Operational Plan 2025/2026

Page 1


Welcome

Each year we move forwards and improve the care and experience for our patients and staff. This plan sets out our 2025/26 priorities moving us closer to our vision of delivering excellent care. Everyone has a role.

In 2024/25 the Care Quality Commission (CQC) recognised our progress. Our hospitals were upgraded to Requires Improvement. Many services were also rated Good. Urgent and emergency and cancer care are our most pressured services. It is everyone’s responsibility to improve the care and patient experience in these areas. Since the CQC’s visit we have made many improvements, shared in this summary.

We know we need to go further and faster in our improvement. Our Moving to Excellence work will connect all our improvement programmes. Through our exciting plans in education, digital, clinical services and estates we want to become an excellent Trust by 2028. This is ambitious but given the amazing staff who work in SaTH, we believe we can do this.

Our people are key to our success. In 2028 we will see the results of a once in a generation investment in our hospitals. This is more than a new building. We need to reform our workforce now to be ready for when the doors open. In 2025/26 we will grow our workforce in some services to improve care for patients. In other areas we need to build a more modern NHS and change the way we work.

This year, more than ever before, we have a triple balancing act: workforce, quality and finance. This means going back to basics –what is the NHS here to provide? Like other hospitals, we will have difficult decisions to make to stay within our budget and add value to taxpayers.

Patient safety will always come first. By focusing on quality and building a modern workforce, we will balance our budgets. We will do this by staying true to our values and listening to our patients, families and staff.

We also want to be a great place to work. Our focus will be building a culture where everyone feels they belong, has a voice and has opportunities to grow.

2025/26 will bring many changes but also opportunities in the NHS. Locally, we believe we are Better Together and will be exploring a Group model with Shropshire Community Health NHS Trust. By having a shared leadership and strategy we can deliver better care for patients and a better experience for staff.

Our plans will be aligned to the three shifts within the NHS 10 Year Health Plan – from hospital to community, from analogue to digital, and from treatment to prevention - which aim to personalise care, give more power to patients, and ensure the best of the NHS is available to all.

We all want to build an NHS that is focused on wellness rather than illness, giving staff the modern tools they need and delivering more services closer to home.

Everyone in Team SaTH understands our challenges and has the ideas and passion to deliver excellent care. We want our teams to lead changes in their areas and we will support them. Together we will create an organisation we can all be proud of.

Thank you for your support.

Vision and values

Our values are what we believe and guide all we do. We will deliver the priorities in this plan by staying true to our values. At the heart of our work will be our patients.

• Partnering – working effectively together with patients, families, colleagues, the local health and care system, universities and other stakeholders and through our improvement alliance.

• Ambitious – setting and achieving high standards for ourselves personally and for the care we deliver, both today and in the future. Embracing innovation to continuously improve the quality and sustainability of our services.

• Caring – showing compassion, respect and empathy for our patients, families and each other, caring about the difference we make for our community.

• Trusted – open, transparent and reliable, continuously learning, doing our best to consistently deliver excellent care for our communities.

Our Trust Strategy

Each year our Operational Plan moves us closer to delivering our five-year Strategy. We have six big priorities which will improve care for everyone.

Moving to excellence

We have made good progress in the last few years. We won’t stop until we are delivering our vision of excellent care for our communities and an excellent working environment for our colleagues.

To be excellent, we know we need to work differently. We have exciting plans underway, including opening new services, improved buildings and using new technology. We also want to become university hospitals known for our training. In 2025/26 we will bring all this together under our Moving to Excellence work. This replaces the Getting to Good programme. We have a clear plan, and everyone has a part to play.

Our achievements 2025/25

Our People

Awarded Disability Confident 3 Statusbecoming a more inclusive employer

556 Staff Network members

29 people completed the Galvanise leadership course for colleagues from ethnic minority backgrounds

94% of staff completed their statutory and mandatory training

10 DFN interns supported through work placements 148 work placements

Our Staff Psychology Service supported 340 requests for individual support and 66 requests for teams

91% reduction in highrate nursing agency useimproving care through safe staffing levels

Reduced medical agency posts by 100 to 32 postslowest for over 5 years

New rapid access to treatment process - helping staff wellbeing and for them to return to work

6,400+ staff supported on Loop - new annual leave system

5,000+ staff trained on new Patient Records System

99.9% accuracy rate in Electronic Staff Records data quality - amongst top trusts

