We continue to strive towards providing excellent care for the communities we serve, and this year we are entering a new phase in our improvement journey. We have made good progress in recent years, which is reflected in our improved Care Quality Commission (CQC) rating and is recognition of the dedication, commitment and compassion shown by our colleagues. We know we have much more to do, as we work towards achieving Good consistently across all services and ultimately aim for Outstanding care. This year brings many exciting opportunities and investment, that long-term will help us to improve care and deliver a positive experience for everyone.
The Executive Team and I are pleased to share our Operational Plan for 2024/25 which sets out our collective objectives, focused on addressing our biggest challenges and driving forward our essential transformation programmes. We are optimistic for the year ahead, as we build on the positive progress we made in 2023/24.
Our teams continue to face significant operational pressures and we recognise the impact this is having, especially as we balance transformation alongside day-to-day delivery. Our recent CQC inspection showed we have a good understanding of our challenges as a Trust and it is vital that these challenges are owned by everyone. Leaders from across our divisions have helped to develop this year’s plan and are committed to delivering our ambitious objectives. Together we will maintain our absolute focus on quality, which long-term will help us achieve both clinical and financial sustainability. It will take time, but we know we have the commitment, the ideas and the compassion in our teams to deliver meaningful change.
Our five objectives and five enablers are vital to creating the long term clinical and financial sustainability we are working towards. It is right that we ensure taxpayers’ money benefits patients and we need to work towards restoring financial balance. We will do this by maintaining our absolute focus on quality and we are keen to hear the ideas and suggestions from our patients, communities and colleagues. This is not about working harder, as our colleagues already go above and beyond, so we need to embrace new ways of working. Through our continued focus on learning we will support our colleagues to grow and develop new
Louise Barnett Chief Executive Officer
skills as we seek to deliver more modern and sustainable healthcare.
Quality continues to be the golden thread through everything we do. Our clinical colleagues have refreshed our nine quality priorities, building on our progress last year and helping us focus on the areas that will deliver the maximum improvements in the care and experience for everyone.
We are truly grateful for the compassion, commitment and innovation our teams continue to show. Our amazing colleagues, and volunteers, are essential to the successful delivery of this Operational Plan. Everyone has an important role to play. We encourage every team to have a conversation about their individual, and team objectives, and how together we can bring about further improvement for our patients and each other. Through our renewed focus on appraisals, we want all colleagues to have a clear understanding of how their role makes a positive contribution. We also want to continue to hear your ideas and suggestions, as you will know how best to improve care, experience and productivity in your areas.
We are confident that by focusing on these priorities, and working together, we can further deliver improvement, and embed new ways of working that will help build an organisation that everyone is proud to receive care in and work for.
Patient experience is at the heart of everything we do.
Vision and Values
Our vision is to provide excellent care for the communities we serve. The Trust strives to provide high quality, safe care for our patients in an environment in which our staff are proud to work. We believe that by adhering to our Vision and working with our Values in mind we will behave in a way which will ensure a positive experience for the people that matter most – our patients and their families.
• 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
Our Strategy aims to bring our Vision ‘to life’ in every aspect of what we do. We developed our Strategic Framework building on the Vision and Values. We have now established our six strategic themes to articulate our Vision that reflects on our goals and in response to the future challenges and opportunities we face.
