ANNUAL PLANNING FRAMEWORK 2007/8 25th January 2007 Deborah Shaw Director of Strategy Shrewsbury and Telford Hospitals

PURPOSE This paper sets out the Annual Planning Framework for Shrewsbury & Telford Hospitals NHS Trust for 2007/8. The Framework outlines: the Trust’s planning framework for 2007/8 and our understanding of the context within which we will be operating; the Trust’s corporate priorities for 2007/8 to provide the basis for more detailed planning by Divisions; initial activity and finance assumptions to support Divisional planning for 2007/8; the timetable for the next stages of the Trust’s business planning for 2007/8. . 2

“ Continuous Improvement” Business Planning Cycle 3

Operating Framework 07/08 4 Better Patient Experience Money following the patients, rewarding the best and most efficient providers, giving others the incentive to improve Tariff uplift from 2007/08-2.5% PPA reduced to 25% Indicative unbundled prices SHA flexibilities Better Care Better Patient Experience Better Value for Money More choice and a much stronger voice for patients Choice: by 2008, choice of any provider meeting NHS clinical and financial standards PBC: All aspects of PCT budgets will be indicatively developed to practice based commissioners More diverse providers, with more freedom to innovate and improve services 70FTs by Spring 2007, 100 by December 2007 Development of new types of providers Commitment to shift care into community settings Phase 2 ISTs to support choice and help deliver 18 weeks A framework of system management, regulation and decision making that guarantees safety and quality, fairness, equity and value for money Contracts introduced for 2007/08 The future regulation of health and adult social care in England, consultation November 2006 Operating Framework 07/08 4

NHS West Midlands Strategic Framework Initial Priorities: Reducing health inequalities Quality and Choice in primary care Race equality in employment practice & service provision Reducing infant and perinatal mortality Systematic management of LTC Patient focused care Infrastructure investment that supports a quantified shift towards community based services Choice secured in geographically isolated areas Addressing clinical viability issues and reconfiguration Regeneration through community infrastructure investment End of life care 5

2007/8 COMMISSIONER EXPECTATIONS The Trust’s main commissioners are developing their plans for 2007/8 but we can expect both Shropshire County and Telford and Wrekin PCTs to be seeking: Integrated Service Improvement Programme (ISIP) 5 local programmes will co-ordinate much of this work: admission avoidance access to diagnostics preventative health shifting the balance towards local services Configuration to reduce review outpatients through community-based alternatives or prior approval mechanisms; outpatients delivered in community settings; to reduce emergency admissions through service redesign and community alternatives; to redesign urgent care to make early progress towards 18 week RTT target especially reducing diagnostic waits; review and reconfiguration of Community based services 6

New Planning process This new process will provide a disciplined basis for: Delivering financial recovery Identifying key departmental priorities Developing business improvement objectives Allocating limited resources Committing to agree performance outcomes Minimising risk to delivery 7

Corporate OBJECTIVES: Are they comprehensive? The Trust has previously agreed a set of five Corporate objectives: 6. To improve partnership working in developing and delivering a coherent vision for the future of health and social care in Shropshire We will develop effective engagement strategies with key stakeholders that will secure sustainable long term success for the organisation. We will shape our services to meet the needs of the populations we serve through effective integrated planning with our commissioners 1. To achieve Foundation Trust Status by April 2008 We will ensure that the Trust achieves Foundation Trust status through improvement in its strategic planning, governance and HR processes to ensure best use of resources available, a stable financial position and a secure base for future development of our services 2. To achieve all key national targets and priorities on an annual basis We will strive to achieve sustainable financial recovery. We will continue to achieve all key national and local targets and seek to develop a culture of continuous improvement within the organisation 3. To continue to improve patient safety and the patient experience We will continue to work to improve the quality of care we provide including addressing issues of infection control, the patient environment and privacy and dignity. We will seek to ensure services respond to patient needs including the needs of the diverse communities that we serve 5. To recognise and enhance through organisational development, the contribution of the workforce to the success of the organisation We will develop and foster a culture and environment in which employees feel valued and are treated with fairness, dignity and respect. We will ensure that the Trust has effective systems in place for the recruitment, development, management and retention of all of its staff groups 4. To achieve Teaching Hospital Status We will continue to promote teaching, education and research as part of our services and we will ensure that our capital and operational plans secure the resources required to deliver the agreed expansion of undergraduate teaching capacity and capability. 8

