Delays to system wide changes Delays in implementing Lincolnshire health and care (LHAC), now STP, plans Uncertainty is causing recruitment problems External Environment Political Urgent Care – government prioritisation of delivery of urgent care targets NHSE – focus in 5 year forward view on improving A&E performance, maternity services, 7 day delivery, delivery of cancer targets and increased cancer diagnosis. Brexit – exit from European Union in 2019 with 2 year transition period – potential impact on workforce and future recruitment Financial NHS funding agreed to increase by £2.5bn in 18/19 – a further £1.6bn was then announced in the autumn budget, followed by £540m made available since then by the DHSC. £1bn of the additional £2.14bn above has been allocated to sustainability funds for CCGs and to support hospitals struggling with deficits. Non-government review panel suggests the NHS requires a further £4bn in 18/19 year to meet national standards plus a further £2.5bn in each of following 2 years. Most forecasters predict that BREXIT options will lead to decline in GDP and reduce funding available for NHS Regulatory & NHS Improvement’s Single Oversight Framework focuses on five areas: quality; finances/use of resources; operational performance; leadership; strategic change The CQC is focussing on four key themes: encouraging improvement, innovation and sustainability in care; delivering an approach to regulation; promoting a single shared view of quality; improving its efficiency and effectiveness New guidance on tendering rules: The “Integrated support and assurance process” describes the integrated NHS England and NHS Improvement process for supporting commissioners and providers looking to procure and bid for complex contracts
Ambitions Objectives Outcomes Our patients Will receive consistently compassionate, safe high quality care Will be listened to and be involved in shaping their care around their needs to achieve successful health outcomes Will be involved in shaping our services around lessons learned from their care Will want to choose us for care and be champions in our communities Providing consistently safe, responsive, high quality care Our services Will work in partnership to develop integrated models of care Will our patients time and get things right first time Will develop centres of excellence across all of our hospitals Will deliver financially sustainable services Providing efficient, effective and financially sustainable services Our People Will be proud to work at ULHT Will feel valued, motivated and adaptive to change Will challenge convention and improve the way we do things Will strive for continuous learning and development being supported to be innovative Providing services by who demonstrate our values and behaviours Delivering Excellence The Trust has developed an improvement programme that will deliver the 2021 ambitions, outcomes and objectives. This is summarised below: Improvement Programmme Key Activities Outcomes Improving quality and safety Quality Strategy Improving CQC rating Delivering the Quality & Safety Improvement Plan We will on having the right numbers of staff, preventing infections and developing a culture of safety Saving money and improving our environment Long Term Financial Plan Financial Turnaround/Grip & Control Efficiency savings Estates We will be smarter, saving money and modernising our buildings Redesigning our clinical services Clinical Strategy Clinical redesign We will make sure patients get the right care first time
Capability to fore-warn of future concerns Benchmarking Better dissemination and utilisation of benchmarking information Use benchmarking data to inform performance reporting and to explore opportunities for development/improvement Key planning assumptions Finance Introduction Financial planning is an embedded part of the Trust’s planning cycle thus ensuring an integrated approach between activity, workforce and finance is achieved. Clinical and corporate teams are part of the cycle to deliver a financial plan that represents the priorities, risks and assumptions agreed as part of the overall process. The key financial metrics for 2017/18 (unaudited) and 2018/19 (planned) are: Key Financial Metrics 2017/18 £m 2018/19 £m Net surplus/(deficit) (84.8) (79.4) STF funding 0 0 Turnover 429.6 439.8 Expenditure (514.4) (519.2) CIP savings 16 19.7 Gross Capital Programme 23.0 37.7 Cash position 1.5 1.6 Contingency 4.0 2.0 SOF Rating 4 4 As part of the Trust’s planning process the Board has considered the financial parameters it wishes to operate within with a balanced view between challenge, risk and long terms sustainability. The plan is therefore predicated on the following key assumptions: A £3m contingency along with £4m quality investment fund are held representing 1.5% of turnover. The Trust’s Single Oversight Framework risk rating remains at a 4. Inflation assumptions have been on national guidance unless the Trust has specific knowledge to the contrary. Cash support through DHSC loans continues to be available to the Trust to cover the deficit. The key operational priorities set out in the national planning guidance are achieved during 2018/19. Financial Forecasts The bridge below shows the impact of the assumptions form 2017/18 to 2018/19.