Partnering Ambitious Caring Trusted
2023/24
Improved in all People Promise themes in the NHS Staff Survey
– 3,412 colleagues took part
12 colleagues completed the 2024 Galvanise Programme –supporting inclusive leadership
Opened our dedicated SaTH Education, Research and Improvement Institute
–enabling multi-disciplinary learning
205 international nurses recruited
Reduced medical agency spend by 36 whole time equivalents
144,524 hours booked on the Bank –reducing agency spend programme –12 interns completed two rotations at RSH transforming lives for young adults with learning disabilities
Mandatory training remains above 90% compliance –helping staff stay safe and deliver safe care
205 apprentices supported –growing our workforce
Staff Psychology Service -supported 470+ colleagues
25,677 hours given by our valued volunteers
88% of staff completed their Tier 1 Dementia Training and 85% Tier
2
Introduc
stimul ation
–suppo rt in g pa ti en ts to m aintain ind ep e nd ence
Improv e d s epsi s tra ining on L – to su pp ort fas te r diagn osi s
Oncology and Haematology assessment area openedsupporting chemotherapy activity
West Midlands Cancer Alliance funding for clinical and nonclinical posts
Introduction of Autocontouring in Medical Physics
Expansion of services in Plaster Room
Implemented robotic surgery and the pathways across gynae, urology and colorectal
Breast implementation of Magtrace - supporting Cancer treatment
Improved partnership working with UHNM, including Urology -more specialist services for patients
Awarded £1million funding to improve Endoscopy waiting times
Maintained Joint Advisory Group (JAG) accreditation within Endoscopy services
Increased Bowel Cancer Screening –with extended age range and Lynch Syndrome –improving earlier diagnosis
Delivered a Breast Pain service supporting Cancer recovery in the community
Opened Trauma Assessment Areas on Ward 4 and Ward 32
Ward 32 and 37 awarded Silver Medal Award by NHS England for Reconditioning the Nation work
Improved Patient Initiated Follow Up (PIFU) - 34th best performing Trust
Significant improvements in CQC ratings – rated ‘good’ across all domains for maternity and children and young people
Launched Paediatric Transformation Programmedriving continuous improvement for patients
Reduced waiting lists - by over 1,000 patients
Substantial improvement in Cancer service provision across Gynaecology services
All 10 safety standards - Clinical Negligence Scheme for Trusts for 2023/24 delivered
100% of Saving Babies Lives (SBL) standards delivered
Delivered our improvement plan for maternity services
Implemented Division’s Cultural Improvement Planwith improved NHS Staff Survey results
Delivered Division’s Cost Improvement Plan (CIP) –demonstrating value for money
Robust workforce plans in place - significant reduction in agency usage across the division (1% for April 24)
Invested in replacing key equipment - hysteroscopes and Oximetry machine
30,000+ screening appointments in the new Community Diagnostics Centre since October 2023providing additional capacity and accessibility for our patients.
Outpatient Parenteral Antibiotic Therapy service launched –supporting earlier discharges and care home
National accreditation in Pathology (United Kingdom Accreditation Service)
Agreed a new Pathology Managed Service contract for the next 7 years
Launched the CSS Patient Engagement Group
Therapy outpatient waiting times have shown significant progressrecovering to key performance indicator standards
Increased Patient Initiated Follow Up (PIFU) for our Therapy Team
Achieved the diagnostic (DM01) targets of 85% across imaging –reducing waiting times for patients (March 2024)
Growing our own pharmacy technicians –improving care and staff development
Discharge Medicines Service success
Reduced reliance on outsourcing and insourcing by recruiting substantively - supporting our Radiology service
Delivered our CIP target for 2023/24
Twin mobile unit introduced to support breast screening with our system
Rated green for Infection Prevention and Control by NHS England - delivering safer care
Outline Business Case approved for the Hospitals Transformation Programme –enabling works started on site
374 Change Agents supported the Electronic Patient Record launch
Launched the Patient Safety Incident Response Framework –improving our systems and embedding learning
1,594 people joined our Community Memberssupporting engagement with local communities.
