East Suffolk and North Essex NHS Foundation Trust - Impact Report

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Levelling Up Impact Report

A Purpose Health Coalition Report


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CONTENTS


Contents 01

Foreword Rt Hon Anne Milton Foreword Nick Hulme, Chief Executive, East Suffolk and North Essex NHS Foundation Trust

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The role of East Suffolk and North Essex NHS Foundation Trust and the NHS in meeting the Purpose Goals

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Impact Assessment Framework Part 1: Activity Audit - East Suffolk and North Essex NHS Foundation Trust’s existing work against the Purpose Goals Part 2: Output and Outcomes - Identifying the direct results of East Suffolk and North Essex NHS Foundation Trust’s current activities and the impact it is having against specific goals.

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Recommendations

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The Journey to the Purpose Goals

CONTENTS

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01

Foreword

Rt Hon Anne Milton

Former Parliamentary Under-Secretary of State for Public Health

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FOREWORD


Despite the best efforts of successive governments, England remains a nation divided by health inequalities. The headline trend, well evidenced by comprehensive data, is a stark north-south divide but that is not the full picture. What the headlines don’t show are the significant inequalities that exist within regional areas. There are significant disparities between communities, towns and cities up and down the country, not only in the general health of their people but also in the impact that today’s major health challenges - obesity, alcohol abuse, dementia and cancer for example - can have on individual areas. In my 25 years as a nurse, I witnessed first-hand the deep-rooted barriers that exist to healthier living. I also saw the huge differences that can exist between two communities within the same area. Today this is well documented in London, but can also be seen in towns, cities and regions up and down the country. The areas covered by East Suffolk and North Essex NHS Foundation Trust (ESNEFT) are a good example of this, with areas of wealth and prosperity almost side by side with areas of high deprivation, including Tendring which is the third most deprived area in Europe. Much progress has, of course, been achieved in addressing some of England’s health gaps and inequalities, anchored by the fantastic work of the NHS, backed by policymakers. But some indices are now stagnating. Nothing illustrates health inequality more starkly than the huge differences in life expectancy across the country and the gradual increase we had seen in life expectancy, for example, had stalled long before the pandemic. Recent research by Imperial College London found that life expectancy went down in almost one in five communities for women and one in nine for men between 2014 and 2019. In 2019 there was a 27-year gap in life expectancy for men, with a man in Kensington and Chelsea expected to live until 95, compared to one in Blackpool who would be just 68. The difference for women was almost 20 years, with a woman in Camden having a

life expectancy of 95, compared to a community in Leeds where a woman was expected to live until 75. Even in some of the healthiest places, where the public’s health is at its best, expectancy can vary by as much as eight years between council wards. Housing, environment, poverty and social isolation are among the many factors that can contribute to this. In his 2020 report Health Equity in England: The Marmot Review 10 Years On, Sir Michael Marmot confirmed the growing gap between wealthy and deprived areas. He also found that more people will be spending more of their lives in poor health, with huge implications not only for their individual wellbeing and prosperity but also for our health and social care system and our economy. On the frontline of this desperately needed shift towards health equality are NHS Trusts. Although at the mercy of pandemics, policies, skills gaps and budgetary decisions made in Westminster, they have a crucial role to play in closing the gap. They also have a huge opportunity to demonstrate clear and proactive leadership. Rooted in their local communities, they can draw on their knowledge and experience of the area and their local partnerships to achieve long-term results. Their ability to reach into, and look after all communities, create exciting career opportunities and raise aspirations in young people are among the many tools at their disposal. This report aims to share valuable insights on how one influential Trust is playing its part in levelling up Britain. Reaching almost one million people, East Suffolk and North Essex NHS Foundation Trust has answered the urgent call to close Britain’s opportunity gap. We hope the learnings within this report inspire and inform many other organisations, within and without healthcare, on their levelling up journey.

