WEST LONDON MENTAL HEALTH TRUST BUSINESS PLAN 2012/13
Introduction
West London Mental Health Trust (WLMHT) is based in North West London and provides a full range of local mental health services for children, young people and families, adults and older people living in the London boroughs of Ealing, Hammersmith & Fulham and Hounslow. These three London boroughs have a combined population of over 737,000.
WLMHT also provides forensic mental health services, including high secure care at BroadmoorHospital and has a range of specialist mental health services including national specialist services for gender reassignment, young people with personality disorders, and services for people with challenging behaviour.
The Trust employs around 3,720 whole time equivalent staff serving diverse populations of many races, religions and languages at 29 sites. The Trust provides care and treatment for around 20,000 people each year.
Vision
The Trust’s Vision is to become:
‘A Leading Provider of Excellent Mental Health Services, which promote recovery’
Our vision is to become one of the country’s leading providers of mental health services. We aim to provide excellent mental health care to our service users and demonstrate that we are one of the top mental health organisations through the quality, range and cost effectiveness of the services we provide.
We will develop and maintain a reputation for providing excellent, recovery focussed care across a comprehensive range of mental health services. Such care will be comparable to and in many cases exceed international best practice. We expect to be the leading provider in certain specialist areas but aim to be amongst the best across the full range of services we provide.
Our Medium Term Plans
As an applicant for NHS Foundation Truststatus, we have developed medium term objectives which aim to take the Trust towards our future vision. Our medium term objectives, known as Corporate Objectives cover the next five years and are detailed in our Integrated Business plan. The Integrated Business Plan (IBP) has been developed to support our NHS Foundation Trust application and sets out our view of plans to move towards providing ‘Excellence in Mental Health.’
Our agreed Corporate Objectives for the next five years are detailed below together examples of the key pieces of work required:
Our Plans for 2012/13
We recognise that to achieve our Corporate Objectives in the medium term we need to focus our resources on achieving key pieces of work in every financial year. Each directorate within the Trust has developed their work plan for 2012/13 and presented these to the Board, along with their financial plans. The emerging themes or priorities arising from these work plans are set our below.
In summary, there are five key priorities for the Trust during 2012/13:
Our 5 KEY PRIORITIES
To redevelop the St. Bernard’s and BroadmoorHospitalsites
St Bernard’s Hospital:
Planning approval June 2012
Outline Business Case approval August 2012
Full Business Case to NHS London October 2012
Services in JCW relocated at St Bernard’s December 2012
PICU relocated to H&F December 2012
CAMHs service relocated December 2012
Full Business Case approved March 2013
BroadmoorHospital
Town Planning Permission granted June 2012
Outline Business Case agreed by ministers September 2012
Public consultation complete December 2012
To implement the quality strategy
Bring clarity to quality
Measure quality
Publish quality performance
Recognise and reward quality
Provide leadership for quality
Safeguard quality
Stay ahead
To redesign services
Agree service models and pathways
CQUIN targets Qtr1, Qtr2, Qtr3, Qtr4
QRP Monthly
To become a Foundation Trust (FT)
Due Diligence review 1(HDD1) June 2012
Final IBP and LTFM September 2012
Due Diligence review HDD2 October 2012
Board to Board November 2012
NHS London (SHA) approval December 2012
FT application to DH January 2013
To maintain financial stability
Implementation of financial plans within Directorates
Our Approach
Our priorities and objectives are supported by the values of the Trust. We consider that these values are reflective of our desire to deliver excellent mental healthcare and underpin the approach we have adopted for the way we conduct ourselves.
Our Approach
The Trust’s promise is to:
‘Care to make the difference’
The agreed values of the Trust are as follows:
Values
Responsibility
This means that everyone in the organisation is accountable for their own actions and knows what their role entails
Excellence
This means that we continuously strive to improve the quality of care we provide, the safety of our patients is our number priority and we aspire to deliver mental healthcare of the highest quality.
Caring
This means that we will treat both our patients and colleagues with care and respect at all times, that we have a positive and aspirational attitude and that we treat others as we would like to be treated ourselves.
Togetherness
This means that we will all pursue the common goal of delivering positive outcomes for our patients, and that we will work in partnership with our colleagues, our key stakeholders and most importantly our patients and their carers
Our Progress:
We made significant progress last year and achieved a large number of tasks as shown below:
New Clinical Service Unit (CSU) Directorate structures were successfully implemented.
