CEO and Chair Message for NHS Orkney Staff – Looking back at 2023 – Thank you Team Orkney

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

Message for NHS Orkney Staff 

Dear Team Orkney

Re: Looking back at 2023 – thank you Team Orkney

As we near the end of 2023, it’s important that we look back on what has been an incredibly busy year, but one you can all be proud of.

This year we have begun to put the necessary foundations in place that will enable NHS Orkney to move forward positively and to have a sustainable future. Whilst we have a long way to go, our improvement journey is underway, and we have started to take the first of many positive steps that are enabling us to reconnect with our patients, our local community and you – Team Orkney.

We have faced challenges and pressures on our health and care system mirroring the wider NHS in Scotland. Many of our waiting times are unacceptably long and we are not consistently delivering timely care to all patients, including our planned care and outpatients, though we now have much better line of sight of our issues and challenges and a set of improvement plans that we can closely monitor our progress against, which is necessary.

Notwithstanding our challenges, there has been much progress we must recognise and many achievements you can be incredibly proud of when we look back over the last 12-months. We have heard time and time again from people in our community that you are delivering compassionate care every day, and you are our biggest asset. Thank you for all you do. Please know you make a difference in our community every day and that this is recognised.

Our ambition is that we will be responsive to the needs of our patients and local community and will ensure the views of and feedback from our patients and local community influence and drive positive change. It is also important to us that we become an organisation where kindness, fairness and honesty are at the heart of everything we do – and that we put people first in all we do.

We are certainly moving in the right direction – as evidenced by these highlights:

STRATEGIC OBJECTIVE 1 – Workforce

  1. Thanks to support from the Endowment Fund, in response to your feedback earlier this year we launched a new Employee Assistance Programme for you (it’s a two-year pilot) – as part of a strengthened staff health and wellbeing offer. A new Wellbeing Co-ordinator has been appointed to support this vital work and joined Team Orkney last week
  2. In partnership with The Orcadian, we’ve launched our new Team Orkney Awards as part of our work to strengthen our value, reward and recognition programme
  3. We have completed an Establishment Review so that we have a baseline for the numbers of staff in post with contracts are budgeted for, which is informing our Annual Planning approach for 2024/25
  4. We implemented E-Roster in November
  5. We are on track to have a fully substantive Executive Team by March 2024 (new Medical Director is joining January 2024 and Director of People and Culture March 2024)
  6. New staff induction launched in response to feedback

STRATEGIC OBJECTIVE 2 – Culture

  1. CEO’s 100-day plan was launched and positively received – and focuses on the work that is needed to meaningfully reconnect with our patients, our local community and staff
  2. The new Senior Leadership Team (SLT) is ensuring faster decision-making in the organisation and clinically-led decision-making (we will review SLT in January 2024, six months after its introduction, as agreed)
  3. A strengthened rhythm of communications with staff and ways of listening to and responding to staff feedback throughout the year has been put in place– via monthly all staff briefings, CEO fortnightly blogs, regular drop-in sessions with the CEO and more regular updates being shared with all staff to keep you better informed
  4. We had a Board development session in November which focused on culture, including learning from other organisations and have introduced Board walkabouts so that we can stay connected to staff and hear your feedback and concerns
  5. A strong focus on creating a speak up culture, with four new confidential contacts in post for staff to speak to about concerns/to be signposted for support (we will share more information early 2024)
  6. A strong focus on visible and compassionate leadership and treating each other with respect and kindness

STRATEGIC OBJECTIVE 3 – Quality and Safety

  1. We have improvement projects underway in a number of services, led by staff – including Pain Services and Physiotherapy
  2. We have increased the frequency of our Joint Clinical and Care Governance Committee to eight-weekly recognising the importance of the quality, safety and experience
  3. A review of Service Level Agreements (SLAs) – both clinical and non-clinical – has been completed and will support our fragile services review
  4. Many congratulations to Olivia Jones, who was a runner-up in this year’s Scottish Health Awards in the Midwife of the Year category
  5. Via our Annual Review meeting, we listened to the views of patients and our local community to learn from their experience and to ensure we have re-introduced patient stories at the Board meeting, monthly patient safety newsletters and are holding our first patient safety learning event in January 2024

