How NHS Orkney is performing against its priorities for 24/25

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When we launched our new Corporate Strategy earlier this year, we committed to keeping our patients, community and partners updated on how we’re performing against our five strategic priorities (and the specific deliverables within each) which were agreed for 24/25.

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

Our Strategic Objectives are People, Patient Safety, Performance, Potential and Place.

This is our second quarterly update which was discussed at our public Board meeting this morning. 

How we did in Quarter 2

There are 77 deliverables in our Corporate Strategy Delivery Plan 2024/25 in Quarter 2. 

At the end of September, 2 actions were rated red (significantly delayed), 18 actions (partially delayed) and 52 actions green and are on track, 5 actions are deferred to 2025/26 following a prioritisation exercise by our Digital Information Operations Group.

Here’s a summary of our progress.

Strategic objective 1 – People

  • In response to staff feedback there are 6 areas we are now focusing on to make NHS Orkney a better place to work:
    • Staff health and wellbeing
    • Valuing and recognising staff
    • Involving staff in decision-making
    • Living our values
    • Listening to and acting on staff feedback (and closing the loop)
    • Creating a culture where staff feel safe speaking up, including about safety issues, knowing they will be heard and that changes will happen as a result
  • Sickness absence rates in July increased by 0.86% to 6.72% compared to June when it was 5.86%. Sickness due to stress and anxiety is worryingly around 30%, which is cause for concern. We have had productive discussions at our Senior Leadership Team, Extended Senior Leadership Team and Area Partnership Forum to explore what we need to do differently to better support staff
  • A recruitment improvement project is well underway in response to staff feedback
  • Our staff appraisal rates remain low and are an area of concern with completion rates at 34% against a target of 40%. Appraisal rates will be a focus of our new Performance Review Meetings, which started yesterday, bringing a renewed focus to the support needed for various aspects of our performance that impact on the experience of our patients and staff
  • Linked to the above updates, we have agreed 5 top ‘People’ priorities via our Senior Leadership Team and Area Partnership Forum, which are:
    • Improving Job Evaluation process and timings
    • Improving sickness absence, including absence related to stress and anxiety
    • Appraisal rates
    • Budgets
    • Training compliance (including that related to health and safety)

Strategic objective 2 – Patient Safety, Quality and Experience

  • A new suite of Key Performance Indicators (KPIs) for patient safety, quality and experience is now included in our Integrated Performance Report (IPR). These include metrics for Maternal Early Warning Scores, Multi-Drug-Resistant Organism (hospital and community-acquired), falls (without harm) and pressure ulcers
  • A new process for anonymous feedback has been put in place in response to staff feedback, providing a way for staff to raise concerns where they might otherwise have not felt safe to do so
  • Care Opinion is now implemented in Maternity and is one of the ways we listen to and are responding to patient feedback
  • We are off-track for two important areas:
    • Ensuring all our operational governance forums have in-date Terms of Reference and Chair’s Assurance Reports that come onwards to our Senior Leadership Team. This work will be a priority in Quarter 4 (January-March 2025)
    • The development of a new Board Assurance Framework aligned to our Corporate Strategy’s strategic objectives. To support the development of the Board Assurance Framework a workshop was held in September. We are aiming to have the new Board Assurance Framework approved by the Board in December

Strategic objective 3 – Performance

  • Our Planned Care Programme Board is now in place and is developing plans to improve access to four key services for our patients, including Pain, Ophthalmology, Orthopaedics and Ear, Nose and Throat Services which are among the services where we have challenges and fragility and where our patients are experiencing unacceptably long waits
  • We remain in line with our Financial Plan and 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 for the year
  • A multi-disciplinary discharge planning group has been established to improve the discharge experience for our patients, particularly those living on the ferry-linked isles, recognising this is an area where our patients consistently let us know we have more work to do

Strategic objective 4 – Potential

  • To accelerate the digitisation of NHS Orkney and better use technology and digital services, work has started on the deployment of the MORSE Community Electronic Patient Record. The first team to go live this year with MORSE will be our Community Mental Health Team
  • To maximise the use of Near Me (virtual appointments) and to reduce the need for patients to go south for treatment, conversations have taken place with NHS Grampian, NHS Highland and the Golden Jubilee to revisit the letters which go out to patients to make it clear to patients that they are expected to be seen via Near Me where clinically safe to do so

Strategic objective 5 – Place

  • We have introduced a new chapter in our Integrated Performance Report which shows how we are performing on key performance indicators related to Population Health recognising its criticality in us achieving our Promise to our community
  • Our CEO is chairing a Remote, Rural and Island Task and Finish Group on behalf of the national Board CEOs. This is part of the national sustainability work to identify solutions for fragile services across Scotland

We are now well into Quarter 3 (October-December), and remain focused on continuing our journey of improvement with the same commitment and focus – these areas are our focus:

  • A continued and unrelenting focus on putting people first and reconnecting with people – including our patients, community and our staff
  • Recruiting a substantive Director of Finance to bring further stability to our Executive Team and senior leadership arrangements (interviews are at the end of next week)
  • A sustained focus on financial and operational discipline and grip so we remain on track for the delivery against our financial plan and savings requirements for the year
  • Beginning to develop a clear and credible plan for de-escalation so we map our path and own this as a Board
  • Ensuring we are ready for external support to exit NHS Orkney by the end of March 2025
  • We have commissioned an external review of our culture development, governance and senior leadership – this review started earlier this month and concludes in December and will inform future improvements when it comes to each of these important areas
  • Early planning for 2025/26 re: budget planning, developing our efficiency programme and developing our Year 2 Corporate Strategy priorities