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					Corporate Plan 2007/8
   Progress Report to Trust Board
          September 2007
           Deborah Shaw
        Director of Strategy
        CO1:To continue to improve patient safety and the patient
                              experience
Corporate           Strategic            Operational             ED                       Assessment                            RAG

Objective            priority             Objective
CO1:To            To continue to   Meet the Healthcare          DSD     System established and progress monitored through        A
continue to       Improve the      Commission‟s standards               assurance compliance unit. Reported to Board
improve patient   quality of our   for 2007/8 set through the           through integrated performance report. The Trust is
safety and the    services         Annual Health Check                  currently not on track to achieve the MRSA target
patient
experience                         Continue to reduce MRSA      CE/DS   The HCAI Action Plan was signed off by Trust             R
                                   and hospital acquired                Board 31/5/07. New STICC arrangements in place
                                   infection rates                      from 31/7/07. DH review 26/9/07. The Trust has
                                                                        particularly focused attention recently on:
                                                                        revising and embedding antibiotic policies,
                                                                        screening policies, central and peripheral line
                                                                        policies
                                                                        establishing cohort infection wards on both sites
                                                                        re emphasising “clean your hands campaign”
                                   Continue work on nursing     DSD     The Trust has made some progress with the                G
                                   standards                            implementation of Essence of Care Standards,
                                                                        specifically focusing on privacy and dignity. Further
                                                                        work is planned when the Head of Nursing Practice
                                                                        joins the Trust. „Programme of Care for the Older
                                                                        Patient‟ project has been launched within the Trust
                                                                        and 16 champions have been identified across the
                                                                        hospital. Agreement with Staffordshire University to
                                                                        jointly appoint a Professor of Nursing who will lead
                                                                        on privacy and dignity practice and development
                                                                        issues. The Trust has developed its own set of
                                                                        Nursing Performance Indicators and developed the
                                                                        software to support the monitoring on a monthly
                                                                        basis.
                                   Deliver CNST level 3 for     DSD     Achieved.                                                G
                                   maternity
        CO1:To continue to improve patient safety and the patient
                              experience


CO1:To            To continue to   Continue to improve the       DSD    Patient Environment Action Team is established led      G
continue to       improve the      patient environment                  by the Director of Service Delivery and includes
improve patient   quality of our                                        Estates and Facilities representation, infection
safety and the    services                                              control nurses, ,nurse managers and PPI
patient                                                                 representatives. Regular programme of planned
experience                                                              assessments and unannounced visits in place. The
                                                                        Trust has consistently scored well in external
                                                                        assessments and both sites recently received a
                                                                        score of 5 (excellent) for cleanliness and food. The
                                                                        Trust has recently been chosen from all Trusts in
                                                                        the West Midlands to become a Learning Partner for
                                                                        the implementation of the „Productive Ward‟ in
                                                                        partnership with the National Institute of Innovation
                                                                        and Improvement.


                                   Continue to improve patient   DSD/   Ward managers identified as champions.                  A
                                   satisfaction                  DCA    Presentation given July 2005. To develop local
                                                                        action plans and exit surveys and monitor through
                                                                        Community Engagement Forum
 CO2: To achieve Foundation Trust Status by July 2008


CO2:To achieve    To deliver a       Perform a fact-based           DS      26 workshops completed June-July 2007. Draft             G
Foundation        long term          assessment of all clinical             outputs reviewed by Divisions, Executive and Trust
Trust status by   service            specialties and produce a 5            Board by 30th August. Shortlist of priorities based
July 2008         development        year market-driven Service             on urgency and impact analysis has been
                  strategy for the   Development Strategy                   produced that will now inform the draft integrated
                  Trust                                                     business plan (IBP). Next stage is to align priorities
                                                                            with the SHA “Investing for Health Strategy“ and
                                                                            commissioner intentions.
                                     Prepare an Integrated          DS      Board SWOT and PESTLE completed. FT work                 G
                                     Business Plan (IBP) that               streams on track to deliver individual elements of
                                     includes detailed market               the IBP for end of September 2007. Good progress
                                     assessment, long term                  on market analysis: health profiles demographic
                                     service and financial                  data presented to Trust Board; Dr Fosters data on
                                     strategies and workforce               referral patterns from GPs now available. Market
                                     plans                                  assessment priorities have been identified.
                                     Working with key               CE/DS   Commissioning Strategy promised from both PCTs           G
                                     commissioners and other                by 30th September 2007. Workshops scheduled for
                                     stakeholders to develop a              September with PCT and PBC leads to share draft
                                     Shropshire WHE Strategy                outputs from service reviews.