FOREWORD

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Nick Hulme

Chief Executive of East Suffolk and North Essex NHS Foundation Trust

Many of us working in the NHS often found ourselves trying to put right the mistakes of the past.

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FOREWORD

When we had the opportunity to create a new Trust bringing together two hospitals and community services in East Suffolk almost four years ago now, we had a once in a lifetime opportunity to do things differently to make life better for the communities we serve. The landscape of the NHS changed dramatically at the same time with the introduction of integrated care systems, bringing everyone involved in health, social care, local government, and voluntary organisations together to find ways of working together differently.


Our ambition to make a real impact for people in East Suffolk and North Essex is becoming a reality as we all work to address inequalities, and together with our partners and the communities we serve to make sure that all services are accessible and equitable. We know we need to be more than a service that people go to when they get ill - we need and want to be part of the community as an anchor institution. This involves exploring new ways to work differently, such as investing in community foundations, local charities and the voluntary sector which bring major benefits to those who need our support the most. We are also finding a common purpose and sharing a commitment to truly address inequalities and bring equity. We care for people who live in areas of severe deprivation as well as caring for people who live in places of considerable wealth. Think of Tendring in North Essex which is home to the third most deprived ward in Europe. Contrast that with Southwold and Aldeburgh in Suffolk. All are coastal towns but worlds apart in terms of prosperity, life expectancy and aspirations. Our vision is to ‘provide the communities we serve with excellent healthcare and build a better future for East Suffolk and North Essex’. We are an integrated community and hospital Trust and provide services at Colchester and Ipswich hospitals, Aldeburgh, Clacton, Halstead, Harwich and Felixstowe community hospitals and Bluebird Lodge near Ipswich together with community services in East Suffolk and North East Essex. Our determination to reduce health inequalities involves facing a number of specific challenges. Many patients live in rural areas where the combination of poor transport links and lower-than-average car ownership makes appointments tougher to access. Tendring also has an average life expectancy significantly below national levels, particularly among men, with poor comparative outcomes from several types of cancer. We are working hard to make sure that we make services accessible to all. Community diagnostic hubs, for example, backed by significant investment, will give patients in hard-to-reach locations access to the very

latest diagnostic technology and techniques. We are also developing a community diagnostic training academy in partnership with a further education provider to train people for future roles within the organisation. Our levelling up strategy is well informed by in-depth data. Studies carried out include looking at the reasons behind the correlation between ethnic groups and low appointment attendance levels. This is particularly important within cancer care, since earlier diagnosis can make the difference between survival and a terminal case. Supporting the mental health and wellbeing of staff is also critical to the Trust’s social mobility impact. A recent addition to its already-comprehensive strategy on this front is our pioneering development of the first ‘wellbeing hub’ of its kind within the NHS. We work with schools and other education partners to raise aspirations among young people in the communities we serve; promoting ourselves as an employer of choice in a wide range of professions beyond medicine. There are around 300 distinct career paths within the Trust, which commissions training from a range of education providers. Clinical roles are accessible to students at the universities of Essex, Suffolk, East Anglia and Anglia Ruskin. We also have a ‘Talent for Care’ team which participates in careers fairs and outreach work with schools to introduce the idea of careers in healthcare to local children as they approach choosing GCSEs or leaving school and going into employment. An annual schools programme (masterclasses, workshops and career day) delivered by the Trust’s ICENI Centre involves over 100 school children who are interested in careers in health. They have the opportunity to meet a range of staff, engage in practical skills relating to specific job roles and learn about both clinical and non-clinical careers in the Trust. This report highlights in detail a consistent, planned approach to creating equity and opportunity for everyone. It has been my privilege to work in the NHS for more than 40 years. I started as a hospital porter before becoming a social worker in an HIV centre and then worked in senior leadership roles in London. I am passionate about equality and opportunity and I am very pleased to introduce this report about our work.