Launched our Menopause support programme

Medicine and Emergency Surgery, Anaesthetics and Cancer

Increased zero day length of stay and more patients seen in the medical Same Day Emergency Care Centre instead of the Emergency Department - overachieved against 30% target

Frailty Assessment Units launched - faster assessment and treatment in a better environment for older, frail patients

Sustained improvement in adult and children’s initial assessment in Emergency Departments

Significant progress in referral to treatment on elective pathways

Reduced waiting times for Cardiology first outpatient appointment from 65 weeks to 28 weeks

Improvements across all wards supporting early discharges, weekend discharges, and use of the discharge lounge

Progress against all People Promise themes in staff survey

Phase one of the Emergency Department works complete - bigger, more modern facility for everyone

Planned Care Hub opened - 3,853 patient operations since 10th June (1,378 since 1.1.25 to 31.3.25)

Reopened ward 5 PRH for elective orthopaedic surgery

First zero-day discharge for knee replacements

First zero-day discharge for hip replacement

Eliminated agency in nursing

New structure within the flow coordination team

Reduced overspend on Divisional budget

£1m Triomic research study for colorectal cancer services

New digital whiteboard in Surgical Assessment Unit - improving care for patients through modern tools

Introduced theatre academy – supporting staff to learn new skills

Maintained accreditation in Endoscopy, Hepatology, Audiology and Sterile Services

Achievement of first High Intensity Theatre List - 11 hernia operations in one day

Corporate Women & Children’s

Children’s and Young People (CYP) and Maternity rated as Good across all domains by CQC

Fully implemented Saving Babies Lives - delivering quality maternity care

Significant progress in paediatric, maternity and neonatal transformation programmes - improving patient care and staff safety

Improved neonatal nursing staffing levels

First Trust in region to meet allied health professional staffing levels in neonatal

Achievement of the Bliss Silver Accreditationsupporting and involving families in their babies’ care

Achievement of UNICEF Baby Friendly Standard Level 2 - empowering staff to support families with infant feeding

Successful launch of ‘paediatric vitals’ electronic recording of vital signs for CYP - supporting more timely treatment

Meeting national staffing standards in CYP through successful recruitment

Dr Banchhita Sahu, Consultant Gynaecologist, awarded the Royal College of Gynaecologist’s Trainer of the Year Award

Clinical Support Services

Extended opening hours for imaging at Community Diagnostic Centre - 6 days a week

Significant improvement in Diagnostics waiting times - CT scans 99% achieved (above national DMO1 target), MRI scans 85% achieved (met system DM01 target)

Post graduate qualification launched for Reporting Radiographers

New Nuclear Medicine services with £3.6m Gamma Camera opened at RSH

New text messaging service - improving access for breast screening appointments

New remote monitoring service for respiratory patients - improving care through technology

1 million+ samples a month processed and reported by pathology

Maintained accreditation in pathology for testing

Successful pilot for Lung Rehabilitation with the Macmillan Integrated Therapy Service - funded by West Midlands Cancer Alliance

Exceeded Patient Initiated Follow Up (PIFU) target for therapies by 15%improving waiting times for patients

Increased our physio offer from 3 to 12 students a year at PRH - better training and experience

£312m Hospitals Transformation Programme (HTP) investment agreedconstruction starts at RSH

60% reduction in monthly agency spending - under £1million per month

£34.3m efficiencies delivered (nearly double 2023/24) - delivering value for taxpayers

Finance Team won two industry (HFMA) awards

1,800 staff complete fire training - supporting safety of patients and visitors

PRH infrastructure upgrades - resilience and support to electric supplies

Reducing clinical wastesaving £150k

Installed 12 electric vehicle charging points

Our porters supported 70,720 patients to get to the right place in hospital

1,098,402 hot patient meals served to patients

5* in Environmental Health Inspections

417 volunteers supported us - 27,624 hours given

Community membership grown to 5,202 individuals - 48 events, listening to communities

£500k invested from SaTH Charity to improve the patient and staff experience

327,132 hours of cleaning (across RSH and PRH) to deliver a safe and positive experience for all

Our progress against our 2024/25 priorities

We have made good progress against our biggest priorities. We know we need to go further and faster to improve cancer and urgent and emergency care waiting times.

Everyone is responsible for improving urgent and emergency care

A&E 4 Hour Performance

We are making progress in improving A&E waiting times –we need to go much further in 205/26.

Ambulance Handovers

We are one of the most improved systems for Category 2 ambulance calls. We will continue to work hard to reduce ambulance handover times.