                                     To develop and implement a     DS      Four agreed priorities for 06/07: Sexual Health,         A
                                     number of integrated care              advanced primary care services (APCS),
                                     pathways with our health and           diagnostics and admission avoidance. Regular
                                     social care partners that              reports to ISIP Board. ISIP maturity matrix
                                     support the priorities                 performed by SaTH, SCPCT and T&W PCT leads
                                     identified through the LDP             as part of a health economy-wide review of
                                     and ISIP process                       integrated planning processes. Draft action plan
                                                                            produced and identifies a need to strengthen the
                                                                            prioritisation process and the programme
                                                                            management approach to ensure that committed
                                                                            plans are properly resourced.
 CO2: To achieve Foundation Trust Status by July 2008

CO2:To achieve    To develop the     Implement fit for purpose     DS/FD   Revised approach to corporate planning process in     A
Foundation        Trusts             business systems into the             place. Divisional business plans developed focusing
Trust Status by   governance         Trust from “Board to floor”           on approach to delivery of corporate objectives.
July 2008         arrangements                                             Revised business case proforma implemented for
                  that are fit for                                         consultant posts and major service developments.
                  purpose for a                                            Performance report revised to focus on exception
                  Foundation                                               reporting and mitigating action. Implemented web-
                  Trust                                                    base analytics for activity data.

                                     Review corporate              DCA/    Integrated governance review to July Board.           G
                                     governance arrangements       FD      Compliance unit in place with terms of reference to
                                     and further develop the               be reviewed in the Autumn in line with Monitor
                                     concept of the compliance             Compliance Framework.
                                     unit
                                     Implement the “Intelligent    CE      Review of committee structure completed and           G
                                     Board” concepts in decision           implemented. Consistent reporting approach at
                                     making                                Board and sub committees against corporate
                                                                           objectives
                                     Review the Board and          CH/     Board development programme implemented.              G
                                     organisational capability     DCA     Board gap analysis planned for October 2007.
                                     and capacity and                      Board to Board Challenge planned with auditors
                                     implementation of a Board             December 2007 and March 2008
                                     development programme
                                     Further development of        FD/     Risk management systems well embedded. Internal       G
                                     performance management        DCA     audit assessment “substantial assurance”. External
                                     and risk management                   Audit assessed internal control as “GOOD” in
                                     systems and processes                 Auditors Local Evaluation. Integrated performance
                                                                           report developed. Balanced scorecard/dashboard
                                                                           approach under review.
CO3:To achieve all key national targets and priorities on an annual
                              basis


CO3:To achieve     To continue      Deliver in-year financial     CE    Surplus £387k at Month 4                                G
all key national   the Trust’s      surplus.
targets and        financial
priorities on an   recovery         Deliver a CIP of at least     FD/   Divisional Finance Review Meetings have been            A
annual basis                        £7.8m.                        DSD   reestablished on a monthly basis to review the
                                                                        operational budget position and performance
                                                                        against CIP. £5.3m CIP identified against a target of
                                                                        £7.5m. The Finance Director and the Director of
                                                                        Service Delivery continue to work with the Divisions
                                                                        to identify a further £2.2m.


