Torbay and South Foundation Trust Annual Plan 2019/2020 Public Summary

Supporting our local communities to live healthy lives.

July 2019

Working with you, for you

1. Working With You, For You

Our organisation and aims What being a foundation trust means Health and care partners across the South The poster below was developed to reflect on Foundation Trusts are different from existing Membership is free and open to anyone Devon and system are recognised for the ‘Our Journey’ as an ICO; staff across all parts NHS trusts in three important ways. They: above the age of 14, who lives within the strength of partnership working culminating in the of our organisation made the first part of our Torbay and area. agreement to pool resources and services to journey a success - we now need to continue • have freedom to decide locally how to meet establish one of ’s first truly integrated our integration journey, delivering great care their obligations; For further information on becoming a care organisations (ICO). within the resources we have available. • are accountable to local people; member, please contact the • To improve people’s experience of health • are monitored by an independent regulator for Foundation Trust Office, and care, making it feel better co- NHS Foundation Trusts and NHS Trusts, Torbay and South Devon NHS Foundation ordinated and personalised. called NHS Improvement (NHSI). Trust • To give people more say in decisions Hengrave House, about their care. Where needed, support They are still accountable to Parliament, but local Torbay Hospital, them to develop the knowledge, skills and people have a real say in how their local hospital TQ2 7AA confidence to manage their own health and services are run by either becoming a Tel: 01803 655705 and wellbeing. foundation trust member or a governor of the Email: Foundation Trust Office • To develop a more flexible workforce, foundation trust. which has the right skills to provide the care people need, when and where they Children’s and young person contract for Devon need it. The Children’s and Young Person contract for • To reduce inequalities in health and care; Devon was awarded to the NHS Devon Children so that people have the same access to and Families Alliance. The ICO has led this as safe, high quality care no matter where prime provider and being awarded the contract is they live. a testament to the strength of our integrated • To remain financially sustainable, ensuring system across Devon. that we can continue to provide the services our local communities need, now and in the future. Our organisation in numbers Our model of care for Torbay and South Devon has been developed in order to achieve these aims; taking into account Number of staff 5,393 Population 293,400 feedback from our local population about Our Integrated Journey represents our Foundation Trust public members 10,500 Visitors during holiday season +100,000 how they want us to deliver health and care strategy to ensure the care we provide is services, and taking learning from what has centred around the person needing our Number of volunteers 588 GP practices 28 worked well elsewhere. services.

Our population Number of outpatients appointments 322,000 The South Devon and Torbay area covers some Torbay and South Devon NHS Foundation Number of elective inpatient procedures 3,660 350 square miles, including rural communities, Trust runs Torbay Hospital, four urban centres and 75 miles of coastline. Its community hospitals, and provides health Number of elective day case procedures 35,600 population of around 293,400 served by GP and social care for the population of Number of Accident and Emergency attendances (including Minor Injury Units) 113,000 practices with services commissioned by the Torbay and South Devon. NHS Devon Clinical Commissioning Group Number of emergency admissions 39,000 (CCG).

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2. Improving access to care

Long term plan for the NHS Our pledge to our population As medicine advances, the needs of the However, it is also a plan that sets the Having this single organisation responsible for population changes so the NHS has to direction for our organisation too as we evolve providing acute and community based healthcare Elective care: reduce to zero the number of continually move forward so that over the course and adapt to the changing needs of the for the population of South Devon and Torbay, patients waiting over 52 weeks for treatment of the next ten years we have a service fit for the population. Over the summer we will be and adult social care services for people in from the time of their referral. future. The NHS Long Term Plan sets an engaging staff and the public locally on Torbay, has enabled closer whole system Emergency care: build resilience in our ambitious path for how we achieve this – it is a aspects of the Long Term Plan to inform the working. Commissioners and providers are emergency care services so that no less than plan for our national health service. Devon Long Term Plan which will be launched aligned in the shared vision and aspiration to 90% of patients are seen treated and in the Autumn. support people to remain independent within discharged within four hours of arrival to our their communities, manage their own health and Emergency Department. Transformation and productivity wellbeing wherever possible, and access the care they need as close to their home as Cancer Waiting Times: To achieve all the The ICO has shown that we are capable of All this in an area that is significantly ahead of possible. national standards for cancer waiting times. taking bold action and achieving results that are the national average for older people living in • 62 days -Patient beginning their first bucking the national trend in managing growth in our footprint. In 2019/20 we will build on what treatment for cancer within 62 days demand on our care system. we have achieved and drive transformation following an urgent GP referral for across five areas: suspected cancer Prevention: enable people to stay • 31 days – patient receiving treatment Right Care in the Right Place: well for longer and manage their own following decision to treat health and care. Clinical Services Review: Working with all partners across the Devon Diagnostic waiting times: To improve STP and STP to develop diagnostic waiting times so that 94% of Wellbeing at Work: to grow and sustainable clinical services. patients receive routine diagnostic tests within develop our care force including 6 weeks of request.

