How we’re doing: our Quarter 3 (October – December 2024) Corporate Strategy progress update

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

Message for All NHS Orkney Staff 

Dear Team Orkney 

Re: How we’re doing: our Quarter 3 (October – December 2024) Corporate Strategy progress update 

When we launched our new Corporate Strategy last year, we committed to keeping our patients, community, partners, and you 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: 

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

Our values are: 

  • Open and honest 
  • Respect 
  • Kindness 

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

This is our third quarterly update.

How we did in Quarter 3 

Our focus in Quarter 3 has remained on delivery and performance across all National and Local Key Performance Indicators (KPIs) which are now an integrated part of our Performance Review Meetings (PRM’s) which commenced in October 2024, providing an opportunity for our senior leaders to share what’s going well, what could be improved and areas where performance is off-track and support is needed.  

At the end of December 2024, 20 actions were rated red (significantly delayed) an increase of 18, 1 action (partially delayed) and 33 actions green and are on track. 5 actions have deferred to 2025/26 following a prioritisation exercise by our Digital Information Operations Group.  Some of the delayed actions where work is underway will be concluded in 2025/26 (more to follow on this and our 2025/26 priorities in the months to come).

Strategic objective – PLACE (Executive Director Lead: Dr Louise Wilson, Director of Public Health) 

Quarter 3 progress:  

  • We continue to have an increased focus through our Integrated Performance Report on KPIs related to Population Health recognising its criticality in us achieving our Promise to our community and the transition to being a population health-based organisation
  • Work is moving forward with Hub North Scotland to complete a full options appraisal 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. A report with the outputs of this work will return to the Board in April 2025
  • All work to decarbonise our estate has now finished – which is an incredible achievement
  • Work continues to review our Service Level Agreements (SLA’s) for planned care this includes Ophthalmology and Orthopaedics to ensure patients only have to travel south or into The Balfour for appointments where absolutely necessary and use digital solutions wherever possible as the default

Strategic objective – PEOPLE (Executive Director Lead – Jay O’Brien, Director of People and Culture) 

Quarter 3 progress: 

  • Sickness absence rates in November 2024 increased by 0.63% to 6.52% against a national target of 6%. A comprehensive analysis report has been undertaken on sickness absence within the organisation. Sickness due to stress/anxiety and other psychiatric illness was discussed by the Senior Leadership Team, the Area Partnership Forum, and Area Clinical Forum to develop meaningful actions to prevent absences, support colleagues to stay at work, and facilitate a return to work. This work remains a top priority
  • Our staff appraisal rates remain low and continue to be an area of concern. Appraisal rates across the organisation decreased at the end of December 2024 to 36.49%. A review of data has been completed to remove staff who are not yet due an appraisal, and additional training dates uploaded to TURAS (our online training platform). Line Managers have been offered additional support from the People and Culture team to increase the number of appraisals
  • A new Operational Workforce Group has been established to oversee a remedial improvement plan for our People which include appraisals, mandatory training compliance and sickness absence, all of which continue to be a focus at our quarterly Performance Review Meetings
  • Our approach to Quality Improvement methodology has been agreed and our NHS Orkney QI programme will launch in October 2025 following approval at Senior Leadership Team. More to follow on this

Strategic objective – PATIENT SAFETY QUALITY & EXPERIENCE (Executive Director Lead: Dr Anna Lamont, Medical Director) 

Quarter 3 progress:  

  • The Board agreed our new Board Assurance Framework in December 2024, which provides the Board with a way of monitoring risks associated with the achievement of strategic objectives which are set out in our Corporate Strategy
  • We have continued to further strengthen our approach to risk management, governance, and clinical engagement. The introduction of risk jotters, changes made to the corporate risk register layout and the management of risks at corporate level will simplify the process. A staff training programme is under development, which you will hear more about in the months to come along with the work our Clinical Executive Directors are doing to improve clinical engagement in the organisation and to relaunch our Clinical Advisory Groups so that the clinical voice is at the centre of all we do

Strategic objective – PERFORMANCE (Executive Director Lead: Sam Thomas, Director of Nursing, Midwifery, AHPs & Chief Officer for Acute) 

Quarter 3 progress: 

  • When it comes to waiting times, recovery plans are being developed for specialties for patients who are waiting 52-weeks and overview which is a directive from Scottish Government to have ‘0’ 52-week waits by 31 March 2026. We are identifying opportunities to apply national waiting time funding allocations to invest in additional capacity for patients whose waiting times are longer than they should be
  • Our Planned Care Programme Board continues to oversee weekly review meetings of wait time performance with specialty representatives. Performance against the 18-week Referral to Treatment (RTT) standard has increased during December 2024 to 86.9% (against the 90% national standard) compared to 79.9% in November and 75.2% in October 2024
  • The Board remains at level 3 of the Scottish Government’s NHS Finance and Escalation Framework. We remain largely on track and in line with the 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 set by Scottish Government and 3% recurrent savings, which is an incredible achievement
  • The discharge planning Multi-Disciplinary Team (MDT) Short Life Working Group is developing an action plan to improve the discharge experience, particularly those living on the ferry-linked isles, working closely with our Isles Wellbeing Co-ordinators
  • One of our key priorities in 2024/25 is to increase the number of patients who are discharged before noon. Our current average performance in Quarter 3 was 14% against a target of 20%. More work is required, including a whole system approach to discharge planning and better use of our collection lounge. More to follow on this work in the next few months

Strategic objective – POTENTIAL (Lead: Laura Skaife-Knight, CEO) 

Quarter 3 progress: 

  • To accelerate the digitisation of NHS Orkney and better use technology and digital services, we have mitigated the risks associated with our DATIX and c-Cube systems
  • Our digital champions network is now meeting every month, and digital skills training will be rolled-out in Quarter 4 2025/26. Information on how to get involved in our digital champions network and how to access information and training can be found in the Teams channel
  • In December 2024, our Digital Services underwent an external audit by Scottish Government on our compliance against the Public Sector Cyber Resilience Framework which helps public sector organisations assess their cyber resilience. As a result of an increased focus on compliance, feedback from auditors was excellent, and we have increased our compliance to 50% which is what we set out to achieve in 2024/25
  • Engagement with all relevant professional groups and leads to develop a single Education Strategy has commenced, which sets out our ambition for the future. At January’s SLT, it was agreed in principle to proceed to a full options appraisal and costed Business Case for a new and inclusive Education and Improvement Hub, which is another exciting development which evidences we are prioritising investing in our staff
  • Over 80 Bright Ideas have been received to date, which has resulted in improvements to services in primary care, theatres and procurement thanks to your feedback. Please keep your Bright Ideas coming in to our Improvement Team. They can be submitted by clicking the link here.
  • A discovery and define session has taken place with clinicians led by our Medical Director in relation to clinical engagement ahead of work commencing in Quarter 1 2025/26 to refresh our Clinical Strategy

We are now well into Quarter 4, and remain focused on continuing our journey of improvement with the same commitment and focus on our highest priorities this year: 

  • Reducing sickness absence 
  • Improving appraisal and statutory training rates 
  • Reducing our waiting times
  • Reducing our Delayed Transfers of Care 
  • Outpatient improvements 
  • Improving population health 
  • Achieving our financial plan 
  • Accelerating digital transformation 

Thanks for everything you do for our patients and community – these updates show the progress we are making whilst helping us to focus on the improvements we still have to make.  

A big thank you Team Orkney, from us both. We are moving in the right direction and it’s important we pause more often to recognise this.

Best wishes 

Laura Skaife-Knight, CEO 

Meghan McEwen, Chair