We have received support from commissioners and NHS London for our Business case and associated works for the redevelopment of Broadmoor and St. Bernard’s Hospitals
We have Town planning approval for the redevelopment ofBroadmoorHospitalreceived and just recently planning approval for St Bernard’s hospital
The application timetable to become a Foundation Trust remains on track with key dates agreed by NHS London, our commissioners and the Department of Health.
We made significant improvements in the level of mandatory training completed in all directorates.
We have commenced a number of staff development initiatives
The service for people with Dangerous and Severe Personality Disorders (DSPD) at BroadmoorHospital has closed in line with national plans for this service and services at the hospital have been re-organised.
We have completed Talent Management assessment programme for senior staff
We have completed the first phases of our leadership programme for clinical staff (the ‘QUAISIC’ programme)
We have again achieved our key financial targets and delivered an operating surplus in 2011/12 despite the difficult financial climate for the NHS and public sector
We have completed the majority of the targets set by our Commissioners for service and quality improvements (CQUIN targets)
We have developed Assessment and Recovery wards for inpatients in Local Services and are adjusting our community teams on the same basis.
We have successfully secured funding to enhance and expand our Psychiatric Liaison services
We have designed and are ready to implement a new Business Intelligence Tool
Key Risks during 2012/13
We recognise that we have an ambitious change management programme during 2012/13. We have reviewed our priorities and identified the associated risks with these plans. Thetop risksare summarised below:
KEY RISKS
1.Inability to deliver high quality care due to a poorly engaged and underdeveloped workforce.
2.Inability to deliver a new medium secure building by 2015 resulting in a loss of income and reputation damage.
3.Inability to develop and deliver clinical models that respond to service user and commissioner requirements.
4.Lack of an effective quality strategy and metrics leading to inconsistent quality of care resulting in poor patient experience and commissioner dissatisfaction
5.Significant failure in care delivery resulting in a loss of confidence in the Trust’s ability to deliver safe and effective services.
6.Risk of clinical disruption at Broadmoor due to complex ward moves between March and July 2012 to progress the Broadmoor redevelopment.
Clinical and Corporate Service Plans
Each of theClinical Service Units has their own Business Plan detailed in Appendix 1, 2 and 3.Corporate Services objectives have also been developed and aim to support the CSUs in the delivery of their plans. Corporate Services plans are detailed in Appendix 4
Governance Arrangements
The CSU Business Plans will be monitored and reviewed on a quarterly basis at their performance meetings. The milestones will be assessed to ensure the goal remains on target. Where a delay is identified a recovery plan will be agreed to ensure progress is maintained and the goal achieved.
As part of the Business Planning Cycle a summary report highlighting where there are issues or delays will be presented to the Board on a quarterly basis. Business Planning Cycle attached at Appendix 5
Appendix 1-Local Services Business Plan
Appendix 2-Specialist & Forensic Business Plan
Appendix 3-Broadmoor Business Plan
Appendix 4-Corporate Services Business Plan
Appendix 5-Business Planning Cycle
WLMHT Annual Plan 2012 131 of 73
LOCAL SERVICES /ANNUAL SERVICE PLAN 2012-13
How this Priority underpins the Strategy / No. / Deliverables / Lead / Key Milestones Quarter 1 / Key Milestones Quarter 2 / Key Milestones Quarter 3 / Key Milestones Quarter 4 / Evidence / Assurance / Risk if not achieved
TRUST PRIORITY: / 1 / To redevelop Broadmoor & St Bernard’s Hospitals
1.1 / Support St Bernard's redevelopment / Head of Inpatients / Specification for re-provision of JCW, PICU [H&F] and OPS ward [Glyn] - Closure of Campion Ward / Decant plans / Service relocated / Relocation / Delay in MSU
1.2 / Head of CAMHS / Specification for re-provision of CAMHS service [Ealing, Windmill Lodge] / Decant plans / Service relocated / Relocation / Delay in MSU
TRUST PRIORITY: / 2 / To implement the Trust Quality Strategy
Performance / 2.1 / Local Services' Quality Account Key Priorities / Clinical Director / Action plans and resourcing agreed / Identify indicators and improvement targets / % improvement TBA / % improvement TBA / Achievement of Key Priorities / Reputation