FOREWORD

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02 The role of East Suffolk and North Essex NHS Foundation Trust

and the NHS in meeting the Purpose Goals The role of the NHS NHS Foundations Trusts can, and do, make a real and sustained difference to create positive change for its workers, patients and society at large. These organisations are central to their local communities and they can be accessible institutions that reach out to everyone. As COVID-19 exacerbated existing health inequalities and created a huge burden for the NHS,

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these organisations will also need help from elsewhere to recover and strengthen, just like the rest of the country. However, as one of our most wide-reaching and cherished public institutions, the NHS will be essential in leading the way by leveraging its position in communities and its size and power as an employer and organisational entity. In doing this, it can help level up the UK.

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The Purpose Goals provide an ambitious and strategic solution to addressing the challenge, setting out for the first time the gaps that will need to be filled to ensure opportunity and fair outcomes are available to all across the country. The goals offer a common framework with which organisations can collate best practice and show impact across all of the key life stages and areas of concern. They provide the shared language needed to collectively discuss the challenges of levelling up and the solutions to existing inequalities. That ambition should apply to one of the country’s most important and impactful institutions, the National Health Service. Of course, the NHS in its day-to-day function makes an enormous contribution to the public and individual good of the UK. As a commissioner and provider of healthcare, the NHS can target services and outreach to address directly the inequalities that exist in health outcomes and experiences, especially amongst those who suffer most under other forms of social or economic exclusion. Health and wellbeing are vitally important to the function of a happy, prosperous and equal country. Aside from its obvious health impacts, there are other aspects of the levelling up agenda that the NHS is well placed to help address. The NHS is the largest single employer in the UK, as of September 2021 there were 1,355,780 NHS Hospital and Health Service staff, with jobs ranging from healthcare provision, information technology, administration and health policy. Its predominance in the employment market can be used to increase social mobility and spread opportunity throughout society. By providing employment and career progression on such a large scale, the NHS makes a vital contribution to the economy, labour market and the available opportunities for individuals across the country. The NHS can help ensure that it makes the best use of

“By utilising the voice, reach and reputation of the NHS, Trusts like East Suffolk and North Essex NHS Foundation Trust can truly act as anchor institutions to level up the regions in which they operate.”

the incredible talent the UK has to offer by providing many people with worthwhile careers that contribute to the social good. In its healthcare provision, organisation and information outreach, the NHS also has a sizable digital presence. COVID-19 has accelerated the digital transformation and NHS Trusts now interact with patients and staff more than ever before. A Health Foundation report found that of those who received NHS care or communicated with the NHS in 2020, 97 per cent used technology and 82 per cent of NHS staff surveyed said they had used technology more in the past year. It is therefore in both the NHS’ interests and capabilities to contribute to making this transition fair and accessible. Likewise the transition to a green and net-zero economy has also accelerated. As it is such a large institution, efforts made by the NHS to use more renewable energy to power its hospitals and clinics and to run their services more sustainably will have a substantial impact. For example, in October 2020 the NHS adopted a multi-year plan with targets and milestones to become the world’s first carbon net zero national health system by 2040. Overall, the NHS has a budget of £130 billion. This spending power and its significant economic levers gives it real potential to ensure its extensive supply chains and procurement processes aid in the green recovery and social good more generally. The NHS is held in high regard by the public and communities all across the country. Its presence in every region and community in the UK means that it can influence and speak up for those places and communities that might be at risk of being left behind. The NHS is already a highly diverse employer and is making efforts to address health disparities in women’s health and in marginalised groups. By utilising the voice, reach and reputation of the NHS, Trusts like East Suffolk and North Essex NHS Foundation Trust can truly act as anchor institutions to level up the regions in which they operate. Equality of opportunity simply cannot be achieved without the participation of our National Health Service Trusts. These organisations are in a unique position to combat some of the barriers to upward social mobility that exist in the UK, and they have to be part of the solution. ESNEFT has already embarked on that journey and, as part of its work with the Purpose Coalition, will be working towards even more transparent and measurable outcomes.

