family or friends and when finished with the shop, the volunteers are able to spend a relaxing time chatting and passing the time of the day.

The year has seen exciting opportunities for volunteers working with the hospital therapy teams. The roles have included hands-on supporting exercise classes and also administrative roles. These opportunities have led to two volunteers having changed their careers, with one opting to train as an Occupational Therapist and the other successfully working as a paid therapy assistant. For people seeking occupational changes, volunteering is an excellent way to have a taste of a new career, as one volunteer reported “It would not have been possible for me to even apply for the job without having the opportunity to volunteer. I had no previous experience and the therapy team were fantastic in supporting my ambitions.”

Essex Lifestyle smoking cessation service provided the perfect opportunity for four student volunteers who were studying their Public Health degree at Anglia Ruskin University. The students were given time as part of their course to work with industry, volunteering in different areas. The students supported smoking cessation days and completed the Making Every Contact Count training programme.

Developing on from the “Green Memories” pilot delivered with Maldon Voluntary Services in 2017, a funding bid for £114,000 has successfully gone through to the second stage with the Big Lottery Fund. The concept uses garden memories and supported gardening activities for socially isolated people. The Volunteer Coordinator and the Director of Maldon CVS have submitted a further bid for Big Lottery funding to develop the concept into a three-year project.

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P r o v i d e

A n n u a l

R e p o r t

2 0 1 7 - 2 0 1 8

Innovations The Patient Independent Feedback Service was an exciting innovation for this year. It is a volunteerled service which works with the Integrated Care Team to contact service users receiving nursing care and to gather independent feedback.

It differs from Friends and Family in that it is conducted as a conversation to elicit feedback in an informal manner. The information is used in improving services and training. The service was developed in collaboration with the Patient Council for Broomfield Hospital and Provide Customer Services.

This year was an exciting year for working with Essex University students on a research project around sexual consent. The students relished the opportunity to work with Provide and the volunteer students were supported throughout by the Essex Sexual Health Service.

They created a range of resources including an animation video and printed information. Other members of the business hub received an exciting presentation from the students and were able to give useful feedback to the students to help them develop their ideas. John Niland, Chief Executive, met with the students at the end of the project and helped them review their experience.

The Volunteer Coordinator was asked to work with Essex Lifestyles to review the Expert Patient Programme (EPP). This is a licenced programme which supports people with long-term conditions to learn positive ways of coping with their condition and is due to end in September 2018. The review included exploring creative ways to develop a brand new service unique to Provide. This will deliver one, three and six week programmes for people to access and also signposting to a range of apps. Working with the existing team who deliver EPP, a new programme has been developed called ‘Managing Health’. This will significantly increase the number of people who access the service, utilise the latest research on engagement and motivation, and provide a versatile service which is tailor-made to the individual and not a ‘one size fits all’ approach. Supporting this project will be a new team of volunteers trained specifically in behavioural change to help support service users become as self-managing as they are able.

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Volunteering with Provide 2017-2018

Welcome Provide is always delighted to host Pets as Therapy (PAT) visits.

These are trained and screened dogs who visit the wards. We are delighted to have a new member of our team, called ‘Millie’, who is a labradoodle and is the proud owner of a recently retired staff member, Lesley Speller. The PAT dog visits are very popular with service users, visitors and staff alike.

In order to streamline the recruitment of volunteers, the Volunteer Coordinator can now undertake DBS screening electronically. This has reduced the time of volunteers waiting for DBS clearance from six weeks down to approximately six days.

In feedback, volunteers felt they wanted to meet up and share ideas. As a result, six-monthly meet up sessions have been set up for each area and the result has been that smaller problems and niggles are being resolved. It is hoped the result should be improved volunteer retention as there is definitely a greater feeling of working as part of a team amongst the volunteers.

This year saw a greater emphasis on specific recruitment for each role with the services taking more responsibility for the training and managing of their volunteers. This has definitely resulted in better feedback from the volunteers in terms of feeling part of the team and also saw improved retention figures.