                                    Make progress with            CE    Resolved by working capital loan and new NHS            G
                                    addressing the historic             Financial Strategy
                                    deficit.
                                    Improve on Health check       FD/   Trust scored 3 for Internal Control. Other elements     G
                                    “Use of Resources”            DCA   improved scores since last year.
                                    assessment
                   To continue to   Make progress towards the     DSD   The Director of Service Delivery has Executive          A
                   improve          18 week referral to                 responsibility and the newly appointed Access
                   access to our    treatment target and                Manager has project management responsibility. A
                   services         achieve national milestones         project group and an IT sub group have been
                                                                        established to develop data collection and reporting
                                                                        systems. The medical secretaries are piloting the
                                                                        role of “patient trackers”. The group is currently
                                                                        developing an escalation policy for reporting
                                                                        information to the relevant managers/clinicians
                                                                        regarding patients‟ progress through their pathway.
                                                                        Further work on reviewing pathways of care will
                                                                        require strong clinical engagement.
   CO3:To achieve all key national targets and priorities on an annual basis

CO3:To achieve     To continue to   Reduce waiting times for       DSD    There has been great improvement in reducing             A
all key national   Improve          diagnostics.                          diagnostic waiting times. The Trust is confident that
targets and        access to our                                          it will achieve a maximum wait of 6 weeks by
priorities on an   services                                               December 07 in advance of national target of
annual basis                                                              December 2008. Pathology waiting times are under
                                                                          scrutiny as a result of some breaches of 11 week
                                                                          target.
                                    Continue to achieve national   DSD    The A&E target has proved particularly challenging       R
                                    access targets in A&E                 this financial year. The challenges are threefold:
                                                                          an increasing number of delayed discharges in
                                                                          acute hospital beds due to social service funding;
                                                                          an increasing number of delayed discharges due to
                                                                          inability to transfer patients to Community Hospitals;
                                                                          disestablishment of 40 unfunded escalation beds
                                                                          (which accommodated delayed discharges) to allow
                                                                          renal unit development at PRH and the infection
                                                                          ward development at RSH.
                                                                          Division 1 action plan is in place with signs of
                                                                          impact. First week achievement of 98% in early
                                                                          August since May 2007.
                                    Continue to achieve national   DSD    The Trust has an excellent track record of               G
                                    access targets in Cancer              consistently achieving the cancer targets.
                                    Achieve target for GUM         DSD/   The Trust has not achieved its internal profile since    A
                                    100% offered an                DS     April 2007 although a month on month improvement
                                    appointment within 48hrs by           is evidenced. The Trust approved the management
                                    March 2008                            transfer of GUM services to PCT at the July Board.
                                                                          This should support the achievement of the targets
                                                                          in managing patients in the appropriate setting.
                                    Plan for maternity services    DSD    Shropshire model of care follows national guidance       G
                                                                          with consultant-led and midwifery-led units. The
                                                                          Trust has performed an assessment against
                                                                          Maternity Matters standard and has minimal gaps
                                                                          but is developing action plan to address. Model of
                                                                          care perceived as exemplar nationally.
 CO3:To achieve all key national targets and priorities on an annual basis

