Annual Report 1
Annual Report 2018-2019
P r o v i d e
A n n u a l
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A View from the Chairman
We l c o m e . . . CONTENTS
3 A View from the Chairman 4 Delivering Our Services to Meet Customer Expectations 10 Demonstrating Quality 14 Being an Employer of Choice 18 Recognising Our People 20 Making Technology Work 22 Being Financially Strong 24 Investing in Our Local Communities 25 Fundraising Activities 26 From the Governors 28 Volunteering with Provide 34 Looking Forward
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A View from the Chairman
A few years ago when we were reviewed by the CQC and achieved a Good rating, I was incredibly proud and jokingly commented that we needed to go from Good to Outstanding, knowing full well how hard that would be to achieve. Nonetheless we set ourselves that target and low and behold we achieved it. What a fantastic group of staff you are! I could not be more proud of you and it is very well deserved. Well done! Over 97% of people who receive a service from us would recommend us to a friend or member of their family. It doesn’t get much better than that. I have spent much more time out and about this year with staff and witnessed for myself the care and compassion that you all continue to provide. Having it externally validated is, of course, the icing on the cake. We have achieved many other things this year which have contributed to an outstanding year. We have: had our main contract with the CCG extended for five years; trained over 500 staff on Mary Gober
Derrick Louis
Looking back over the last 12 months has been an absolute pleasure for me. What we have and continue to achieve is totally amazing. At the beginning of each year, the Board and I set targets for the organisation that we aim to meet and we consistently over-achieve them in a remarkable way. customer care; created Workforce Solutions (our own staff bank) with over 170 staff on the books; created a joint children’s centre in Chelmsford with NELFT; begun the development of the new South Woodham Ferrers health centre; started a new sexual health service in Thurrock and Southend; started a new telecare service in Hertfordshire; and embedded the Home First and Supported Living Services. On a sad note, we lost the Cambridge Wheelchair service but, I am pleased to say, managed to hold on to most of the staff. We continue to punch above our weight within the wider health arena with both myself and the Chief Executive participating in, and often leading, parts of the STP as it transforms into an Integrated Care System as outlined in the NHS Ten Year Plan. We have continued to grow our own talent with several members of staff qualifying as nurses and, as celebrated at our annual awards, many staff gaining advanced qualifications
in their specialist areas. We pride ourselves in being a learning organisation and we continue to invest in training and development. We believe that our staff are our biggest asset and we continue to look at ways to improve working conditions. We have spent considerable resources on improving premises; we have extended the staff benefit scheme; and we have put more resources into the staff pension scheme and undertaken more staff wellbeing days than ever before. I, for one, will ensure that this continues with the able help and assistance of our staff Governors who have been doing a great job in advocating on your behalf. Finally, let me thank all our staff once again for the incredible hard work and commitment that they have given the organisation over the last 12 months. I remain honoured to be your Chairman and I look forward to another successful year.
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Delivering Our Services to Meet Customer Expectations
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Delivering Our Services to Meet Customer Expectations At Provide we want the experience of our service users, families and carers to be the best it can be and for their voices to shape our decisions about future healthcare services.
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Over this last year, Provide staff have been working hard to ensure that as an organisation it adheres to the Accessible Information Standard Principles by reviewing and exploring the opportunities that our service users have to provide feedback to the organisation with access to a number of methods that will suit them.
Complaints
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1 April 2018 - 31 March 2019
Our care and compassion values have been supporting our overall aim for our patients to feel better cared for and our staff to feel valued and supported. Successes and room for improvement are evidenced and identified by the feedback we receive from our service users. Provide continues to encourage feedback to anyone wishing to comment about the services they receive.
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Year-end totals for complaints divided into categories Concerns Moderate complaints Severe complaints Total
189 36 0 225
Environment Privacy Access to services Waiting time for appointment Attitude of staff Care Communication Confidentiality Equipment Continuing Healthcare Process Discharge Planning Other
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The number of contacts with service users for the period of this report has increased by 15% from the previous financial year of 2017-18. The number of complaints received, however, has proportionately decreased. This means that the number of complaints received in comparison to the number of contacts with service users continues to remain extremely low but as any complaint made is an expression of dissatisfaction, as an organisation we must not be complacent. Communication continues to produce the largest number of complaints and work is on-going to improve the way in which we communicate as an organisation.
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Compliments Our organisation has received some wonderful compliments during the past year >>>
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Community Hospitals, Minor Surgery and Outpatient Services Locality and Neighbourhood Services
69 55
Specialist Children and Adult Services
57 2 358
St Peter’s Ward, March 2019
You are a mine of information, helping us and our son through a difficult time. We appreciate your calmness, honesty, knowledge, advice, care and attention given to all of us. With grateful thanks. Children’s Diabetes Service, January 2019
I was treated with great care. Everything was explained during my procedure and after it. The whole department is run so well. It made me feel better if I ever need further treatment.
Many, many thanks for giving my mum the best [palliative] care ever. You were all so kind and caring and always had time for her as well as for me. The end of her life was happy, with no pain and lots of nice nurses. She was very fond of you all. Thank you. Witham ICT, June 2018
I had a coil fitted for the first time ever yesterday. The team at Moulsham Lodge in Chelmsford were great. They took great care of me and were helpful, kind and professional and made me feel that it was okay that I was taking time to recover. They even moved rooms so I could stay in the same room and feel comfortable with the nurse while the rest of team carried out their jobs. Mid Essex Sexual Health Service, March 2019
Urgent Care Care at Home
My daughter had over the last four years become less confident and more frightened of the world around her. Despite my best efforts she often felt that no one understood her or listened to her. It had got to the stage where she would not leave the house without me and does not like to be left with other people.
Other TOTAL
A patient commented to me today that all the new nurses that have been to see her recently are all so lovely. Every one of them has had such a smiley face and are all lovely and friendly. Chelmsford ICT, January 2019
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We would like to thank each and every one of you for the first class care and kindness you gave [patient name] while she was recovering from her stroke. I’m sure this helped her to recover a lot more quickly and to be able to come home.