2.2 / Local Services' CQUIN Key Priorities / Head of Partnerships / Action plans and resourcing agreed / CQUIN targets funding agreed / % targets TBA / % targets TBA / Achievement of CQUINs / Reputation
How this Priority underpins the Strategy / No. / Deliverables / Lead / Key Milestones Quarter 1 / Key Milestones Quarter 2 / Key Milestones Quarter 3 / Key Milestones Quarter 4 / Evidence / Assurance / Risk if not achieved
2.3 / Further develop Performance Reporting and LS-KPIs [Benchmarking] / Head of Finance & Business / Review existing KPIs with Heads of Service and agreed changes / Agree key indicators to performance monitor / % improvement TBA / % improvement TBA / LS-Performance Framework and KPIs / Lack of continuous improvement
2.4 / Local Services' KPIs e.g. - PDRs, DNAs, LOS, Delayed Discharges / Heads of Service / Projects, Action plans and resourcing agreed / Agree key indicators to performance monitor / % improvement TBA / % improvement TBA / Achievement of Key Priorities / Reputation Productivity Plans not achieved
Governance alignment / 2.5 / Embed the 'new' governance structures throughout LS / Clinical Director/Head of Clinical Governance-LS / Re-launch of LS Governance Framework / Staff Consultation 'new' LS Governance Hub & Implementation / Flowchart
Structures in place and Intranet updated / Reputation
Workforce alignment / 2.6 / Workforce review - Psychology / Professional Head of Psychology & Psychological Therapies / Feedback Report from Staff Consultation / Implement new leadership structure / New structure in place / Psychology siloed and not aligned to new structure
2.7 / Workforce review - Psychological Therapies / Professional Head of Psychology & Psychological Therapies / Staff Consultation / Feedback Report from Staff Consultation / Implement new leadership structure / New structure in place / Psychological Therapies siloed and not aligned to new structure
How this Priority underpins the Strategy / No. / Deliverables / Lead / Key Milestones Quarter 1 / Key Milestones Quarter 2 / Key Milestones Quarter 3 / Key Milestones Quarter 4 / Evidence / Assurance / Risk if not achieved
2.8 / Workforce review - AHPs / Professional Head of AHPs / Feedback Report from Staff Consultation / Confirm new OT leadership structure & implement - Confirm Arts Therapies proposals & implement / Proposals for Physical Health Care staff linked to Physical Health Care Plans in LS / Implementation Physical Health changes / New structure in place / AHPs siloed and not aligned to new structure
2.9 / Workforce review - medical staff [and support to training] / Clinical Director / Review / Report / Implement alignment plans and job plan review / Job plan review / New structure in place / Medical staff not aligned to new structure Reputation
2.10 / Workforce review - administration staff / HR Business Partner/Director of LS / Staff Consultation - leadership structure & SMT administration support / Implementation / New structure in place / Administration staff not aligned to new structure
User satisfaction / 2.11 / Implement patient satisfaction measures / Heads of Service / Project plan agreed to implement new system / Pilot and review new system / Roll out new system to all services and link to Performance Framework / Review and agree satisfaction targets / System in place and agreed action plans / Lack of continuous improvement
Users/Carers involvement / 2.12 / Review of Users/Carers involvement in LS CSU / Professional Head of AHPs / Review of existing arrangements / Report & Recommendations / Implementation of changes / New involvement processes in place / Lack of engagement
Staff / 2.13 / Implement talent management & SMT Development Plan / HR Business Partner/Director of LS / Develop Local Services Plan
Identify no of staff / Implement / Review / Plan implemented / Lack of succession planning
How this Priority underpins the Strategy / No. / Deliverables / Lead / Key Milestones Quarter 1 / Key Milestones Quarter 2 / Key Milestones Quarter 3 / Key Milestones Quarter 4 / Evidence / Assurance / Risk if not achieved
2.14 / Continue with Leadership Programme [QUASIC] / HR Business Partner/Heads of Service / Plans for continued rollout agreed for 2012/13
Staff identified / Staff attendance / Staff attendance / Staff attendance Review / Plan implemented / Poor local leadership, impact on care and finances
TRUST PRIORITY: / 3 / To deliver new service models and service redesign
