A year of further progress for Team Orkney – looking back at 2024

Dear Orkney Community

As we near the end of 2024, it’s important that we look back on what has been an incredibly busy year, but one we are especially proud of. By working together, our staff have made so many positive improvements for our patients, our community and our colleagues. We have reached a number of important milestones and achievements that are important to recognise and celebrate.

Mirroring the wider NHS in Scotland, we have faced significant challenges and pressures on our health and care services in Orkney. Our staff have all responded to these so well, with a relentless focus on continuing to deliver safe and compassionate care for our patients and our community.

Looking back at just some of the achievements from the previous 12-months there is so much to reflect on and be proud of.

Our ambition and promise is to look after our community and provide excellent care on a consistent basis, and we want to be an organisation where being open and honest and treating each other with respect and kindness is at the very heart of everything that we do. We are certainly moving in the right direction – as evidenced by these highlights:

• Earlier this year, after three months of engagement with our patients, community, partners and staff we launched our new Corporate Strategy – called: ‘Delivering what matters to our community’ along with our new promise and values. With this we have five new strategic objectives which we are still embedding into all we do: People, Patient Safety, Performance, Potential and Place. We launched year one of our Corporate Strategy priorities in April and report how we’re doing against our priorities for the year on a quarterly basis
• Through this engagement work, and wider work with our community, partners and staff, we continue to prioritise the work we need to do to reconnect with people by building meaningful relationships and by listening to and acting on feedback
• We launched our new values – open and honest, respect and kindness– which set the tone for how we care for our patients, community and each other, underpinning everything we do
• We launched ‘the ways we listen’ so that our staff know where to go and turn to for the support they need and to escalate their concerns, including those about safety. We now have three Confidential Contacts at NHS Orkney who are here to signpost staff to appropriate support, as we continue our work to create a speak up culture
• We shared our clear digital priorities for the year after engagement with our teams, including clinical colleagues, which includes an Electronic Patient Record in our Community (Morse) and upgrading C-Cube, our electronic document management system – we are on track to deliver these
• Our 2024 report into our compliance against the National Information Security (NIS) Audit review provides evidence on the controls we have in place to ensure our systems and data is safe and signals an improvement in compliance over the last year from 28% to 50%, which is another great example of progress
• Our iMatter (staff survey) results showed improvements versus 2023 – and when the national benchmarking was published, Orkney improved more than any other Board in a number of other areas including response rates (59% to 69% 2023 to 2024 for NHS Orkney) and we had the biggest improvement in Scotland for Board members being visible in the organisation, which has and continues to be a focus for us. NHS Orkney was the only Territorial Health Board in Scotland to improve for the question: ‘I would be happy for a friend or relative to access services in my organisation’ – all of these results signal progress
• We listened to feedback from our staff and invested in the areas colleagues said were most important to them, and would further improve their experience of working here by setting six top priorities, which are:

1. Improving health and wellbeing
2. Introducing a new value and recognition programme, including staff awards and long service awards
3. Listening to and responding to staff feedback more consistently (and closing the loop)
4. Doing more to involve staff in decision-making that impacts them
5. Leading with kindness, one of our values
6. Creating a culture where staff feel safe speaking up, including about safety concerns, so they are confident knowing when they do speak up they will not suffer detriment and we will make positive changes