4,266 members in total
Over £90million capital investment across our sites –improving the experience for patients
New business hub and front entrance at PRH opened –improving the patient and colleague experience
Achieved the Level 2 Future Focus finance accreditation –delivering value for money for taxpayers
– ensuring good
Reviewed the Board Assurance Framework governance in the Trust
Head of Internal Audit Opinion: Substantial Assurance
Full compliance with the Government Functional Standard 013 for Counter Fraud - ensuring every pound benefits patients
New People and End of Life Care Strategy launched
Supportive ward visit programme introduced for People and End of Life Care
Reduction in falls by
Our progress against our 2023/24 objectives
Deliver phase 3 of our Getting to Good Programme to continuously improve care for our patients and community standards
Good progress on our actions: 13 actions ‘Evidenced and Assured’ and 6 actions ‘Delivered but not yet Evidenced’, with 4 actions remaining as ‘Not yet Delivered’
Improved workforce planning and recruitment to essential clinical roles reducing agency spending
Launched the Quality Dashboard and monthly quality audits
Focused on training and education
Improve efficiency, deliver within our budget, demonstrating financial prudence and making every penny count
Eliminated over 104 and 78 week waits
Reduced over 65 week waits to 378 (English) patients against our reforecast plan of 550 patients
Achieved 80% theatre utilisation (March 2024)
Validated (clinical and admin) waiting lists to maximise capacity
Significant reduction in agency spend, at its lowest level since September 2021 – working towards our ambition of near-zero agency usage
Significant reduction in our vacancies –with 2.1% vacancy rate at the end of March 2023
All divisions contributed to c.£17.2m in cost improvement programme (CIP) efficiencies
Value difference and live the People Promise in our teams
Restore and sustain elective orthopaedics and other services Estates
Improved in all People Promise themes in the Staff Survey
Mandatory training remains above 90% target, but more work to do to ensure consistency in all areas
1,300 staff used resources on SaTH Talent Programme
Community Diagnostic Centre opened in Telford supportin 30,000 screenings in 2023/24
Improved workspace for clinical and admin teams, and improved catering options in multi-million pound PRH new front entrance
Ongoing maintenance at both sites
Progress our Hospitals Transformation Programme plans to improve care for all
Clinical teams engaged in the detailed designs with full support from Clinical Advisory Group across all divisions
Full planning permission received for works on RSH site
Outline Business Case formally approved and developed Full Business Case
Contractor awarded and enabling works started on site in January 2024
Improve flow through our hospitals by delivering our Emergency Care Improvement Programme
Improvement in time to initial assessment patients seen within 15 minutes in emergency departments and we are working to improve this further
Reduction in length of stay (discharge pathway 1-2) from 4.5 days to 3.5 days
Developed an action plan - working with Getting it Right First Time (GIRFT) colleagues to improve flow in and out of our hospitals
Continued to focus on improving 4 hour target - achieving 60.2% at end of March
Achieve 28-day faster Cancer diagnosis standard for patients
Improved Faster Diagnosis Standards (FDS) for Cancer - 74% against the national target of 75%
Reduced Cancer waiting times (62 day
standard). 197 patients being prioritised for treatment against the 62 day standard - slightly ahead of our target of 212 patients. We are working to ensure no patients wait over 62 days for treatment
Improved Colorectal Oncology waiting times - 3-4 weeks
Implement phase one of our Electronic Patient Record (EPR) programme - includes replacing the Patient Administration System
Vitals went live in October 2023, improving the way our clinical teams capture patient observations
Over 374 change agents trained to support our teams with the roll-out of CareFlow systems in April 2024
80% training compliance for CareFlow systems achieved by end of March 2024
Information Governance (IG)
Data Protection Officer and IG Manager appointed
Significant project underway to support retention of documents/storage
Our objectives 2024/25
Building on our work in recent years, we have agreed five core objectives for the coming year. These objectives will provide focus and help us move forward together in our improvement journey.
Deliver our quality priorities and the next phase of our Getting to Good programme
Deliver elective services and implement enhanced recovery
We will...
1. Deliver the quality priorities
2. Embed the Patient Safety Incident Response Framework (PSIRF)
3. Develop a Safety Strategy
We will...
1. Achieve 85% theatre utilisation by end of Q3 2024/25
2. Achieve PIFU performance to maximise productivity in outpatients
3. 90% of patients waiting over 12 weeks are validated every 12 weeks
4. Focus capacity on specialties with significant waiting lists to implement one stop diagnostics where appropriate
5. Achieve 52 week waiting times
We will...
1. Adopt Best Practice Timed Pathways for all tumour sites
Our enablers
Live the People Promise in our teams through valuing difference and inclusivity
Deliver our workforce plan, agency cost reduction, based on the principles of Train, Retain and Reform
Develop an estates plan to optimise our current estate and continue to progress our Hospitals Transformation Programme
Maintain Faster Diagnostics Standard and achieve 62 day Referral to Treatment Standard
2. Reduce backlogs for 104 and 62 day waits to deliver the 62 day performance standard
3. Ensure timely tracking and validation of patient pathways
We will...