Same Day Emergency Care

More patients are being seen by the Same Day Emergency Centre, reducing waiting times in the Emergency Department.

Our finances – delivering value for patients

Deficit

We have agreed a planned deficit of £45.1m for 2025/26. This is a nearly a 50% reduction in the last few years. Our aim is to have no planned deficit by April 2028.

Efficiencies

We have delivered nearly double the financial efficiencies in 2024/25 than 2023/24. Our Cost Improvement Programme (CIP) efficiencies for 2025/26 is £41.4m.

We have delivered a 60% reduction in monthly agency spending - now under £1million a month.

Performance

65 and 52 week waits

We significantly reduced 65 week waits from 1,700 to 400 by March

Endoscopy appointments

Patients are waiting less time appointments – by summer 2025 99% of patients seen in six weeks.

Diagnostic performance

In late 2024/25 we made big diagnostics (tests) – we want meet the national target by X

week waits from 1,200 to 0 in June 2025. We are making good progress and want to reduce 52 week March 2026.

Radiology appointments

18 week waits

Our waiting list was c.50,000 in August 2024 and is now c.41,000 we want 60% of patients to be seen in 18 weeks by Mar 2026. appointments for endoscopy 2025 we want weeks.

Patients are waiting less time for radiology appointments. By late 2025 we want patients to be seen in six weeks.

performance

big improvements in our want to go further and X

Cancer waiting times

Cancer waiting times remains a challenge – we have a plan to improve.

Our objectives 2025/26

Building on our progress in recent years we have agreed six objectives.

Focus on our people – thriving workforce and inclusive culture

Highest quality of care for our patients

Timely access and improved patient experience

Service transformation in line with NHS 10 Year Health Plan

Be the change

Develop Group model for integration of services

Delivery of our financial plan and focus on longer term sustainability

Stronger Together priorities

To deliver our objectives we will focus on the following priorities in 2025/26.

Focus on quality and safety

• Keep improving services through our quality priorities (see page 10)

Maternity transformation

• Keep delivering meaningful and lasting improvement in maternity services, listening to families, communities and staff

Upgrade our digital tools

• Improve patient care through using more modern technology

Improve urgent and emergency care

• Improve Emergency Department waiting times for patients within four hours (from 53% to 60%)

• Increase the number of patients transferred from the Emergency Department within 12 hours (from 76.8% to 83%)

Reduce waiting times for elective care (planned appointments and treatment)

• Improve percentage of patients waiting no longer than 18 weeks from referral to treatment (from 48.9% to 56.4%)

• Improve the percentage of patients waiting no longer than 18 weeks for a first appointment (from 53% to 60%)

• Reduce the number of people waiting over 52 weeks to less than 1%

Improve access to cancer treatment

• Improve against national 28-day cancer Faster Diagnosis Standard. Patients referred urgently for suspected cancer should be diagnosed or have cancer ruled out within 28 days (move from 58% to 80%)

• Improve against national target: patients start cancer treatment within 62 days from referral (move from 53% to 70%)

Improve diagnostic tests and reporting

• On boarding second reporting provider

• Workforce plan for substantive recruitment and retention

• Extended opening for CDC to support diagnostics in a community setting

• Commitment in the operational plan to achieve DM01 at 99%

Improve the working lives of staff

• Deliver the People Plan

• Build a culture where everyone belongs

• Support dignity and respect

Deliver value for taxpayers

• Reduce waste

• Increase productivity, for example more operations in our theatres

• Live within our budget

• Deliver what we promise

Work with partners to improve the health and wellbeing of our communities

Do our bit to deliver our five-year plans:

• Urgent and emergency care

• Local Care Transformation – more care in the community, closer to home

• Hospitals Transformation Programme – better care through two thriving hospitals

Work with partners to reduce differences (inequalities) in healthcare and focus on prevention

• Reduce differences in using health services as we restore planned care (booked operations and treatments)

• Reduce differences (inequalities) for patients using maternity, severe mental illness, respiratory (breathing), early cancer diagnosis, blood pressure and stroke services

• Bring together our data – using this with partners to plan services that meet local needs

Our quality priorities

Patients are at the heart of everything we do. Our nine quality priorities build on last year’s work. They will make the biggest difference to our patients.