STRATEGIC OBJECTIVE 4 – Systems and Governance

  1. We have introduced a new Integrated Performance Report to present a more rounded view of performance to our Board, local community and staff, spanning quality and safety, people, workforce and culture, financial performance and operational performance (acute and community services). The new report gives an overview of how we’re performing against national standards and summarises how we’re doing against measures that are important to us in Orkney
  2. In response to some concerns raised about data quality at NHS Orkney, we commissioned an External Review by Public Health Scotland (PHS). This review has now concluded and the final Adherence to Waiting Times Guidance in NHS Orkney Report and improvement plan published. The review confirmed that we are accurately reporting our waiting times, but pointed to areas where we can make further improvements to ensure waiting times are better owned by clinical teams across the organisation
  3. Board and SLT agendas are now aligned to our strategic objectives and a standard Chair’s Assurance Report is in use across the organisation
  4. We have refreshed our risk register and now have 16 Corporate Risks (including three very high risks – our financial position, fragile services, surveillance concerns (colonoscopy))
  5. Our Extended Senior Leadership Team is now in place and we had our first Board-extended SLT meeting last week to build strengthened relationships between our Board and wider leadership community
  6. We are investing in building strengthened relationships with our wide range of external partners and stakeholders, including public sector partners and the third sector as well as local politicians and media

STRATEGIC OBJECTIVE 5 – Sustainability

  1. We are leading the way in Scotland when it comes to net zero and sustainability – which is testament to the hard work of many colleagues across NHS Orkney. We were awarded £4 million from the Scottish Central Government Energy Efficient Grant Scheme to further invest in our estates along with those outwith The Balfour. In line with Government policy, the Board aims to reduce reliance on the use of fossil fuels and ensure alternative renewable energy systems are installed
  2. We have developed an Annual Delivery Plan for 2023/24, Medium-Term Plan (3-year plan) and Anchor Strategy for NHS Orkney
  3. After notification of our formal financial escalation status, we have appointed a new Recovery Director andRecovery Team to work alongside our in-house team, to ensure we return the best possible results for 2023/24 and build a credible savings plan for 2024/25
  4. We have a Grip and Control Board in place, chaired by the CEO, and monthly Finance and Performance Committee meetings to ensure the required focus on improving our financial position
  5. We have set up a Green Theatres project team as part of our sustainability work
  6. We have a new Improvement and Planning Hub in place in The Skara Room, CSB where staff can share ideas for improvements, efficiencies and money saving schemes.

Looking ahead to 2024, we are really clear about our top priorities and the areas in which we need to retain focus to see the continuous improvements that are necessary for our patients, local community and staff.

    1. A continued focus on the delivery of safe, high quality and compassionate care for our patients
    2. Timely care and addressing our longest wait patients (urgent and unscheduled care, planned care, outpatients and cancer care – recognising our very mixed performance against these important national standards presently)
    3. Living our values – leading with kindness and visible leadership
    4. Recovering our financial position through an organisational-wide focus, whilst keeping safety, quality and staff wellbeing front and centre of all of our decision-making
    5. Developing a new Corporate Strategy so that this, with our Clinical Strategy, become our ‘compass’ for all decision-making moving forward, along with new values, vision and strategic objectives for the organisation
    6. Further strengthening our governance by ensuring the groups and forums that feed into Board Committees and into SLT are effective and aligned to our priorities and risks
    7. Developing an organisational culture programme, which has fairness, honesty and kindness at its centre and a new behavioural framework to underpin our values
    8. Introducing performance review meetings so that clinical and non-clinical teams can be held to account for performance across a range of indicators, including our waiting times
    9. Introducing a new integrated improvement function; bringing together quality, financial and digital improvement under one umbrella, recognising these functions cannot work in isolation
    10. A continued focus on improving risk management and mitigation across NHS Orkney, which will see a new risk register being developed in the months to come which aligns to our new Board Assurance Framework

Thank you once again to every member of Team Orkney for your hard work and focus on delivering safe and effective care to our patients and local community. We are incredibly proud of how you continue to pull together to respond to the challenges we are facing and we go into 2024 with hope, optimism and a belief that we will make further progress for the benefit of our patients, local community and staff.

There is much to look forward to as we look to our future.

Thank you to those working over the festive period to care for our patients. For those who are taking leave, please enjoy your down time and family time. Work-life balance is hugely important.

Here’s to 2024 Team Orkney! Take care all.

Laura Skaife-Knight and Meghan McEwen

CEO and Chair