To all in the children’s Diabetic Team: well, where to start? Obviously, thank you, but these words do not sum up our gratitude to all of you who provide such a valuable support to us as parents and to our son. It cannot be easy providing on-call support day and night but we honestly can’t express how helpful it was to know you were only a phone call away.
Minor Ops, BCH, November 2018
Primary and Prevention Pathways
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Delivering Our Services to Meet Customer Expectations
Thank you so much for everything you have done for [child’s name]. It’s been a constant source of joy to see his ability to communicate expanding and to see him be able to (safely) indulge his love of food. We’ve really appreciated how accessible and approachable you’ve been, and the times you’ve gone out of your way to help.
In the last six weeks she has been seeing [staff name]. What a difference! When going to the appointment there is no anxiety and she will even walk in front of me to get there. After the meeting we come out relaxed and there are not the usual demands to go straight home. I feel so happy with the way my daughter has changed and I would like to recommend [staff name] to everyone. I can see this making life changes and differences for my daughter. Please tell [staff name] to keep up the good work as she has made this mum very happy. Essex Lifestyle Service, August 2018
Children’s Speech and Language Therapy, November 2018
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Delivering Our Services to Meet Customer Expectations
Some feedback from the comments made.
FRIENDS & FAMILY TEST
10,191 people took the opportunity to provide feedback using the Friends & Family Test (FFT) during 2018-19, with an average satisfaction rating of 98.3%. This means that 98.3% of people providing feedback via FFT would recommend our service to their friends and family.
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You said...
We did...
Patients on St Peter’s ward asked for daily newspapers.
Newspapers can now be ordered and are taken in by volunteers.
The continence service users asked for chairs with armrests.
There is now a choice of chairs within the clinic area.
Patients of the phlebotomy service asked to be reminded of when their appointments are due.
Set up an appointment reminder service.
The patients on Halstead Ward said it would be lovely to be able to buy newspapers.
A volunteer collects orders from the ward and takes the newspapers back to the patients.
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Demonstrating Quality
Demonstrating Quality Clinical strategy
What do our customers say?
The way in which we deliver our clinical services and how our staff interact with our customers is fundamental to the delivery of safe, effective, caring, responsive, and well-led services, as defined by the Care Quality Commission and experienced by our customers. At the same time, we live in ever-changing times were we need to keep pace with the changing healthcare needs of our population, changing healthcare practices, and changing levels of resource.
‘The carers were so lovely, helping or showing how to do things, teaching new ways to complete a task. They allowed dignity at all times, never trying to speed up so allowing time.’ (FFT feedback, Early Supported Discharge & Stroke Services, April 2018)
In 2016 we developed a three-year clinical strategy to help us look forward and develop our clinical services, not only to keep us relevant and fit for purpose but to ensure that the quality of the services we deliver is continually improving. Our clinical strategy priorities were aligned to our organisation’s Vision and Values. In 2018-19 we reached year three of our three-year clinical strategy. Below is a summary of what we successfully achieved.
Care and compassion
Nurture and empower
Innovation
We will introduce quality improvement (QI) methodology to Provide and build on customer feedback.
We will focus on clinical practice development to support new roles and new ways of working to enable staff and promote competence.
We will contribute to the national benchmarking programmes and build on the range and format of quality data provided to the Board, including benchmarking and control charts to measure performance.
We identified key staff to undertake QI training as an introduction to QI. We identified funding for, and have now recruited, a dedicated QI Facilitator to develop a QI training programme and tools for staff during 2019-20. We have introduced a process to monitor which services receive little or no Friends and Family Test feedback and have been reporting this to our Board. We have devised a new process to be implemented in 2019 to contact a small sample of customers each month in services where customers are less likely to provide Friends and Family Test feedback to have a conversation about their experience of the service.
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Stephanie Dawe Executive Clinical & Operations Director
We identified staff to undertake training to become Associate Nurses which is a new nursing role developed nationally to support the workforce of the future. We have ensured Care Certificate competencies have been completed by all eligible Provide staff, including new starters and existing staff. The Care Certificate ensures that all health and social care workers have the required values, behaviours, competencies and skills to provide high quality, compassionate care.
We participated in the National Audit Intermediate Care. We continued participation in the following national audits:
• National Safety Thermometer.
• SSNAP – Sentinel Stroke National Audit Programme.
• PASCOM Audit Podiatric Surgery.
• National Diabetic Foot Care Audit. We included benchmarking measures in the Board quality assurance reports, including:
• Patient harm rates.
• Falls/1,000 bed days.
• Friends and Family Test ratings.
We have identified funding and joined the NHS Benchmarking Network and will commence contributing data to this in 2019. Control charts were introduced to Board quality assurance reports to enable a measure to be viewed in context, as small variations in data can appear significant unless viewed within a set of upper and lower controls. We introduced a new Board Quality Assurance Dashboard which provides clear data on service quality set against the five CQC domains of quality and safety. Alongside this, the Board set clear indicators of performance for each quality area they wanted to monitor to provide a clear view of whether the level of performance required was being achieved using a red, amber, green rating. This, coupled with the new control charts, has set in place a method of quality monitoring that is objective and transparent for the Board. In addition, to provide an alternative approach to quality testing, each operational business unit contributed to the annual clinical audit programme during 2018-19.
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Demonstrating Quality
Our Quality Assurance Structure
Our approach to quality
Provide quality assurance process
Our focus is to ensure our services are safe, effective, caring, responsive and well-led. To achieve this, the Board has ensured that there are well-defined governance systems and processes in place to support and assure the quality of the services we deliver.
Our Board monitor and assure quality standards by monitoring, reviewing and evaluating a wide range of quality data and information, such as:
This starts with our organisational culture which is driven by our shared Vision and Values. Our Board, in consultation with our staff, have set out a clear statement of our Vision and Values which underpin everything we do.