Improve Urgent and Emergency Care (UEC) performance in line with GIRFT recommendations
In addition to our five objectives we have identified five key enablers, which will help ensure success. 1 2 4 3 5
Use of resources – operate within our budget through delivery of efficiency and productivity measures
1. Adopt and implement the SHOP (Sick, Home, Other, Plan) model across all our wards
2. Achieve 33% of discharges before midday
3. Deliver minors, urgent treatment centre and children and young people 4 hour performance
We will...
1. Deliver our efficiency programme
2. Deliver our headcount plan
3. Deliver within our agency budget
4. Deliver our income plan through our activity
Electronic Patient Record (EPR) complete phase one (implement and embed CareFlow PAS and ED) and commence phase two 1 2 4 3 5
Develop and implement a sustainable travel plan to improve patient and staff experience
Our quality priorities
Patients are at the heart of everything we do. Building on our progress last year, our quality leads, working with all divisions, have agreed nine quality priorities for 2024/25. We will continue to embed these priorities, as we strive to deliver high quality care for everyone.
Learn from events and develop a safety culture
Patient
Safety Clinical Effectiveness Patient Experience
Quality improvement
Integrate learning from both positive and negative incidents, using electronic communications, quarterly learning and sharing forums and an annual Trust safety conference.
Support deteriorating patients
Early recognition, escalation and response for patients at risk of deterioration and sepsis.
Reduce inpatient falls
Continue to sustain the reduction of inpatient falls and reduce the level of harm caused by falls by embedding the reconditioning games into everyday processes.
Reduce missed dose medicines
Reducing the number of omitted doses of time critical medication through improved understanding, learning from incidents and clinical guidance. Implementing the Electronic Prescribing and Administration (EPMA) system.
Reduce missed radiology results
Improve patient experience by reducing waiting times, supporting timely decision making and intervention through timely Radiology reporting.
Reduce pressure ulcers
Develop and implement a learning process through a new Pressure Ulcer
Working Group to deliver our action plan. Implement Purpose-T in line with national guidance across all inpatient adult areas and emergency care.
Right care, right place, right time - emergency care
Ensure improved patient experience in our emergency departments, reducing waiting times, timely decision making and intervention. Increase screening for delirium/cognition - 75% by March 2025.
Right care, right place, right time - improving flow
Improve our admission and discharge processes through the Trust.
Best clinical outcomes for people with Diabetes - improve care
Address and improve care for people with Diabetes working closely with system partners.
Best clinical outcomes for people with Diabetes - foot care
Improve the care and experience for patients with learning disabilities and/or Autism. 1 3 8 2 4 5 6 9 7
Improving foot care for people with Diabetes through a diabetic foot clinic and improving foot assessments and care. To provide inpatient foot reviews and increased use of OPAT
Learning from experience
Learning and improving from patient, carer and public experience through complaints, patient surveys, feedback and
Mental health training
Implement quality standards and demonstrate NICE guidance compliance.
Learning disabilities and autism
We will continue to champion quality improvement throughout the Trust, as we know this leads to the delivery of excellent care for patients. Every year we continue to embed improvement in all our work, building on our Getting to Good and quality improvement programmes. We are proud that our focus on quality improvement and building a learning culture was recognised by the CQC, but recognise we have more to do to embed and sustain improvement. We are embracing the national NHS Impact (Improving Patient Care Together) approach. This will help us to create the right conditions to deliver continuous improvement and high performance to improve care for our patients and deliver healthier outcomes for our communities. We are committed to building on our progress last year to improve the quality of all our services for patients.
We are grateful for the way our colleagues embraced the new Patient Safety Incident Response Framework (PSIRF) that launched in November 2023. This national framework fundamentally changes the way we investigate and learn lessons from incidents. This new way of working is helping us to further grow our learning culture within the Trust by increasing understanding about how incidents happen and increasing learning through earlier identification of themes. In 2024/25 we will continue to embed PSIRF throughout the organisation and everyone will have a role in making this a success.
Our Improvement Hub is here to support and empower colleagues at all levels to have the confidence, capability and passion to test changes and make improvements for the communities we serve. If you have an idea for improvement please email sath.improvementhub@nhs.net who will be able to support you to take this forward.