volunteers across the community and Integrated Care Model within the hospital. • maximising the benefits of the first phase of the integrated care Working with partners Sharing Information: Making model. information sharing easier across • accelerating delivery of the second Our plan has been developed and aligned with In addition to our commitment to work with health and care services so a person phase of the model, including the plans of our partners across Devon. system partners to help transform how care is only has to tell their story once. extending partnerships and ways provided and to realise efficiency of working with mental health This plan has been built on a shared approach to opportunities, our plans include our Strengthening Partnerships: services; and strengthening deliver the best care for our population within the commitment to: Strengthening current and forming partnerships with GPs agreed funding resources available. new partnerships with the • deliver the core National Standards of care independent and voluntary sector To meet the growing demands for services we which tells us how long people are waiting who are integral to us continuing to are committed to supporting transformation of for treatment; provide quality person centred care in how services are delivered across Devon as well • meet our annual cost saving of 4% of our the future. as locally and will work with the wider Devon total budget.

Market management: supporting system to share and adopt best practice.

and improving domiciliary care,

residential home, and nursing homes capacity and partnership.

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3. How we are going to deliver services

Our workforce plan Our quality priorities To help our staff deliver services for our The ICO’s latest CQC inspection resulted in an Our challenges • expand the use of real time patient population we will focus on: overall rating ‘Good’ and ‘Outstanding’ for Caring. We face a number of challenges that our feedback to inform our plans; This is a fantastic achievement and reflects the • building our culture that strengthens staff workforce plan will seek to address: • implement learning from national tireless efforts by staff to improve people’s involvement, innovation, and service • support recruitment to critical medical and investigations; experience of services. improvement whilst maximising local, professional roles to maintain safe and • reduce gram negative blood stream

empowered decision making; efficient service delivery We will drive the changes and quality infections by 50% by 2021; • support teams to recruit and retain the right • support improved staff health and wellbeing improvements necessary to realise our • maintain strong operational system and person, with the right skills, at the right as we respond to the needs of our system integrated care model aspirations and deliver board oversight of all quality outcomes and place and time; to adopt and engage with transformational what is important to the people we support. metrics. • support enabling technologies to improve change. Our Plans include Our aspiration is to the way we work; • support teams impacted by infrastructure • supporting work towards 7 day services to secure an overall • develop new roles to reduce reliance on failure / staff shortages and wider system deliver consistency of care; “Outstanding” rating in bank and agency staffing, address skills resilience which can be out of our direct • implement the medical examiner role to our next CQC control. support review of all deaths by 2020 ahead shortages, and develop new skills; inspection. • grow strategic partnerships with local and of the national roll out; national education providers; Our money • growing our own future workforce for Torbay and Devon; In 2019/20 we have agreed how much money we will have to run our services and the savings we • ensure we deliver equal opportunities and Finance Plan need to achieve to deliver our financial support diversity. agreement as part of the wider Devon system. Income £497m As part of this agreement we are committed to Our new organisational structure work with system partners to be more efficient Pay £246m This year we have implemented our new The new structure will give teams greater and productive as a Devon system against Non Pay £239m operational structure. This has created two control to build on our integration journey and national performance standards. systems of care; one being TORBAY which deliver rapid improvement across pathways of Key investments to support increased clinical Savings target reflect boundaries with and the care for our local population. These teams capacity have been agreed within our plans to £ 17.5m + £2.5m other our remaining catchment across SOUTH form Integrated Service Units. ensure we can deliver against the key requiring Devon wide DEVON performance standards. solution

Torbay System South Devon System We are investing in the following projects: The financial pressures are significant and • theatre refurbishment and upgrading on two require delivery of an internal cost Integrated Torquay Newton Coastal Moor to theatre’s air conditioning systems improvement programme of £17.5M this year. Service Unit and Abbot (, (, • CT scanning equipment replacement This represents 4% of our budget. ) Dartmouth, • IT server and network upgrade and Bovey • medical equipment for outpatient Whilst this is a significant challenge we have Tracey) procedures proven in recent years that we can achieve • diagnostic mobile van to increase number these level of savings. of CT and MRI appointments • weekend working in gastroenterology and ophthalmology to increase capacity This information can be offered in other formats on request • increase theatre staffing to continue weekend and extended theatre lists.

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