Quality & Safety Committee
Audit Committee
Our Current CQC Rating
which occur during the year. They see reports and action plans from incidents and complaints and are able to be assured that appropriate measures are in place to deal with issues when things go wrong.
The Board regularly visit different areas across the organisation to see first-hand the quality of the services being delivered and to speak with staff and our customers face-to-face.
‘Kind and considerate and my feet feel so much more comfortable.’ (FFT feedback, Podiatry, July 2018)
Essex Sexual Health Group
Clinical Excellence Group
Mortality Review Group
Information Governance Group
Sign up to safety We are committed to:
To view our current CQC reports visit the Care Quality Commission website: www.cqc.org.uk/provider/1-168055209
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of staff said they are likely to recommend this organisation to friends and family if they needed care or treatment. (Staff Survey 2017-18)
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Serious Incident Review Group
Our Quality Account 2018-19 is published on our staff intranet and the public internet. It has also been published on the NHS Choices website.
transparency in all we do and have backed the implementation of our statutory Duty of Candour.
This robust governance framework provides assurance for the Chief Executive, Chairman, the Board of Directors, CQC Registered Manager, and the senior managers and clinicians that the essential standards of quality as set out by the Care Quality Commission are being met in every part of the organisation.
Annual Quality Account Each year all providers of NHS services are required to publish a report on the quality of the services they deliver. This is called the Quality Account. Our Quality Account aims to provide clear information about the quality of the services we deliver and our plans to improve further with the needs of service users and their families at the centre of all we do.
The Board are aware of all serious incidents
The breadth of assurance provided to the Board allows structured discussions at Board meetings and provides detailed insight into the quality of the care being delivered as the norm across services, while recognising the need to improve where things go wrong in an open and transparent manner.
Workforce Group
Risk Management Group
Health & Safety Group
Customer Engagement Group
in relation to medicines management, safeguarding, infection prevention, information governance, learning and development, health and safety, service delivery issues, and patient experience.
Infection Prevention Group
Specialist reports from all support services
Learning & Development Group
shared bi-monthly.
Strategic Safeguarding Group
Well-defined processes for risk assessment
The Board encourage openness and
What do our customers say?
Finance & Risk Committee
Bi-monthly quality and safety reports. Clinical Excellence Group
Our Board has set robust systems and structures in place to ensure that quality of the services we deliver to our customers is at the centre of everything we do.
Provide Board
Putting safety first and reducing avoidable harm. Continually learning by acting on the feedback from patients and incidents and by constantly measuring and monitoring how safe our services are. Being open and honest by being transparent with people about their progress, tackling patient safety issues and supporting staff to be candid with patients and their families if something goes wrong. Collaborating with the wider health, social care and volunteer community to improve the local services that patients use. Supporting and helping people to understand why things go wrong and how to put them right. Giving staff the time and support to improve and celebrate their progress.
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Being an Employer of Choice
Being an Employer of Choice to recognise mandatory training completed with previous employers which avoids duplication and enables our new starters to begin working in their teams sooner than before.
Our commitment to invest in learning and development for our entire workforce has continued to be a priority during 2018-19. New learning opportunities have been added to our established menu of development activities which enables our staff to consistently deliver high quality people-centred care. This year, 96% of staff completed all their mandatory training requirements and we consistently exceeded our contractual performance target of 90% for the whole year. 96% of our staff had an annual appraisal with their line manager. 100% of our new starters completed their corporate induction programme. Following feedback from new starters and managers, we reviewed our induction programme during 2018 and we launched a new threeday programme in February 2019. A new on-boarding intranet page is also being developed which will enable new starters to complete aspects of their induction and mandatory training prior to joining us. We are now also able
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We have continued to make good use of the apprenticeship levy, both for new apprentices and also to support staff development and growing our own workforce model. The apprenticeship levy has supported our ‘grow our own’ workforce model which has enabled five of our healthcare support staff to start their higher apprenticeship in nursing programme. They will complete this work-based university programme over two years, resulting in a registered nursing qualification. Two of our existing staff also completed their work-based learning nursing programme at the University of Essex in November. They are now working as registered nurses in our community nursing teams. These programmes give our existing healthcare support staff the opportunity to complete the registered nurse training programme whilst continuing to work. Feedback from our staff suggests that this is a popular alternative to completing the three-year full time undergraduate programme. We received this feedback from one of the trainees:
‘Just wanted to say thank you to you and Provide for supporting me on my journey to becoming a trained nurse. The course provided me with an opportunity that I could never have afforded if it wasn’t for the secondment on offer. Without this opportunity I would never have been able to achieve my dream of becoming a registered nurse: with three kids it would never have been an option!’
We have also been part of a system-wide mid and south Essex partnership group, supporting the introduction of the new Nursing Associate role across our clinical services. Two of our existing staff have commenced this two-year work-based learning programme at Anglia Ruskin University which aims to bridge the gap between a healthcare support worker role and a registered nurse.
The Learning and Development team were successful in renewing their Skills for Health Quality Mark which recognises outstanding health care training. The Skills for Health Quality Mark is the only standard for the UK’s health sector. It defines and endorses superior delivery of learning and training that healthcare employers need for a highly motivated and effective workforce.
With Health Education England funding support, six of our staff completed their District Nurse training programme with Anglia Ruskin University. This training will support our commitment to deliver responsive, high quality health care to people in their own homes and communities by highly qualified and experienced community nurses.
The theme for our 8th Annual Conference held in May 2018 was ‘Listening to the Customer Voice’. 194 staff were in attendance. The keynote speakers were extremely well received with Ashley Brooks, the NHS Patient Champion, receiving overwhelmingly positive feedback. There were 12 interactive workshops and for the first time, four were delivered by customers sharing their stories and experiences of using our stroke services.