CO3:To achieve     To continue to   LOS reductions emergency         DS/     Not achieving monthly profile for elective and non      A
all key national   improve our      and elective:                    DSD     elective LOS. Statistical process control charts
targets and        productivity     to reach England upper                   show inconsistencies between sites that need to be
priorities on an                    quartile LOS over the next               explored. Action plan is being developed by the
annual basis                        18 months                                Head of Service Improvement focusing on patient
                                     to reduce pre-operative                 flows and standardized patterns of working. Some
                                    LOS by 10% by March 08                   progress with social care delays.
                                    Increase day surgery rates       DS/     The day case rate for surgical procedures was           G
                                    to 78% by March 2008.            DSD     reported at 77.8% in July 2007 and is above profile
                                                                             and on track to achieve 78% by March 2008.
                                    Maximise theatre utilisation     DS/     Target to increase theatre utilisation to 85%           A
                                                                     DSD     Monitoring to be included within Integrated
                                                                             Performance report in September. Live theatre
                                                                             utilization system being developed through SEMA.
                                    Maximise use of outpatient       DS/     Outpatient review completed with action plan.           A
                                    capacity                         DSD     Nominated project lead and service manager
                                                                             identified. Project group established . Plan approved
                                                                             and being progressed.
                                    Clinical support services        DS/     Clinical service review has identified lack of          A
                                    review                           DSD     integrated systems and processes across sites.
                                                                             Review of Imaging and Pathology flagged within
                                                                             service improvement priorities. New Head of
                                                                             Pharmacy starts in post September 2007 with a
                                                                             remit to review site specific issues .
                                    Application of lean principles   CE/DS   Implemented in A/E and theatres. Review of              G
                                    particularly to corporate                structures to be undertaken in corporate
                                    functions                                departments by September 2007
                                    Review of all non clinical       FD      Estates maintenance & operations workshop (phase        G
                                    support functions                        3 corporate services review) undertaken
                                    Implementation of                DS/FD   Clinical element of productivity improvement action     A
                                    Productivity Improvement                 plan has been incorporated into service
                                    action plan                              improvement plans. Non clinical elements
                                                                             incorporated into CIP targets.
       CO4:To recognise and enhance through organisational development, the
          contribution of the workforce to the success of the organisation
CO4:To             To improve     Implement and maximise the       DSD   The Trust has now successfully appointed 3              G
recognise and      staff          value from the new                     Divisional Directors and three Divisional General
enhance            satisfaction   management structure                   Managers for each of the new Divisions. All
through            and staff      through staff development              managers in the supporting infrastructure have also
organisational     engagement     and KSFs.                              been appointed. A Management Development
development,       in effective                                          Programme is being developed for Autumn 2007.
the contribution   decision
of the workforce   making         Implementation of the clinical   DSD   Implementation of the recommendations of the            G
                                  skill mix review findings              Nursing Skill Mix review is almost complete. A
to the success
of the                                                                   priority for the newly appointed Head of Nursing
organisation                                                             Practice is to develop a Ward Managers
                                                                         Development Programme to support „Modernising
                                                                         Nursing Careers‟.
                                  To respond to changes in the     FD    Contingencies in place for MTAS                         A
                                  medical workforce to include           Increasing Staff Grade and Trust Grade
                                  EU WTD, Modernising                    appointments for service
                                  Medical careers and new                Job planning tool available September 2007
                                  consultant contract
                                  Embed the concept of “the        DSD   The Divisional Boards are now established, with the     A
                                  business unit” and the culture         Divisional Director and the Divisional General
                                  of “earned autonomy” within            Manager receiving dedicated Finance, Human
                                  the business systems and               Resource and Professional Advisory Support.
                                  processes of the organisation          Divisional Review meetings are planned on a
                                                                         quarterly basis first of which is August 2007. Focus
                                                                         on achievement of national, organizational and
                                                                         divisional key performance indicators; will determine
                                                                         the level of earned autonomy.
                                  Develop a management and         MD    Options paper presented to Organisational               G
                                  leadership programme for               development Group. Considering corporate sign-
                                  clinicians                             up to BAMM “Fit to Lead”
                                  Develop an OD strategy to        Ch/   Work in progress with gap analysis. Interviews with     G
                                  support change management        DCA   key stakeholders taken place. Strategy development
                                  programme                              by October 2007
                                  Develop more formal              DS    Internal communications improved through regular        G
                                  processes to capture idea              staff bulletins and CE briefings
                                  generation from staff
                       CO5:To achieve Teaching Hospital Status

CO5:To achieve    To achieve        Provision of suitable            MD   Shrewsbury and Atcham Borough Council deferred            A
Teaching          Teaching          additional residential                a decision on the application for planning
Hospital Status   Hospital Status   accommodation for                     permission from 15th August 2007 to 11 th September
                                    undergraduates through a              2007. It has now been approved with conditions.
                                    partnership approach with             Further discussions to take place with the Secretary
                                    the private sector                    of State to agree use of land adjacent to
                                                                          Racecourse Lane for recreational purposes.
                                    Provision of enhanced and        MD   Plan on schedule                                          A
                                    improved professional                 Awaiting formal PCT approval
                                    education facilities through
                                    the development of an
                                    Integrated Education Centre
                                    based at RSH School of
                                    Health
                                    Foster and facilitate research   MD   Trust now represented on the new West Midlands            G
                                    and development for all               North Comprehensive Local Research Network.
                                    professional groups                   Currrent focus is a review of research governance
                                                                          arrangements. DH R&D funding reducing year on
                                                                          year as is management resource to support
                                    Development of the clinical      MD   Joint teaching appointments with University on            G
                                    teaching infrastructure               schedule. One of the aims of the R&D group is to
                                    required to support the               provide an environment for the new undergraduates
                                    curriculum requirements for           to “experience” research both in the form of clinical
                                    96 undergraduate students             trials and as applied research.
                                    by 2008
                                    To develop an Institute of       CH   A group has been established to focus on best use
                                    Applied Research within the           of intellectual property and information related to the
                                    Trust that supports the               evaluation of new techniques or treatments. A key         G
                                    application of research and           aim is the introduction of a knowledge management
                                    evidence-based practice               system that allows access for all staff to outputs
                                    through improving and                 from research and best practice. A conference is
                                    enhancing the experience              being organized in the Spring 2008 to celebrate
                                    and outcomes for patients             applied research projects and evidence based best
                                    and employees.                        practice.
     CO6:To improve partnership working in developing and delivering a
          coherent vision for the future of health and social care