• As the Board with the highest uptake in Scotland for flu vaccinations (adults) and COVID vaccinations, we are playing a fundamental role in keeping our patients, community and each other safe
• We launched a Board and Executive Team Development programme – recognising leadership and culture starts with the Board
• We’ve retained our UNICEF Gold Accreditation (part of the baby friendly accreditation), which is testament to our Health Visiting and Maternity Services – evidencing a strong commitment from staff towards this evidence-based, patient-centred approach to care for babies and their families
• We’ve received national recognition and confirmation that medical students on placement here get an excellent experience
• We were awarded the Gold Award for the Defence Employee Recognition Scheme in recognition of our commitment to the Armed Forces earlier this year. Representing the highest badge of honour, the Gold Award identifies organisations that employ, advocate for and support those who serve, veterans and their families
• We’ve won/been finalists in a range of national awards, including:
  • Three finalists in the Scotland Health Awards, including two winners (Nurse and Midwife of the Year)
  • Anne Gregg was awarded an MBE for her commitment to the NHS and to improving care and services in her role asMacmillan Specialist Nurse
• We are consistently a top three Board in Scotland for our four-hour emergency access performance (timely care in our A&E department)
• We’ve introduced a new Planned Care Board to focus on the work we need to do to further reduce our waiting times for patients  
• In response to feedback from our community, we now publish on our website a simple summary of our waiting times by specialty each month for our community, so it is easy to understand and digest, so we are being open and transparent, consistent with our values
• We’ve introduced a new Improvement Board which reports to our Finance and Performance Committee where we can oversee progress against our Improving Together (efficiency) programme
• Over 70 Bright Ideas have been received via our new staff ideas scheme – supporting continuous improvements to patient and staff experience and empowering staff to lead change at all levels of the organisation
• 80 members of Team Orkney have completed an introduction to change management training as part of our approach to providing staff with access to Quality Improvement (QI) training across the organisation. Work is underway, with leaders from across the organisation, to develop NHS Orkney’s approach to QI which we will launch in 2025
• We’ve introduced new Performance Review meetings to share good practice between teams, offer support with recovery plans where teams are off track, to hold to account and to further improve relationships between the Executive Team and Clinical and Corporate teams
• At month seven, we remain on track to deliver our Financial and Savings Plan for the year and of the £4m savings we are on plan to achieve (which is the highest level of savings we will have ever made as an organisation), 72% of these are recurrent (i.e. not one-off savings), which is an incredible achievement
• We’ve developed a new Board Assurance Framework so we can have oversight as a Board of the risks to the delivery of our strategic objectives (People, Patient Safety, Performance, Potential and Place)
• We’re playing a much more active role in the Orkney system, in the North of Scotland and on the national stage, leading a number of key pieces of work, and ensuring Orkney’s voice is heard, with a commitment to our patients living longer, healthier lives and having better health outcomes
• To further improve health outcomes and reduce health inequalities for our community, we have developed the beginning of 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 has been developed to give Population Health the focus it needs to have, recognising its criticality in us achieving our Promise to our community
• We’re exploring the options 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 and valuations have been completed and our Board is overseeing this work
• We are on track with our decarbonisation project – which involves removing fossil fuels and increasing the thermal insulation of four NHS Orkney-owned properties – Sanday, Stronsay, North Ronaldsay and Westray Surgeries – this project is on plan and on budget and is another way in which we are continuing to lead the way regarding the sustainability agenda nationally

These are just a selection of our many improvements. There are many more.

Looking to 2025 – there is much for us to look forward to and so much more to do that will enable our improvements to be embedded, sustained and built upon. We are really clear about our top priorities as we head into January 2025, and these include:

• A strengthened focus on further improving patient and staff experience, and patient safety through a co-ordinated programme
• Reducing our waiting times, so that our patients get a better experience and access to key services – including mental health, primary care and dentistry
• Maintaining financial grip and control so that we continue to manage our pay and non-pay spend, recognising our challenge will get tougher still
• A continued focus on improving our organisational culture (open and honest, respect and kindness – always), with Board members taking a leadership role in building the culture we want to see
• Investing in leadership development and agreeing an approach to succession planning

We’d both like to say thank you to our partners, external stakeholders and community for your support throughout the year and for the important part you are playing in our continuous improvement journey.

We recognise that for some, this time of year is difficult. Please remember help and support is always available and reach out if you need to. You are never alone. The number for the Samaritans is 116 123 and the Mind Information Line is 0300 123 3393.

On behalf of our Health Board, we extend our festive greetings to you all and wish you a very healthy, happy and prosperous New Year.

Here’s to 2025!

With our best wishes,

Meghan McEwen
Board Chair

Laura Skaife-Knight
CEO