In September 2018 Anglia Ruskin University opened their new medical school. We have been involved in supporting the design and delivery of the curriculum for the first cohort of students and staff from our Lifestyle Service. They have delivered training which focuses on promotion of healthy lifestyles, including smoking cessation and ‘making every contact count’ training. In October 2018, our health coaching training programme achieved accreditation through the European Mentoring and Coaching Council. This in-house programme enables staff to use a health coaching approach in everyday conversations with our customers to support self-management and a sustainable change for improved health and wellbeing. As one of the partners in the Mid/South Essex STP, our staff have had the opportunity to be part of a number of training programmes, including development programmes for nonregistered staff in Bands 1-4, leadership programmes for BAME staff and quality improvement training.
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Recruitment Nationally and locally it is recognised that the scale of the workforce challenges now facing the health service poses a threat to the delivery and quality of care over the next 10 years. In response to this challenge we have continued to strengthen our recruitment practices, developed enhanced career pathways, redesigned roles and services to support greater staff engagement and job satisfaction.
In the light of these challenges we have generally been able to recruit to key roles and to maintain turnover through voluntary resignations at around 14%. We have extended our use of social media to promote our organisation as an ‘employer of choice’ and to highlight roles. We have also increased the utilisation of other recruitment technologies, such as LinkedIn and developed an on-boarding intranet site. We continue to work to streamline our recruitment processes to ensure that this is efficient for both prospective employees and our services. Feedback on our recruitment process by applicants using NHS Jobs consistently places us above the national average. In the last 12 months we have been developing our own staff bank arrangements through Provide Workforce Solutions. Some bank staff have moved into substantive roles within the organisation, which is encouraging and supports one of the fundamental objectives of this project in creating a natural pipeline for development and progression and supporting recruitment. The project also aims to reduce further the reliance on agency staffing. Provide has successfully been reaccredited as a ‘Mindful Employer’ (committed to the mental health of our staff); accredited as a ‘Stonewall Champion’ (ensuring all lesbian, gay, bi-sexual, transgender, queer (LGBTQ) staff are accepted without exception in the workplace); and ‘Positive about Disabled People’ (committed to employing disabled people). In addition, this year we have established a Black and Minority Ethnic (BAME) staff group for Provide staff shared with NELFT and an LGBTQ staff group in conjunction with the University of Essex. A new benefits package called Hapi Benefits was launched in December 2018 and we now have 38% of our permanent staff registered to use the website and/or mobile phone app. This enables us to have a platform where all the benefits of working for Provide can be centralised for easy access by staff, as well as providing access to a range of discounts. The launch included one-toone support being available for staff to enable them to register and have the functions demonstrated.
Being an Employer of Choice
Technology
Staff survey
Provide continues to drive improvements and efficiencies through the use of online technologies. All payslips are electronic, annual leave and sickness absence are all managed through ESR or our e-rostering system, and 95% of training bookings are made by ESR self-service. Less than 1% of travel expenses are now claimed on paper.
Feedback from the staff survey in 2017 suggested that there were too many questions which took too long to complete. Therefore in January 2019 we decided to run the survey in bitesize chunks over the year. In January and March all employees received survey questions, as we have some questions that need to feed into statutory returns. However, for the other months only a sample of employees receive them.
A programme of ESR supervisor self-service continues to be rolled out to help reduce form filling, ensuring better oversight and reduced duplication of effort.
Health and wellbeing Provide has some of the lowest sickness absence levels of community service providers across the country. This has been maintained at low levels for the past five years through the successful application of our attendance management policy, a programme of monitoring and support.
We ask just five or six questions each month and it takes under two minutes to complete. The responses are communicated to staff through our monthly communications cascade system, Team Brief. This allows us to focus on key issues each month and to align our interventions throughout the year to respond to the changing feedback. This year 89% of staff respondents indicated that they would recommend friends and family to receive care from Provide. 70% would recommend Provide to friends and family as a place to work. 92% of respondents believe they can make a valuable contribution to the success of Provide.
However, it is recognised that staff working in the health and social care field can experience significant pressures and so Provide continues to invest in health and wellbeing activities for our staff.
We also provide an opportunity for staff to make comments on their experience of working for Provide and below are a couple of the positive comments received.
As part of our Health and Wellbeing Strategy we have continued to run meditation programmes for all staff. Feedback from these staff indicate that the majority of them are still practising meditation regularly and have experienced both physical and mental health benefits. Our volunteer Wellbeing Champions have run a range of engaging activities for staff over the year, including a staff hydration challenge, seated massage, yoga sessions, cycling and walking challenges.
‘I love working for Provide and especially with the team. We are a varied bunch, but work really well together. The organisation has a great vibe. I have only been employed with Provide for six months but look forward to coming to work each day. I find my work interesting and my manager allows me to work independently, but is very aware of my work load and projects. The team is very, very busy but I leave work ready to come back for more.’ ‘I love that the organisation offers courses and seems to understand that education of staff is important. I also think that they care for their staff with resilience courses etc.’ ‘I joined Provide a year ago and have so far had a very positive working experience. My induction was one of the most comprehensive I have ever had (with over 30 years working within various health care settings). I find people within the organisation to be respectful of each other and supportive with a real sense of caring about what they do, whatever their role. Managers have been equally supportive, not only in respect of encouraging learning and staff development but also with regard to the personal wellbeing, health and safety of their staff.’
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Recognising Our People The Annual Provide Staff Awards have become a key feature in the Provide calendar, recognising and celebrating the outstanding achievements of our health and social care staff, as well as the volunteers who work with them. This year’s event was held on 21 March 2019 at The Greenwoods Hotel and Spa, Stock Road, Stock with 170 people attending. In addition to the Staff Awards, 57 members of staff received Educational Achievement Awards and eight members of staff received Long Service Awards for over 25 years of service to Provide and the wider NHS and care services. The Outstanding Employee and Outstanding Service Awards were both nominated by our staff and selected by a staff vote. The winners were:
Outstanding Employee:
Innovation Award:
Helen McRorie, Team Leader, Child Health Information Service.