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P r o v i d e

A n n u a l

R e p o r t

2 0 1 7 - 2 0 1 8

Firstly, let me say how I am always amazed when I read our Annual Report about the amount we have achieved in the year looking back. I do often smile as I read my predictions for the forthcoming year as I note that not all of them have come about.

I guess that is the nature of my contribution, to help give at least some indication about what is likely to be round the corner. Right now, as it was last year, this crystal ball-gazing is incredibly difficult but I can only tell you for sure that which is in our gift.

We still have the same Government as last year with mostly the same health policy, although we now have a new Health and Social Minister who is not only quite local but is also a big supporter of social enterprises and staff owned mutuals. We will try and meet with him as soon as we can.

The fact that the new ministry is now Health and Social Care does allow us to speculate that we will be required to work even more closely with our colleagues in Social Services. Provide already does a lot of this but I am very excited by the work that we have been doing in the Integrated Health and

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Social Care Board. By the time this document is published we will have held a significant joint workshop as we continue to develop a model for out of hospital care within mid Essex.

I am confident that as we are going about this the right way and we have the commitment from Essex County Council, we will be able to create a model that will significantly change the way we collaborate.

In addition to this, we will be working with primary care in a significantly different way. Mid Essex CCG is signed up to a new model of primary care which will see us working with

GP clusters or groups of practices covering up to 100k population. We will be delivering a more pro-active based service structured around this population size with something called Population Health Management.

This is at its embryonic stage but will gather pace as the year progresses.

Examples of this are beginning to take shape in Chelmsford and South Woodham Ferrers. It will mean that we will have to adapt to a new model and in some cases new management but we will do so having been part of the co-design of the service to be delivered.

Looking Forward

Looking Forward

We will, as I have previously said, continue to invest in technology and improved estate. We will need an agile workforce equipped with the latest technology, always looking at having a cutting edge. We will be working with both our local universities on areas like artificial intelligence and augmented and virtual reality, to work alongside staff, to improve what we are able to do and the speed we are able to do it. This will mean investment in both the Care Co-ordination Centre, as well as customer-facing sites.

We have pledged to get out of old NHS estate that is not fit for purpose and we will be investing significant resources in new and better environments for our customers and staff.

We have, as our Chairman has mentioned, up to now played a significant role within the Sustainability and Transformation Partnership (STP).

This will continue and in my view, increase as we work with colleagues to adjust to a newly formed acute trust covering mid and south Essex. This will be the 10th biggest acute trust in the country and they will expect

consistent pathways both in and out of their hospitals. We will work with staff in EPUT, NELFT, Social Services, Healthwatch and the acute trust to develop these pathways in a collaborative way to ensure the needs of our patients are fully represented.

part of this, we will look to add to our existing private companies which will help the CIC financially and allow us to invest more. This will probably mean creating some form of Company Group Structure to allow us to make the most of our growth.

As you can see, we have a full and challenging year ahead. We will need to do all of these things in an environment where staff are more difficult to recruit and the demands of our customers are increasing.

This is why I am convinced we need to innovate and continue to push the boundaries of what can be achieved with the use of better and more focused technology. A shared patient record is round the corner and will be implemented across Essex by 2020. We must be ready to take full advantage of this.

There you have it. My annual predictions for the future. They are in my view very positive but not without difficulties and significant hurdles.

However, I believe we will achieve all that we set out to because I believe we have the will and the staff to do it. You are our biggest asset and my warmest and sincere thanks to you all who continue to travel with us on our evolutionary and sometimes revolutionary journey.

Finally, I predict that our Provide Wellbeing service and our other companies such as Tollgate Clinic Ltd will add value to our organisation.

We will look to do a full review of our strategy in the autumn which will include Governors and Managers. As

John Niland Chief Executive

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If you need this booklet in braille, audio, large print or another language, please contact our Customer Service Team on: 0300 303 9951 / 9952 or by email at: provide.customerservices@nhs.net Provide Corporate Offices 900 The Crescent Colchester Business Park Colchester Essex CO4 9YQ

T: 0300 303 9999 E: provide.enquiries@nhs.net www.provide.org.uk

PBO-2787A-1837-01