Patient Safety

Clinical Effectiveness

Patient Experience

Improve how we look into things that go wrong. Using our national reporting tool (Patient Safety Incident Response Framework (PSIRF)

This will:

• Reduce the risks of a patient getting worse in hospital (deteriorating)

• Reduce the risk of falls for hospital patients

• Give patients the right medicines, on time

• Deliver faster reporting (results) in radiology

Reduce the number of patients who get bed sores (pressure ulcers) during their hospital stay

Patients have nutritional assessments and nutritional care planning in place 3 8

Improve the experience in planned care (elective care):

• Reduce waiting times for radiology

• Reduce delays in radiology reports (results)

Improve the patient experience in emergency care

Work with partners to have earlier conversations and plans ready to help patients leave hospital, when they no longer need hospital care

Involve patients in planning for what happens after hospital care

Improve foot care for patients with diabetes who are on our hospital wards

Give patients who are very unwell the best outcomes, reducing the risk of avoidable death (mortality)

Improve the experience of patients and their loved ones who have a learning disability and/or autism 1 4 2 5 6 7 9

Becoming university hospitals

Our aim is to become a centre of excellence for education, improvement and research. With our partner Keele University, we want to become university hospitals. This will deliver better care for patients, through training, a focus on quality and more research. In 2025/26 we will be working to meet the university standards.

Every year hundreds of students train with us. We know that our students speak positively about their training with us. We want to give them the right tools, training environment and support. We believe in training our doctors, nurses and other professions together through real-life experiences.

We believe strongly in homegrown research led by our doctors and nurses. Our multi-million pound research projects offer patients the best care and advanced treatment. This may mean a better quality of life or a better chance of recovery.

We believe strongly in having a caring, learning and psychologically safe environment. We will support our staff to be the best they can be, seeking new ways of providing care and courageously asking how we can make a difference for our patients and each other.

Our People

Our SaTH family is made up of 7,300 staff and 417 volunteers. In 2025/26 we will continue our important work to build a culture where everyone matters, everyone has a voice and everyone belongs.

Our 2024 Staff Survey shows we are making progress against the national People Promise. We want to go further and faster to build a Trust where everyone feels proud to work and recommends us as a place to receive care.

We know how difficult it is right now and the uncertainty in the NHS. Our staff have told us they want us to do more to help them stay healthy. This means helping them to take breaks, to work flexibly and to manage the stress at work. This will be a focus for us this year.

Listening to staff, we have plans in place to improve the care and experience for everyone. This takes time but we know our teams have the ideas and the enthusiasm. We want to help them to feel confident in making the small changes that make a big difference.

We also want to do more to recognise and celebrate our staff. We are Team SaTH and we want people to feel proud to be part of the positive changes happening. In 2025/26 we will continue to progress our four key pillars in our People Strategy:

New way of working and delivering care making effective use of the full range of our people’s skills and experience

Growing for the future how we recruit and keep our people, and welcome back colleagues who want to return

Looking after our people with quality health and wellbeing support for everyone
Belonging in the NHS with a particular focus on tackling the discrimination that some staff face

Digital transformation

We want to give our staff the right tools to deliver excellent care. We are upgrading and launching new digital systems. In 2025/26 we will:

• Give patients access to more information through a patient portal and NHS app –starting with electronic appointment letters and requests to change appointments

• Support teams to better manage supplies and reduce waste – with a new Inventory Management System

• Improve access to radiology test requests and results across GPs, community and hospital services – with a more modern system (ICE Order Comms) in early 2026

• Introduce a new bleep (alert) system for doctors – improving safety and communication

• Explore new technologies, such as artificial intelligence (AI) and digital records – sharing information between systems and making the most of our resources

• Developing our data warehouse and analysis systems through the nationally recognised Federated Data Platform – improving care through more modern reporting

Our digital teams are also busy planning our future digital advances. To become an excellent trust, we will:

• Connect and use the NHS app more

• Use technology to create efficiencies and automated processes

• Deliver faster, safer prescribing of medications

• Connect services – so that patient information is shared once

• Make it easier to access information in the right place at the right time

• Work with partners to share learning and services through using digital tools.

Our Estates

In 2025/26 we will share our Estates Strategy. Our estates include buildings, grounds and energy use. We are investing millions of pounds in upgrading our estates. Making the most of our estates is essential to delivering better care. Our aim is to build more services in the community, supported by two excellent hospitals.

We would like to thank people for their patience during the building works as we improve care for everyone.

Hospitals Transformation Programme

It is exciting to see the Royal Shrewsbury Hospital (RSH) transforming every day. We are building a modern four-storey hospital building and bigger Emergency Department. In 2025/26 we will modernise and open further areas in our Emergency Department. In 2028 we will open our new hospital building:

These changes will deliver better care for patients, improve the work environment for staff and make the most of both our hospitals.