There were three awards in this category:
Outstanding Service: Physiotherapy Outpatient Service. Following nominations from staff the winners of the Outstanding Volunteers Award, Outstanding Leader Award and Innovation and Enterprise Award were judged by a panel.
Outstanding Volunteer Award: The joint winners were Pat Ratnage and Pam Tokeley, volunteers for the Tissue Viability and Lymphodema Service.
Outstanding Leader Award: Kerry Hooper, Assistant Director – Clinical Pathway Lead.
Gold Winner: Gabrielle Constantinou, Natalie Gardner, Karen Schembri for Sustainable Uniform Solutions. Silver Winner: Child Health Information Team for an Automated Upload of Childhood Vaccinations.
Recognising our People
Speaking about the awards, Provide’s Chairman, Derrick Louis said:
‘These awards recognise and acknowledge the commitment, hard work and achievement of our staff. We celebrate the exceptional teams and individuals who have gone above and beyond what is required of them to provide an excellent level of service. It is an occasion where we publically recognise these successes. We also acknowledge staff who have achieved national recognition.
Outstanding Volunteer Award_ Winner Pat Ratnage and Pam Tokeley, Tissue Viability and Lymphodema Service
There was an outstanding response for our Care and Compassion Award with patients, carers and their families nominating services and individuals they feel deserve to be recognised for their hard work and inspiring efforts. Many entries demonstrated how caring, compassionate and valued our staff are and I was proud to hear about the support shown by our staff to patients, often at difficult times for families.’ Gold Award Winner Gabrielle Constantinou, Natalie Gardner, Karen Schembri Sustainable Uniform Solutions
Bronze Winner: Nicola Hughes for the ICT Tracker System.
Care and Compassion Award: Following nominations from our patients, clients, service users and customers, the winners of the Care and Compassion Award was selected by a judging panel. Individual Winner: Carol Gilbert, Podiatrist Highly Commended: Annabel Hamilton, Community Matron and Laura Cook, District Nurse Team Leader. Team/Service Winner: Halstead Hospital Ward.
Outstanding Service Award_Winner Physiotherapy Outpatients Service
Care & Compassion Award Service Category Halstead Hospital Ward
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Technology
Making Technology Work
Security and Compliance
What do our customers say?
Security and compliance have continued to be of the highest priority for the Technology Team. The team have worked hard to maintain their Cyber Essentials Plus Certification and ISO 27001:2013 certification that was gained last year. Work has started to expand the scope of ISO27001 to the Child Health Information Service.
Richard Bradley, Gateway Assure
‘The staff were brilliant with my two sons and helped them relax and play to get the most out of the appointment.’
(FFT feedback, Whilst we only have to read the news to Children’s Audiology understand the cyber threats that exist, Service, April 2018) the latest guidance and precautions to take are now notified to a new system the Technology Team use that shows the vulnerabilities for each and every device we use, allowing the Technology Team to keep our data safe and secure. To monitor how healthcare organisations are protecting against cyber threats and more traditional Information Governance (IG) threats, the IG Toolkit was replaced with a new Data Security and Protection (DPS) ISO 27001 REGISTERED Toolkit which was much more This document certifies that stringent so it was a great the information security manag ement systems of PROVIDE (CIC) 900 The Crescent, Colche achievement to submit a ster Business Park, Colche ster, Essex CO4 9YQ have been assessed and approv ed by QMS International Ltd successful DPS toolkit at the following information securit to the y management systems, standa rds and guidelines:first attempt. ISO 27001 : 2013 The approved information security management system s apply to the following:THE PROVISION OF IT AND DATA SERVICES AT PROVI DE (CIC) HQ.
Original Approval:
30 January 2018
Current Certificate:
30 January 2018
Certificate Expiry:
Certificate Number:
29 January 2023 278342018
On behalf of QMS International
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Ltd
This Certificate remains valid while the holder maintains their management system in accordance with the published standard. To check the validity and status of this certificate please email certificates@qmsuk.com This Certificate is the property of QMS International Ltd and must be returned in the event of cancellation
Supporting Estates The Technology Team worked closely with the Estates Team last year to ensure moves and new buildings were introduced successfully. In addition, the use of selfcheck-in screens have been expanded and are now common-place across Provide. Also, some locations are now complimented by a Virtual Receptionist that allows customers to touch the screen and be connected with a receptionist at another site via a video call.
Health and Social Care Integration The Mid and South Essex STP and East of England regions have started working closer together on regional projects. Provide is involved in these and are part way through the upgrade of N3 connections to the new Health and Social Care Network (HSCN) that will make working with local authorities and social care much easier. Bringing real benefit to patients will be the work to implement a single shared record for the STP, allowing the full health and social care journey to be viewed in a single portal.
Systems, Software and Devices The Provide Technology Team have embraced an ‘Internet First’ policy so that we can have more flexible systems and, as part of this, have moved the large CHIS Data Warehouse to Azure and are working with Knowledge Management to migrate their databases to Azure.
The use of e-Roster has been expanded to include many more teams and has been further integrated with ESR and payroll to avoid duplication and allow for weekly pay for Workforce Solutions. New quicker devices, including a hybrid tablet/laptop device (Lenovo ThinkPad X380 Yoga), are now available for staff to choose and the migration to Windows 10 has started with over 200 devices migrated so far. Following negative feedback about the current J3 (2016 model) mobile phones, Provide will be undertaking some testing with a team of mobile clinicians with a variety of mobile phones to help choose a new standard device. The team will be asked to assess many areas which include the size of the phone, responsiveness, battery life, reception, performance of apps and usability. We will also be involving Infection Prevention staff in the selection of the phone and case, with the chosen device becoming the new standard moving forward. New phones will be distributed as part of a 3 year refresh cycle that will see the handset choice reviewed on a yearly basis, ensuring staff have modern phones that support them in their work. The refresh cycle will be front loaded so that all J3 (2016 model) phones are replaced in the first year with mobile clinical staff and on-call staff being prioritised for replacements.