We are incredibly grateful to all our colleagues for everything you continue to do for our patients, communities and each other.
Our People
Our people are at the heart of everything we do and are critical to achieving our vision of ‘providing excellent care to the communities we serve’.
We have c.7,480 people, 1,330 bank only colleagues and over 400 volunteers who play a vital role in delivering the compassionate and inclusive culture we aspire to - through caring and supporting our people.
We are pleased that our NHS Staff Survey 2023 results show that we havesignificantly improved in all areas of the NHS People Promise themes. We know we have more work to do and are committed to building a Trust that everyone is proud to work for and would recommend as a place to receive care.
In 2024/25 we have a careful balancing act as we continue to prioritise our cultural and quality improvement, deliver safe services through sustainable workforce planning, grow and develop our colleagues and work towards restoring financial balance. This is a real opportunity for us to take stock of where we are and explore new and innovative ways of working that will improve care for patients, improve the experience for colleagues and ultimately deliver clinically and financially sustainable services.
Fundamental to our plans is strengthening an inclusive culture of diversity, innovation, and continuous improvement to support us in delivering excellent care for our patients.
Our People Promise
We are committed to four strategic pillars:
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
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
This year we launched our People Strategy, which sets out our long-term vision and plans, aligned with the Trust’s overall Strategy.
Transforming care
We recognise that to deliver excellent care, our clinicians and staff need to be given the right tools to help them in their vital work. Our digital transformation will be essential in delivering more modern healthcare and improving quality for our patients.
We are in the second year of our multi-million pound digital transformation programme. Thank you to everyone who has supported with the preparations for the launch of the CareFlow and ED systems in April 2024. This was a significant undertaking, as we replaced our 20 year old SemaHelix system:
•Over 5,000 staff trained
•Over 1 million patient records transferred
This is more than a new digital system, it is fundamentally a new way of working for our colleagues. Through these new systems we have a real opportunity to improve flow in our hospitals and support more integrated working within our teams and the system. To do this, we need all staff to embrace the new systems and ensure we are inputting data as close to real-time as we can. We know this will take time to get used to the new systems and processes and we will continue to support you through this.
The introduction of the new patient administration system is a significant step change and will put the necessary foundations in place, paving the way for other exciting digital upgrades in the coming years that will enable our clinicians to improve care for patients, through more modern and sustainable healthcare systems.
We are currently finalising our roadmap for 2024/25, and beyond, to prioritise systems based on the clinical and technical risks in the organisation and to maximise the funding available. We will share our roadmap with you soon. In the meantime, our digital team have been supporting the launch of other key systems, including:
•Medisoft/Medisight – electronic records for Ophthalmology (June 2024)
Find out more on our website: https://digital.sath.nhs.uk/
Developing our Estates Strategy
We have an exciting, multi-million pound investment programme happening across all our estates, as we seek to develop enhanced community services supported by two thriving hospitals. Maximising the use of our estate (buildings and land) is essential to us delivering excellent care for our patients. We will continue with our estates refurbishment and investment programme throughout 2024/25 and will be developing a detailed Estates Strategy to guide our development in the future.
Planned Care Hub, PRH
In June 2024, we opened our new purpose-built, multi-million pound Planned Care Hub. This will provide more theatres and recovery beds dedicated to day case surgery. This will significantly increase the number of same day operations that can take place, enabling services to be provided all year round and providing a more positive environment for patients.
Improving cancer care
More services out of hospital
In July 2024, we opened our fantastic £3.6m Gamma Camera on the RSH site. The new camera will support earlier detection of Cancer, paediatric conditions and other acute conditions. It will produce better quality images,
improving outcomes through earlier diagnosis. The investment in the new camera will complement the facilities offered at the new Community Diagnostic Centre (CDC), based at Hollinswood House, Stafford Park, Telford.
This year we are also installing a much-needed fourth LINAC bunker on the RSH site. The equipment delivers radiation therapy for patients with Cancer and will significantly increase the resilience of our Cancer services and reduce waiting times for patients.
During 2024/25 we will continue to work towards our ambition of delivering more services within our communities, reducing unnecessary hospital visits for patients. Our final services moved into the modern building at Hollinswood House, Telford. Cardiorespiratory services have now joined our diagnostic, renal and teledermatology services.