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The role of East Suffolk and North Essex NHS Foundation Trust With more than 11,500 staff and a responsibility to serve nearly a million residents, East Suffolk and North Essex NHS Foundation Trust is able to deliver purposeful change on a mass scale. One of ESNEFT’s strategic objectives is to keep patients in control of their own health, recognising that the average person might spend 1 or 2 hours a year in the Trust’s care. To have a real impact on lives and to address inequalities, the trust partners with organisations and ensures that services are accessible to all communities. The Trust recognises the need to be more than a service that people go to when they get ill, it needs to play a wider role. Finding ways to work differently, such as investing in community foundations, local charities and the voluntary sector. The Trust’s ambition – “,,,,to offer the best care and experience is supported by five strategic objectives which will guide planning and investment: Keep people in control of their health Lead the integration of care Develop our centres of excellence Support and develop our staff Drive technology enabled care” Serving areas of deprivation, as well as considerable wealth, the trust strives to reduce health inequalities but faces a number of specific challenges in doing so. Many patients live in rural areas where it is harder to access health services because of poor connectivity and low car ownership. Tendring, for example, has an average life expectancy significantly below national levels, particularly among men, with poor comparative outcomes from several types of cancer. The Trust endeavours to ensure that its healthcare infrastructure makes services accessible to all. A community diagnostic centre (CDC) in Clacton gives patients in hard-to-reach locations access to some of the very latest technology on their doorstep. The Trust also has a partnership with a local further education provider to train people at a new community diagnostic training academy that it is developing.

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Studies are carried out to ensure that its levelling up strategy is having a considerable impact. Studies include; the reasons behind correlation between ethnic groups and low appointment attendance level. Using this data ensures that the Trust’s strategy is properly targeted. In its drive for equity, the Trust aims to deliver a deliberate, targeted, unequal allocation of resources to ensure that outcomes are equal. The mental health and wellbeing of staff is also a top priority for the Trust and one that has an impact on the levelling up agenda. For example, the Trust has recently developed the first ‘wellbeing hub’ of its kind within the NHS. There are around 300 different career paths within the Trust, meaning it has an important role to play as an employer within the region. The organisation works with education partners to raise aspirations among young people in the communities it serves; promoting itself as an employer of choice for a wide range of medical and non-medical jobs. It also has close links for clinical roles with the universities of Essex, Sussex, East Anglia and Anglia Ruskin. As part of work to raise awareness of the Trust as an employer, there is a ‘Talent for Care’ team which participates in outreach work with local education institutions. The team introduces the idea of careers in healthcare to children as they approach choosing GCSE or leaving school and going into employment. An annual schools programme, which includes masterclasses, workshops and career days, delivered by the Trust’s ICENI Centre usually involves over 100 school children who are interested in careers in health. Children attending have the opportunity to meet staff, engage in practical skills relating to specific job roles and learn about careers in healthcare. Furthermore, the ICENI centre, a business unit in the organisation, has evolved in recent years into one of the UK’s leading centres for surgical training. It attracts trainees and experienced clinicians for its courses globally and recently expanded its range of specialties and training approaches.

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T H E R O L E O F E A S T S U F F O L K A N D N O R T H E S S E X N H S F O U N D AT I O N T R U S T

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Assessment of East Suffolk and North Essex NHS Foundation Trust in the context of Purpose Goals Many organisations have strong commitments to traditional Corporate Social Responsibility and the environmental, social and governance agenda. This section of this report will map several of ESNEFT’s specific initiatives against the Purpose Goals, to track where progress is being made and where efforts could be redirected or better targeted.

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ASSESSMENT

It is important to note that it would be difficult for any one organisation to work effectively toward every single one of the Purpose Goals. As more organisations adopt the goals, it could be more efficient for individual organisations to focus on particular areas where they can make a real impact, rather than making a superficial impact across many goals. NHS Trusts are perhaps in a better position than most organisations to make a real impact against all of the Goals. As anchor institutions within communities, the work of Trusts does not begin and end with treating patients, they have a much wider role as big employers and purveyors of opportunity. Below is a list of the Purpose Goals, their definitions, and our team’s assessment of how ESNEFT is currently meeting them. These have been assessed through a document review process; we then map the amount of activity done by ESNEFT across each of the Purpose Goals. We can then progress to measuring specific impact across these activities.