CO6:To improve      To improve    Develop and deliver an            DS    Stakeholder mapping exercise completed and            G
partnership         partnership   external and internal                   communications plan presented to Trust Board.
working in          working       communications action plan              Focused on improving stakeholder relations,
developing and                    for the Trust                           developing staff as ambassadors for the
delivering a                                                              organisation, strengthening media relations, and
coherent vision                                                           developing effective internal and external
for the future of                                                         communication systems CE face to face staff
health and                                                                briefings completed, Frequent Staff Updates and
social care                                                               monthly Team Brief now all in place.



                                  Develops a hospital               DS    Draft market assessment plan completed. Thinking      A
                                  marketing strategy                      around organizational values and future corporate
                                                                          brand management begun linked to Foundation
                                                                          Trust work.

                                  Improve integrated planning       CE/   Progress via Chairs/CEs meeting and STEG.             G
                                  processes with both               DS    Improved relationship with SCC and T&W OSCs
                                  commissioners and partners              and Powys LHB
                                  in health and social care


                                  Focus on reputation               CE/   Head of Communications and Business                   G
                                  management to ensure that         DS    Development now in post, with a focus on reputation
                                  the Trust has a high external           management with the media. Opportunities for
                                  profile “for the right reasons”         Ministerial visits currently being scoped linked to
                                                                          major hospital developments.
                       Glossary of Terms
•   A&E      Accident and Emergency
•   CE       Chief Executive
•   CIP      Cost Improvement Programme
•   CNST     Clinical Negligence Scheme for Trusts
•   DH       Department of Health
•   EUWTD    European Union Working Time Directive
•   GUM      Genito-Urinary Medicine
•   IBP      Integrated Business Plan
•   ISIP     Integrated Service Improvement Plan
•   IT       Information Technology
•   KSF      Knowledge Skills Framework
•   LDP      Local Delivery Plan
•   LHB      Local Health Board
•   LOS      Length of Stay
•   MRSA     Methicillin-Resistant Staphylococcus aureus
•   MTAS      Medical Training Application Service
•   OD       Organisational Development
•   OSC      Overview and Scrutiny Committee
•   PBC      Practice Based Commissioning
•   PCT      Primary Care Trust
•   PESTLE   Political, Economic, Social, Technological, Legal, Environmental
                       Glossary of Terms
•   PPI      Patient Public Involvement
•   PRH      Princess Royal Hospital
•   RSH      Royal Shrewsbury Hospital
•   R&D      Research and Development
•   SaTH     Shrewsbury and Telford Hospital
•   SCPCT    Shropshire County Primary Care Trust
•   SDS      Service Developed Strategy
•   SHA      Strategic Health Authority
•   STEG     Shropshire and Telford Executive Group
•   STICC    Shropshire and Telford Infection Control Committee
•   T&WPCT   Telford and Wrekin Primary Care Trust

•   CH       Chairman
•   CE       Chief Executive
•   DCA      Director of Corporate Affairs
•   DS       Director of Strategy
•   DSD      Director of Service Delivery
•   FD       Financial Director
•   MD       Medical Director

				
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