This dedicated centre is significantly increasing the number
of elective diagnostic tests we offer and providing a better environment to support patients.
Hospitals Transformation Programme (HTP) The Hospitals Transformation Programme will improve care for everyone. Our ambition is to deliver two thriving hospitals and throughout 2024/25 we will continue to involve our clinicians, patients and partners as we develop our detailed clinical pathways that will improve services. Enabling works have already started on site with our contractor IHP.
The Trust has received national approval of its Full Business Case (FBC) for the Hospitals Transformation Programme (HTP), which is the final stage of approval. This releases the full £312million investment in local services and means implementation of a new model of healthcare in the county, including construction, can now begin. You can find out more about all these schemes on our website.
A greener future
We are excited to have been awarded £16.2m of funding from the Salix Public Sector Decarbonisation Scheme (PSDS) as we work towards delivering a greener NHS through net zero emissions. This is better for our patients, communities and also our colleagues who work or live on our sites. Throughout 2024/25 we will be reducing our carbon footprint, with more solar panels being installed, maintenance works to improve the efficiency of our buildings and supporting greener ways of working.
Developing healthy communities through partnership working
LOCAL AUTHORITIES
VOLUNTARY AND COMMUNITY SECTOR
In 2023/24 we established stronger relationships, as we continue towards establishing our local Provider Collaborative. This is a local network, bringing together the NHS providers in Shropshire, Telford and Wrekin. We know that by working together, and breaking down barriers for patients, we can improve care and deliver a more positive experience for everyone.
This means we need to change how we work, and we need to look beyond our organisation’s walls and explore more collaborative working. This includes:
Supporting multi-disciplinary working
• Equipping our teams with the skills and knowledge they need to embrace integrated working
• Developing new services, bringing together the right teams
• Supporting more care in the community, to prevent avoidable admissions to hospital
• Reducing health inequalities for everyone
• Embracing new technologies.
We know we cannot deliver this Operational Plan in isolation and we have a duty to work collaboratively with our partners to improve the overall health and wellbeing for all our communities.
In 2024/25 we will be building on last year’s progress, continuing to strengthen and embed the Virtual Ward, OPAT schemes and the new rehabilitation and recovery wards. We want to listen to the ideas and suggestions of our colleagues, and our partners, as we trial new ways of working and play our part in delivering our ambitious system priorities.
SCHOOLS UNIVERSITIES COLLEGES
In 2024/25 the chairs and chief executives of all local NHS provider organisations will work together to further our local Provider Collaborative, by forming a Committee in Common, where we can work more strategically together to deliver integrated care, for example working to improve flow in and out of our hospitals.
In 2024/25 we will also work with Shropshire Community Health
NHS Trust to recruit a new Chair in Common. This move signals our shared commitment to strengthening joint working for the benefit of patients, service users and families. Whilst the trusts remain as separate statutory bodies, they will seek to appoint
We also know we need to work beyond our NHS and local authority relationships, as we seek to work more closely with the Police, Fire Service and voluntary and community sector. There is a wealth of insight and experience in these different agencies and we will play an active role in working together to deliver
It will take time, and that is why it is so important we have these priorities which will help us deliver clinically and financially sustainable services for the future.
Conclusion
last year’s progress, as we continue to tackle the significant
It is right that we continue to set ourselves ambitious priorities, as together we seek to improve the care for our communities and the experience for our colleagues. We are determined to build on pressures we continue to face.
2024/25 will bring exciting opportunities for the Trust, and wider system, and we are keen to hear your ideas and suggestions as we seek to evolve our services.
This year, more than ever, we will need to balance our absolute commitment to quality improvement whilst also working to restore financial balance. We know that the dedication, care and compassion shown by our teams, and partners, will deliver the necessary cultural change and help us increase productivity through new ways of working. It will take time, and that is why it is so important we have these priorities which will help us deliver clinically and financially sustainable services for the future. Together we know we can make a difference for our patients as we enter this next phase in our improvement journey.
We remain incredibly grateful for all the support we receive from our patients, visitors, carers and volunteers.