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Being Financially Strong
2 0 1 8 - 2 0 1 9
Being Financially Strong
A further £3.4m was paid to us for services at Braintree Community Hospital under a separate agreement with Mid Essex CCG. This is lower than the previous year following the closure of the Braintree Ward in May 2018, and a part of this funding was used to set up the Home First team, which contributed to the increase in the main contract.
4% 10%
5% 2% 5%
9% 25% 5%
Analysis of income 1 April 2018 - 31 March 2019
Analysis of pay costs 1 April 2018 - 31 March 2019
41%
We spent £62.6m to provide our services leaving a surplus of £0.7m (after tax). It is important that we make a surplus of income against expenditure as this provides the cash necessary to manage the business. In the longer term, we will re-invest all of our surpluses back into our community.
50% 20% Nurses and Healthcare Assistants
23%
Therapists and Scientists Admin and Clerical
NHS Mid Essex CCG Local Authority
Senior Management and the Board
NHS England
Doctors
Other CCGs
18%
Braintree Hospital Other NHS Other
In the year ended 31 March 2019, Provide received £63.3m of income for the services it delivers. Half of this income was received from Mid Essex CCG for the main community health services in mid Essex. At £31.5m, this is almost £2m more than we received in the previous year and represents a higher proportion of our overall income. 22
42%
Analysis of Non Pay Costs 1 April 2018 - 31 March 2019
0.7% 0.6% 0.7% 19%
Note: There are rounding issues in all of the figures
We do not receive all of our money from this one CCG though, and the 9% we receive from other CCGs (£5.6m) demonstrates success in marketing our services outside of mid Essex. We also received 23% of our income from Essex County Council and other local authorities (£14.6m) and 5% from NHS England (£3.3m).
Supplies Establishment expenses
19%
Premises Charitable donations Miscellaneous Corporation Tax Services provded by other organisations
Our costs were split between pay (£35.3m) and nonpay (£27.3m). The biggest staff group are nurses and healthcare assistants, with this staff group costing £14.3m in the year. Admin and clerical staff cost £8.7m in the year, and our third largest group of staff were therapists (£7.2m). The rest of our staff costs were spent on management (£3.5m) and doctors (£1.6m). The £26.6m of non-pay costs include supplies of £4.8m, premises costs (including rent, electricity, gas, water, insurances, refuse collection, and so on) of £5.3m, as well as establishment expenses (for example printing and stationery, postage, telephone rental, travel expenses, etc) of £5.2m. We also paid around £11.8m for services provided by organisations like Mid and South Essex University Trust, NHS Shared Business Solutions and our partners who deliver parts of the sexual health pathway (East Suffolk and North Essex Foundation Trust and Essex Partnership University NHS Foundation Trust). The remaining non-pay costs relate to miscellaneous charges (such as depreciation). We also made charitable donations of £0.2m. The overall financial performance was excellent, and in making a surplus, Provide delivered the savings requirements set by commissioners in our contracts. Making non-recurrent surpluses and non-recurrent charitable donations does not remove the on-going need to make recurrent savings, and our NHS and Local Authority commissioners will continue to ask us to show that we are using taxpayers’ money effectively and efficiently. All staff have shown that they are able to rise to the challenge of delivering savings and controlling costs. This puts us in a good position as an organisation as we continue to contract with the NHS and Local Authority commissioners.
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Investing in Our Local Communities & Giving Month
Investing in Our Local Communities
Fundraising activities
Provide Foundation Our partnership with Essex Community Foundation (ECF) means that we can effectively invest funds into voluntary, community and charitable organisations whose work complements our own. As a Community Interest Company, Provide is committed to reinvest a part of its surpluses back into the communities that it serves. Having established the Provide Foundation with ECF we can do this in the most efficient and effective way, and will be awarding grants year-on-year to support the voluntary sector where we provide services. There are many community schemes and projects making great strides to improve the health and wellbeing of people in mid Essex and beyond, and through the grants from the Provide Foundation, we can help them continue and expand their work. In 2018-2019, 21 community projects run by voluntary and community groups were given a major cash boost with grants totalling £90,617 from the Provide Foundation. There was a top award of £20,000 which was presented to Action for Family Carers, and 20 organisations received grants and donations ranging from £1,000 to £10,000. We have also invested a further £50,000 in the Provide Foundation fund in 2018-2019.
Investing in local communities Action for Family Carers
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Investing in local communities Farleigh Hospice
In addition to the work we do with ECF, our Governors are responsible for agreeing additional grants and charitable donations through two separate mechanisms. The Governors approve grants to local communities based upon requests from members of our organisation. They also approve sponsorship matching where members undertake their own fundraising efforts on behalf of local and national charities. In 2018–2019, the Governors approved a total of £15,975 to many different charities and voluntary sector groups, including the following:
Addenbrooke’s Charity Investing in local communities Support an Essex Admiral Nurse
A full list of grants made is as follows: Action For Family Carers
£20,000
The Dengie D-Caf (Essex Admiral Nurse)
£10,000
Braintree District Mencap Society
£2,472
Brainwave Centre
£4,000
Chelmsford Community Transport
£3,151
Essex Dementia Care
£4,976
Essex Respite & Care Association
£4,976
Families in Focus (Essex)
£5,000
Farleigh Hospice
£5,000
Headway Essex
£4,042
Home Start Essex
£5,000
Kids Inspire
£5,000
Rainbow Trust Children’s Charity
£5,000
St Luke’s Hospice
£5,000
Accuro Care Services
£1,000
Beacon House Ministries
£1,000
Colchester Bangladeshi Mohia Society
£1,000
Dengie Project Trust
£1,000
MAZE Group
£1,000
South East & Central Essex MIND
£1,000
Wilderness Foundation UK
£1,000
Alzheimers Society
£100 £1,000
Basildon Breast Cancer Unit
£282
BBC Children in Need
£400
Beat it Box
£2,000
Braintree District Council Awards
£200
Breast Cancer Now
£438
Cancer Research UK Coram Daniel Robinson & Sons
£1,393 £850 £1,190
Our chosen charities In 2018–2019, Provide also asked its members to agree specific charities that we should donate money to, based upon the fundraising efforts of our staff. Four charities were chosen and these were Farleigh Hospice, East Anglia Children’s Hospice, Autism Anglia and Huntington’s Disease Association. In September, we launched an initiative to promote fundraising by teams within the organisation, and agreed to split the money raised between the two chosen charities. Efforts to raise money included:
Donar Family Network
£500
East African Playgrounds
£812
Essex Community Foundation
£160
Great Ormond Street Hospital
£254
Headway
£500
Our Charity Golf Day in September (specifically for Huntington’s Disease);
MacMillan
£101
A Christmas quiz;
Maldon Rugby Club
£300
Raffle and tombola at the Christmas Party;
Maldon Up Project
£1,000
MIND
£565
Christmas party ticket sales;
Much Loved
£100
Samaritans
£830
A quiz night (specifically for Autism Anglia);
The Café, St Peter’s Hospital
£2,000
St Helena Hospice
£1,000
On the basis of all of the money raised and with a matching amount donated by Provide, we were able to donate a total of £11,208 which was distributed amongst these charities.