Planning / 3.1 / LS Activity & Capacity Model and Plans [Peer Benchmarking] / Head of Partnerships / Appoint Consultancy / Inpatient Model / Community Model / Discussion with Commissioners / Functioning Model and more robust activity/capacity plans / Reduction of capacity without plans
Inpatients / 3.2 / Develop alternative provision to support discharge / Head of Inpatients / Link with Activity & Capacity Model / Work up solution with Commissioners / Business Case / Supported Business Case / Lack of improvement on delayed discharges
3.3 / Supporting Inpatient OD Plans [Assessment & Recovery wards] / Head of Inpatients/HR Business Partner / OD Plans Agreed / Commence OD Plans for Teams / OD Plans delivered / Assessment & Recovery model not fully functioning
Community / 3.4 / Assessment Teams / Head of Community / Teams operational Agree productivity target / Commence OD Plans for Teams
Review productivity / Model patient flows link to Clusters/Activity/Capacity Planning
Review productivity / Report / OD Plans delivered / Productivity Plans not achieved
How this Priority underpins the Strategy / No. / Deliverables / Lead / Key Milestones Quarter 1 / Key Milestones Quarter 2 / Key Milestones Quarter 3 / Key Milestones Quarter 4 / Evidence / Assurance / Risk if not achieved
3.5 / Recovery Teams / Head of Community / Teams operational Agree productivity target / Commence OD Plans for Teams [informed by ImROC & Recovery Hub]
Review productivity / Model patient flows link to Cluster/Activity/ Capacity Planning
Review productivity / Report / OD Plans delivered / Productivity Plans not achieved
3.6 / Early Intervention Service / Head of Community / CSU-wide EIS Model agreed linked to clusters / Consultation & Restructure / Commence OD Plans / OD Plans delivered / Productivity Plans not achieved
3.7 / Assertive Outreach Team / Head of Community / CSU-wide AOT Model agreed linked to clusters / Consultation & Restructure / Commence OD Plans / OD Plans delivered / Productivity Plans not achieved
3.8 / Eating Disorders [adult] / Head of Community / Review Model linked to clusters / Consultation & Restructure / Commence OD Plans / OD Plans delivered / Productivity Plans not achieved
CAMHS / 3.9 / Standardised Operational Processes / Head of CAMHS / Operational policies, protocols & processes reviewed / Best Practice' identified / Standards developed and implemented / Agreed protocols in place / Inconsistency of service provision
3.10 / Standardised Clinical Care Pathways / Head of CAMHS / Clinical pathways based on potential PbR clusters / Feasibility study to centralise specialty services / Standardised pathways implemented / Documented Care Pathways / Inconsistency of service provision. Potential loss of business
How this Priority underpins the Strategy / No. / Deliverables / Lead / Key Milestones Quarter 1 / Key Milestones Quarter 2 / Key Milestones Quarter 3 / Key Milestones Quarter 4 / Evidence / Assurance / Risk if not achieved
3.11 / OD Plans / Head of CAMHS / Staff skills review / Training needs analysis vs. cluster requirements / OD Plans agreed & commenced / OD Plans delivered / Lack of competency, reduced quality of care
3.12 / Tier 2/Tier 3 Pathways / Head of CAMHS / Stakeholder engagement / Review current pathways & threshold / Transition protocols agreed & single access [if required] / Implementation / Protocols in place / Inconsistency of service provision
3.13 / Transition CAMHS - Adult / Head of CAMHS / Review current practice / Report & Consultation / Implementation / Protocols in place / Inconsistency of service provision
Enabling projects / 3.14 / Choose and Book/Single point of access / Programme Manager / Commence pilot - H&F [9 GPs], Adult & Dementia / Evaluate pilot H&F - Commence Hounslow [via Referral Service] / Evaluate Hounslow - Commence Ealing / Evaluate all and develop further roll-out plans / C&B in place and operational / Loss reputation with GPs to deliver change, missed opportunity to stream-line process
3.15 / GP Information Portal/website linked / Programme Manager / Load content / Test portal / Full implementation, extranet links / Website and extranet links established / Loss reputation with GPs to deliver change, missed opportunity to improve communication
How this Priority underpins the Strategy / No. / Deliverables / Lead / Key Milestones Quarter 1 / Key Milestones Quarter 2 / Key Milestones Quarter 3 / Key Milestones Quarter 4 / Evidence / Assurance / Risk if not achieved
3.16 / RiO interface with Hounslow GPs [system 1] / Programme Manager / Agree tool to enable viewing access / Commission / Implement / Evaluate / Viewing access obtained to Physical Healthcare record / Linked to CQUIN