2007/8 TRUST PRIORITIES (1) It is proposed to set 8 main strategic priorities to enable the Trust to make progress towards its corporate objectives during 2007/8. Priority Lead 1. To continue the Trust’s Financial Recovery 1.1 Deliver in-year financial balance. 1.2 Deliver a CIP of at least 3.5% 1.3 Make progress with addressing the historic deficit of £34m. 1.4 Improve on Health check “Use of Resources” assessment. SS 2. To continue to Improve Access to Our Services 2.1 Make progress towards the 18 week referral to treatment target – achieve national milestones 2.2 Reduce waiting times for diagnostics. 2.3 Continue to achieve national access targets in A&E and Cancer. 2.4 Achieve target for GUM. 2.5 Plan for maternity services TR 9

2007/8 TRUST PRIORITIES (2) 10 Priority Lead 3. To deliver a long term Service Development Strategy for the Trust 3.1 Perform a fact-based assessment of all clinical specialties and produce a 5 year market-driven SDS 3.2 Prepare an Integrated Business Plan (IBP) that includes detailed market assessment, long term service and financial strategies and workforce plans 3.3 Working with key commissioners and other stakeholders to develop a Shropshire WHE Strategy 3.4 To develop and implement a number of integrated care pathways with our health and social care partners that support the priorities identified through the LDP and ISIP process. DS 4. To continue to improve our Productivity 4.1 Improved capacity utilisation: LOS reductions emergency and elective Maximise theatre utilisation Maximise use of outpatient capacity Clinical support services review 4.2 Application of lean principles particularly to corporate functions 4.3 Review of all non clinical support functions 4.4 Implementation of Productivity Improvement action plan TR/DS 10

2007/8 TRUST PRIORITIES 11 Priority Director Lead 5. To continue to Improve the Quality of our Services 5.1 Meet the Healthcare Commission’s standards for 2007/8 set through the Annual Health check 5.2 Continue to reduce MRSA and hospital acquired infection rates 5.3 Continue work on nursing standards (Essence of Care) 5.4 Deliver CNST level 3 for Maternity 5.5 Continue to improve the patient environment 5.6 Continue to improve patient satisfaction TR 6. To develop the Trusts governance arrangements that are fit for purpose for a Foundation Trust 6.1 Implement fit for purpose business systems into the Trust from “Board to floor” 6.2 Review corporate governance arrangements and further develop the concept of the compliance unit 6.3 Implement the “Intelligent Board” concepts in decision making 6.4 Review the Board and organisational capability and capacity and implementation of a Board development programme 6.5 Further development of performance management and risk management systems and processes DS/JB 11

2007/8 TRUST PRIORITIES JB 12 Priority Director Lead 7. To improve staff satisfaction and staff engagement in effective decision making 7.1 Implement and maximise the value from the new management structure through staff development and KSFs. 7.2 Implementation of the clinical skill mix review findings 7.3 To respond to changes in the medical workforce to include EU WTD Modernising Medical careers and realising the benefits of the new consultant contract 7.4 Embed the concept of “the business unit” and the culture of “earned autonomy” within the business systems and processes of the organisation 7.5 Develop a management and leadership programme for clinicians 7.6 Develop an OD strategy that supports the change management programmes 7.7 Develop more formal processes to capture idea generation from staff JB 12

2007/8 TRUST PRIORITIES SE 13 Priority Director Lead 8. To achieve Teaching Hospital Status 8.1 Provision of suitable additional residential accommodation for undergraduates through a partnership approach with the private sector 8.2 Provision of enhanced and improved professional education facilities through the development of an Integrated Education Centre based at RSH School of Health that will support the educational requirements of the medical undergraduates, nurse education and the local health economy as a whole. 8.3 Provision of designated R&D facilities 8.4 Development of the clinical teaching infrastructure required to support the curriculum requirements for 96 undergraduate students by 2008 8.5 To develop an Institute of Applied Research within the Trust that supports the application of research and evidence-based practice through improving and enhancing the experience and outcomes for patients and employees. SE 13

NEXT STEPS IN ANNUAL PLANNING PROCESS Key milestones in the Trust’s new annual planning process are summarised below. 1st cut LDP w/c 18th Dec 2nd cut LDP w/c 2nd Jan Issue Annual Planning w/c 15th Jan Framework to Divisions LTFM submission to SHA 19th Jan Plans to achieve national priorities 19th Jan LDP target confirmed end Jan with commissioners First Cut Divisional 9th Feb objectives inc. CIP Review of Divisional w/c12th Feb Submissions Second cut Divisional 19th Feb objectives Board workshop 22nd Feb SHA Confirm & Challenge February Draft Trust Annual Plan 2nd Mar Final SLA negotiations March Annual Plan presented to Trust Board for approval March TB 14