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From the Governors
From the Governors During 2018-2019 the Council of Governors have continued to be the members’ representatives to the Board. We are happy to have this opportunity to share with you some of the activities we have been involved in on your behalf. At every Board meeting, two members of the Council of Governors are there to assist the Board in taking into account the members’ thoughts when considering decisions across the organisation. A verbal report is also presented which highlights any issues raised by you, the members, and is discussed at Governors’ meetings.
Amy Jackson
Carol Doggett
Carol Gerrard
Cheryl Ellis
Claire Aldridge
Ellen Van Gemmert
Helen McRorie
Hellen Mullem
Hollie Jamison
Ian Martin
We have worked with both the Board and senior managers to develop the new three-year organisational strategy which was recently launched. It is important that we are able to take part in this vital work and that staffs views are taken into consideration. We fulfilled our responsibilities in decisions required about the Non-Executive Directors in terms of remuneration and lengths of terms in post. We are planning how we best communicate and engage with you, the members, and are planning to carry out more engagement leading up to the Annual Members’ Meeting. We want to encourage attendance at this event and find out what staff expect from their membership of the organisation.
T H E
Jayne Peden
Jules Martin
Karen Dresser
Mike Fair
Nicola Yarnell
Nisha Desai
G O V E R N O R S
We have been proud to serve the organisation and members for another year and look forward to future engagement with as many colleagues as possible.
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Sian Webster-Hirst
Steph Rivett
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Volunteering with Provide 2017-2018
One of the goals for 2018-19 was to expand volunteer opportunities to different services within the organisation and this has been achieved: Volunteer service in Tissue Viability – the role includes ensuring service users complete the Friends and Family Test (FFT) which they input into the system for prompt reporting.
Volunteering with Provide 2018-2019 This year has been a year of change within volunteer services to ensure that we are able to adapt to the changes and needs of the organisation.
There has been an increase in productivity of 23% with individual average annual hours completed up from 78.4 hours (2017-18) to 96.9 hours (2018-19). Feedback from volunteers who are completing regular and longer hours report an increase in their level of satisfaction and in feeling part of a team, which contributes positively to the experience of service users. 28
Phlebotomy volunteer, based at Halstead Hospital, which previously had a very low response rate for FFT. The volunteer role specifically assists patients to check in and encourages feedback, so they now have an excellent FFT response rate. Halstead Hospital – personal shopping service which was started in March. A good response was received from service users, although this has been put on hold as it is complicated to administer and there is an aspiration to have a physical trolley as used in St Peter’s Hospital. The Estates service has also created new roles to support staff in Halstead and St Peter’s Hospitals, with volunteers helping at meal times. This year saw the launch of the Supported Volunteer Programme which gives opportunities to people with underlying health issues who might otherwise not be able to volunteer independently. Currently one volunteer has been regularly working and their confidence and self-esteem have greatly improved to the extent they are searching for permanent employment. There is also another volunteer who has a learning disability who is currently going through the recruitment process.
External volunteer partner projects Externally the Volunteer Coordinator is working with Greenfields Housing to create and support a project designed to tackle social isolation, utilising technology as part of a new Digipals project. This will be based in Halstead focussing on a cohort who have been identified as at risk. Working with Maldon Community Voluntary Service (CVS), who have funding to expand the scope of the Essex Shed Network which is designed to engage more participants. This is hoped to tackle social isolation amongst men. Recruitment is underway for volunteers to support the surgery at Steeple Bumpstead and encourage FFT feedback.
The reception area in Braintree Hospital Tissue Viability Clinic now have a team of 10 volunteers to cover the reception area and provide a warm welcome to service users, arrange transport, and support clinical staff with simple duties.
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Volunteer Service Review The current volunteer service has evolved over the last four years and a review is needed to ensure it is developing in a way which reflects the current needs of the organisation and is in line with the new Corporate Strategy. The full outcome of the review will be available in the summer.
Volunteer of the Year Award This year there were two volunteers who received this accolade. Pat Routledge and Pamela Tokely have been volunteering with Provide for four years. They transferred from supporting the Braintree Hospital ward patients to the Tissue Viability Clinic. After a patient became unwell during a clinic, the two volunteers stepped up to provide reassurance, made tea and organised lunch. They stayed with her until she had fully recovered and was ready for her transport home. All the volunteers attending the event had provided outstanding service. One nominated volunteer who had been supporting patients in Halstead Hospital, travelled to St Peter’s Hospital where her befriended patients had been transferred, following a flood on the ward.
