How we’re doing: our Quarter 1 (April-June) Corporate Strategy progress update

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Meghan McEwen and Laura Skaife-Knight pictured together in The Balfour

When we launched our new Corporate Strategy earlier this year, we committed to keeping our patients, community, partners and staff updated on how we’re performing against our five strategic priorities (and the specific deliverables within each) we agreed for this year.

As a reminder:

  1. Our promise to our community (our vision) is looking after our community and providing 

 excellent care.

  1. Our values are:
  • Open and honest
  • Respect
  • Kindness
  1. Our Strategic Objectives are: People, Patient Safety, Performance, Potential and Place.

This is our first quarterly update which we discussed at our public Board meeting earlier today. 

How we did in Quarter 1

There are 77 deliverables in our Corporate Strategy Delivery Plan 2024/25 in Quarter 1.

At the end of June, 3 actions were rated red (significantly delayed), 6 actions (partially delayed) and 68 actions green and are on track.

Strategic objective 1 – PEOPLE

Quarter 1 progress:

  • We’re developing a new staff experience programme which sets out how we’ll listen to and act on employees feedback and measure how they are feeling about working here throughout the year.
  • 80 members of staff have completed an introduction to change management training as part of our approach to providing employees with access to Quality Improvement training across the organisation.
  • In May 2024, sickness absence remains lower than the 6.17% NHS Scotland average, at 6.09% (an increase of 0.51% from the previous quarter).
  • We’ve started to develop a new recruitment and retention programme which sets out how we will make NHS Orkney an attractive place to work and pursue a career ,building on our relationships with Developing the Young Workforce and Orkney College.
  • There has been a slight downturn in appraisal rates in June 2024 which are now at 32.02% comparted to 32.14% in April 2024. Our target is over 40% and this is therefore one of the 3 red rated actions for Quarter 1. This remains a key area of focus for us.

Strategic objective 2 – PATIENT SAFETY

Quarter 1 progress:

  • To ensure our patients are more consistently treated with kindness, dignity, and respect, we have started to map out a training plan for Compassionate Conversations with the aim of 25% of all staff completing the training by the end of March 2025.
  • We are beginning to see learning from incidents, complaints and Significant Adverse Events shared more widely across the organisation, with lessons learned summaries now discussed at our Senior Leadership Team meetings and Joint Clinical and Care Governance Committee.
  • We are in the process of introducing Care Opinion which is a clear way of listening to and responding to patient feedback.
  • The ‘Ways we listen’ document is regularly communicated to staff and quarterly meetings are in place for the CEO and our three Confidential Contacts to raise the profile of Confidential Contacts and whistleblowing leads so we can create a culture where staff feel safe speaking up about concerns, including safety concerns, and can have more confidence that when they do speak up, they feel heard, listened to and see their feedback acted on and the feedback loop closed.
  • Last year we strengthened our Corporate Risk Register and how we manage risk in the organisation. We are now focused on further strengthening our approach to risk management, governance, and clinical engagement, with the introduction of an Integrated Risk Management process and staff training programme under development.
  • We are behind track for two important areas (and these are the two other red rated actions for Quarter 1):
    1. Ensuring all of our operational governance forums have in-date Terms of Reference and Chair’s Assurance Reports that come onwards to Senior Leadership Team
    2. The development of a new Board Assurance Framework is off track and is being prioritised in Quarter 2

Strategic objective 3 – PERFORMANCE

Quarter 1 progress:

  • Our Annual financial Accounts for 2023/24 have been approved by the Board and submitted to Scottish Government on time.
  • To reduce our waiting times for planned care patients, which includes outpatient appointments, operations, tests, scans and cancer care, a new Planned Care Programme Board has been stood up, which is chaired by our Medical Director. We have completed a deep dive on planned care waiting times at our Finance and Performance Committee and are now developing plans to improve access to key services, including: Children’s, Mental Health, Primary Care, Dentistry, Pain and Eye Services – which are the services where we have particular challenges and fragility and where our patients are experiencing unacceptably long waits.
  • We continue to make good progress on delivering our Financial Plan for 2024/25 through our Improving Together programme. Plans are in place and on target to achieve our £4million savings requirement set by Scottish Government. We are broadly in line with our Financial Plan for Quarter 1, reporting a £1.8m deficit position.
  • Work is well underway to improve theatre utilisation, efficiency and reducing cancelled operations so that patients get a better experience in our care by undertaking a review of key services including Diagnostics and Gynaecology. Conversations continue with NHS Highland about our Ophthalmology service recognising many of our longest waits (including for cataract operations) are in this service. Identifying solutions for our patients will be a focus of our new Planned Care Board.

Strategic objective 4 – POTENTIAL

Quarter 1 progress:

  • To accelerate the digitisation of NHS Orkney and better use of technology and digital services to improve patient outcomes. Our Senior Leadership Team have agreed over the next 12 months we will focus on delivering three top digital priorities, which are the roll-out of Electronic Patients Records for community-based staff, upgrading our electronic document management system (cCube) and re-provision of our GP IT systems.
  • The first meeting of our digital champions network meeting took place in June, with 20 people from across the organisation volunteering to be part of the digital transformation workstream of our Improving Together programme.
  • To maximise the use of Near Me (virtual appointments) and to reduce the need for patients to go south for treatment, work is underway to establish virtual consultations pods in The Balfour and the community, and this will form part of our Outpatient improvement plan.

Strategic objective 5 – PLACE

Quarter 1 progress:

  • In response to feedback from our community, we’ve published a simple summary of our waiting times by specialty each month to our community, so it is easy to understand and digest, so we are being transparent – something that is important to us to do consistently. You can access this here https://www.ohb.scot.nhs.uk/waiting-times-report
  • To further improve health outcomes and reduce health inequalities for our community we have started to develop a new approach to Population Health Management and Prevention reporting with clearer Key Performance Indicators and metrics so that year-on-year improvements can be measured. A new chapter in our Integrated Performance Report is being developed to give Population Health the focus it needs to have, recognising its criticality in us achieving our Promise to our community.
  • We are moving forward with our plans for the Old Balfour site and King Street to ensure we maximise the use of these assets to support the delivery of our Corporate and Clinical Strategies. An options appraisal is being completed for King Street and we have requested a valuation of the Old Balfour Site.
  • Executive Directors have been identified to ensure we are well represented at a national and local level where it makes sense for our patients and staff to have a stronger ‘voice’ and to explore opportunities where relevant to work more closely with the other island Health Boards (NHS Shetland and NHS Western Isles) to ensure our collective views are better heard and understood. This includes our CEO chairing a new Remote, Rural and Island Task and Finish Group on behalf of the national Board CEOs, which is part of the national sustainability work to identify solutions for fragile services across Scotland.

We are now well into Quarter 2, and remain focused on continuing our journey of improvement with the same momentum and focus – with these areas our highest priorities this year:

  • Improving Planned Care
  • Recruitment & retention
  • Outpatient improvement
  • Improving access to our key services
  • Improving population health
  • Achieving our financial plan
  • Accelerating digital transformation

We recognise we have some way to go; however, it is equally important to recognise that we can evidence improvement in a number of areas, including our recently improved staff survey (iMatter) results.

We are grateful for the support we continue to receive from our community and partners as we continue our improvement journey, and to our staff for all they do to look after our community and provide excellent care.

We welcome any feedback you have on this update, including how we can further improve and ensure they are more useful moving forward – do send this to laura.skaife-knight@nhs.scot.

Best wishes

Meghan McEwen, Board Chair

Laura Skaife-Knight, CEO