New wards

We will have two new, modern wards, through a new building on the RSH site. Work is starting again and we are working hard to have the wards in Winter 2025/26. This will deliver more hospital beds supporting our surgical teams. They will also give us more space when we deep clean other wards.

Investing in Princess Royal Hospital (PRH)

Work has started at PRH to remove the Reinforced Autoclaved Aerated Concrete (RAAC) near the kitchen area. We have secured multi-million-pound funding to do these upgrades. We are making the most of this opportunity and will have a new kitchen and restaurant area at PRH to improve the experience for patients, visitors and staff. We will also create a better Doctor’s Mess to support our colleagues to rest, recharge and share best practice. We expect the works to finish in Spring 2026.

We are working closely with Lingen Davies who have launched their Sunflower Appeal. This is their biggest appeal, aiming to raise a massive £5m to enhance cancer services at Princess Royal Hospital by 2029.

Find out more at: www.lingendavies.co.uk/sunflower-appeal

Further improving cancer care

In Summer 2025 we will open our new LINAC accelerator in a new bunker at the RSH site. This replaces one of our current machines that is nearly 10 years old. This machine delivers high-energy X-rays or electrons to the cancer tumour. The investment in the new LINAC means we can advance cancer care and reduce cancer waiting times.

A greener NHS

Our Sustainability team has secured over £17m funding to make our estates greener. Our hospitals use a lot of energy, including heating, lighting and waste.

We want to use this energy wisely. Our NHS Waste Clinical Strategy in 2024 has reduced the clinical waste we throw away. This is better for the environment and we also saved £150,000.

Work is starting on a new Energy Centre at RSH. This will upgrade our old heating system. By 2040 we want to be net zero for carbon emissions. This funding will help us reduce our carbon footprint.

We will have more solar panels and LED lighting, recycling, and electric vehicle points. We will also support more greener transport options, working with partners. In 2025 we will also increase recycling in all sites.

Greener hospitals will provide a better environment now and contribute to a healthier future for our communities.

Working as partners

The NHS does not stand still and changes to meet the needs of communities. This means using new technology, new medicines and working differently. In July 2025 the Government launched its 10 Year Fit for the Future plan. Working with partners, we will focus on these longterm priorities. This includes developing more services in communities and a more modern NHS.

We have made good progress building closer relationships with our NHS and council partners. Our local Provider Collaborative (group of NHS organisations that deliver care) includes Shropshire Community Health NHS Trust (ShropCom) and Robert Jones and Agnes Hunt Orthopaedic Hospital (RJAH). This year we will work more closely together on our shared goals:

• Deliver more care in the community

• Reduce waiting times

• Focus on wellness not sickness, with the right services and shared teams

• Improve care through joint working

• Reduce differences in health for communities

• Reduce waste and do things once

• Grow our teams, with the skills and tools for a modern NHS.

This aligns with the national changes happening. NHS providers will take on more responsibility for local decisions on services. To do this, we will need to work together with our partners.

In 2024 we appointed a Chair in Common with Shropcom. We will be continuing our work in 2025/26 as we recruit a shared Chief Executive and explore becoming a Group. We would stay as two separate, legal organisations but would have a shared leadership team and priorities.

By working together we believe we can deliver better care and a better working environment for staff. Many of our teams are already having conversations to look at how we can do things once, for example our people services (HR). This will improve care and add value for our communities.

We will also work more closely with the police, fire and voluntary and community services. Working together and using our shared knowledge of our communities, we can reduce differences in healthcare and deliver better care closer to home.

Conclusion

This plan sets out our biggest priorities for 2025/26.

These are part of our three-year Moving to Excellence plan. Everyone will have a role to deliver what we promise. If we do this, we will rebuild confidence in our NHS. We will:

• Focus on quality and safety

• Listen to people’s ideas and feedback

• Reduce waiting times

• Be open to new ways of working

• Ensure everyone feels they belong

• Reduce waste and add value for taxpayers.

We will need to work differently as we get ready for 2028. We cannot stay as we are if we want to deliver excellent care. This will mean we need to make some difficult decisions, but patient safety will always come first. Together we will support staff to grow, stay healthy and be ready for the modern NHS. We want everyone to feel valued in our hospitals.

We would like to thank our patients, carers and FIT FOR THE FUTURE

10 Year Health Plan for England

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