Volunteering with Provide 2018-2019
CONCLUSION What do our customers say? ‘Staff were all lovely/ friendly and made me feel at ease. Facilities are clean/modern. No waiting time from appointment time.’ (FFT feedback, Minor Operations Service, Feb 2018)
To put a monetary value on volunteer hours, based on minimum wage, the total for this year is £47,809.98. Although this does not reflect all the soft skills which volunteers bring and which greatly enhance the patient experience. Volunteers have had a big impact on services who were not receiving FFT feedback and services have commented on how useful this has been. Overall, volunteer engagement increased across a wider number of services and with the primary care network which supports the Provide commitment to social prescription.
There were also representatives from the team of ten volunteers who have been running the pop-up shop for over a year in St Peter’s Hospital. Jean Littler, who is a longstanding volunteer with Provide and who provides outstanding administrative support, received special acknowledgement for her commitment.
Student volunteer projects Essex University students who volunteer as part of their course, worked very hard on a campaign to promote the Managing Health Service and they produced a film of a service user, studied clinician response to the service, and also produced a social media campaign. John Niland attended the presentation and provided useful feedback to the students. Anglia Ruskin University student volunteers manned a presentation table in the therapy department of Braintree Community Hospital and their report was very useful. It highlighted that, even when people had several long-term conditions, they were not necessarily interested in attending a self-management programme. The results of the report were passed onto the Managing Health Team to provide useful feedback for future campaigns.
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Volunteering with Provide 2018-2019
Data for existing volunteers Existing volunteers reported an increase in the numbers of hours being completed. This showed volunteers completing two to three hours increased from 38% to 50% compared to last year and an increase in four to six hours being completed from 23% to 32%. 60 50 40 30 20 10 0
1-2 hours
2-3 hours
4-6 hours
6-8 hours
more than 8 hours
Training provided: 100% of volunteers found the training satisfactory to excellent with the highest ranking in good to excellent. No volunteers reported negatively. 40
80
35
70
30
60
25
50
20
40
15
30
10
20
5
10
0
Asked whether they found the volunteer coordinator information and supportive responses were identical showing the majority responded as good to excellent with 18% satisfactory. There were no negative responses.
Satisfactory
Poor
Very poor
0
60 50 40 30 20 10
Yes definitely
Yes, to some extent
Not sure / don’t know
Not really
No, not at all
0
Excellent
Good
Satisfactory
Poor
Very poor
Can’t say
In response to whether the volunteer recruited was satisfactory, there was a 100% positive response.
‘Did the coordinator keep you updated?’: the majority of 60% responded positively, 20% did not know and 20% said ‘not really’. 100
80
35 30
40
60
25
30
20
40
15
20
10
10
32
Good
For services wishing to recruit volunteers, the overall experience was rated between satisfactory to excellent with no negative responses.
40
50
0
Excellent
45
60
Volunteer satisfaction: 72% of volunteers reported they were definitely satisfied with their role, with the remaining 30% divided between satisfied to some extent and 14% not really.
20
5 Excellent
Good
Satisfactory
Poor
Very poor
Can’t say
0
Yes definitely
Yes, to some extent
Not sure / don’t know
Not really
No, not at all
0
Yes
No
Not yet
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Looking Forward
Looking Forward
John Niland Chief Executive
Having just read my contribution to last year’s report, I feel that I could almost just change the date on it and it would pass for an up-to-date version. Many of the things I talked about happening are still happening and taking shape, although they are called slightly different names. For example, the creation of Primary Care Networks (PCNs) were not conceived of 12 months ago but I did write about GPs working in clusters managing population health and how we would need to accommodate this in our structures. PCNs are now happening and we will indeed need to adjust the way we work.
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PCNs will involve new staff, some of which we will employ on their behalf, as well as more staff. New Health Centres will be built, such as the one in South Woodham Ferrers, that we will be managing and a proposed build in Braintree. These should give us the opportunity to work in a much more integrated way with our Primary Care colleagues. In addition, we will be looking at opportunities to work in joint teams with Social Care and indeed other community care providers such as NELFT and EPUT. We also intend to establish our first Buurtzorg Nursing team within the next 12 months with a view to rolling the model out across mid Essex if it proves successful. Many of you will have felt the positive effects of working within new or purpose-designed buildings in recent years. We intend to continue to look for opportunities to relocate services that improve both customer and staff experiences. Our new Children’s Services building (Stapleford House) is a good example of both joint working and a purpose-designed building.
We will look to extend the range of services we provide as we develop our expertise. We are currently on the lookout for more ‘Supported Living’ opportunities for people with learning disabilities. We are also hopeful of extending our range of businesses with the acquisition of at least one more health business in this year. We will continue to invest in staff training and talent. We have a great track record of staff development and ‘growing our own’ and we will continue with this policy where possible. It is important to us that we keep the culture we have within our organisation and we will encourage our own staff to improve themselves and advance within the organisation. We have seen many changes in personnel over the last few months, with several senior managers retiring. We of course wish them well and thank them for their fantastic service and we look forward to our new managers bringing us to the next level.
We will continue to invest in technology, both hardware and software. We intend to create our own Digital Development team so that we are not reliant on other’s ideas or capabilities. This will be something new and exciting for us and we will be picking your brains to prioritise where we need to invest. Finally, by this time next year we will have agreed a new Vision for the organisation. We may even have left the EU! I cannot predict what that will mean for us but I am confident that we will continue to provide outstanding services for our customers. We have significant security from our commissioners for many years to come and we will continue to reward their faith by ensuring we always give our best, which as we know, has now been recognised by the Care Quality Commission. Thank you.
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If you need this booklet in braille, audio, large print or another language, please contact our Customer Service Team on: 0300 303 9951 / 9952 or by email at: provide.customerservices@nhs.net Provide Corporate Offices 900 The Crescent Colchester Business Park Colchester Essex CO4 9YQ
T: 0300 303 9999 E: provide.enquiries@nhs.net www.provide.org.uk
PBO-3381-1936-01