1 Strong foundations in Early Years

Close the early years development gap by delivering the best possible start for every child

school years 2 Successful

3 Positive destinations Post 16+

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Right advice and experiences

recruitment 5 Open

Every child successfully achieving their potential in attainment and development

Every young person and adult to have the choice of a high quality route in education, employment, or training

Access to the right advice and experiences at the right time to unlock opportunity through a person’s life

Careers and professions open to people of all backgrounds through transparent, accessible, and open recruitment practices

Health Ambassadors programme

Participating in the Kickstart scheme

Work experience placements

NHS Graduate management Training Programme

Integrated weight management pilot for severely obese children in Clacton

Run summer health science workshops (under development)

In-house ICT training Open recruitment policy

Medical career days Talent for Care Team Internship programme

career progression 6 Fair

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Widening access to savings & credit

health and well-being 8 Good

enterprise 9 Extending

the digital divide 10 Closing

Opportunities for career advancement for all based on ability and potential, not connections

Widening access to responsible credit and closing the savings gap

Improving mental and physical health at all ages to boost overall well-being to allow people to fulfil their potential

Extending private enterprise and entrepreneurship to all people and communities

Closing the digital divide in technology access, skills, opportunities, and infrastructure

Faculty of Education and Innovation Centre (under development)

Retirement seminars

Prevention model of public health

Innovation Voucher scheme for internal staff

Wellbeing Hub for staff

Funding Community Foundations

Involved in provision of digital equipment to those who do not have access

Leadership development programmes

Employee assistance line

Mental Health First Aiders

Healthwatch research into digital tools in healthcare

ASSESSMENT

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for opportunity 11 Infrastructure

Developing the physical infrastructure that connects people and places to opportunity

Community Diagnostic Centre at Clacton Hospital

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Building homes & sustainable communities

Creating affordable quality homes so people can live in safe and sustainable communities

the energy 13 Harness transition

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Ensure that the energy transition is fair and creates opportunities across the UK

Create a level playing field on opportunity for all, to fully unleash Britain’s potential for the first time

Sharp decrease in organisational carbon footprint

Reciprocal mentorship scheme

Achieve equality, through diversity & inclusion

Staff networks for under-represented groups

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ASSESSMENT


Key Strengths:

Goal 6:

Goal 3:

Fair Career Progression

Positive Destination Post 16+ ESNEFT is involved with various programmes to raise awareness of the approximately 360 different job roles available within the NHS. These include taking advantage of the cutting-edge innovation at the ICENI Centre to showcase medical careers to the next generation. The Trust is taking part in the Kickstart scheme, as well as spreading opportunities through internships across different areas of the organisation.

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The Trust is developing a new Faculty of Education and Innovation Centre which brings together education and training for all staff. When starting employment, all staff are given clear objectives and the Trust has a target of having a quarter of roles filled by internal candidates.

Key Activity Strengths

Goal 8:

Good Health and Well-Being: Prevention is embedded in the development of all ESNEFT’s models of care, to address the wider determinants of public health and causes of illness. The Trust is committed to addressing inequalities and being a true anchor institution that touches the communities it serves at all times, not just when people are ill.

ASSESSMENT

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Activity school years 2 Successful

Has the organisation helped to allow every child to successfully achieve their potential in attainment and development? ESNEFT supports the Health Ambassadors programme across North Essex and South Suffolk by attending school and college events to promote careers in health. The Trust participates in the Essex and Suffolk Health and Care Academies, designed to give an insight as to what careers are available in health and social care. Involved in a partnership with St Johns Ambulance to help deliver the NHS cadets scheme. This is primarily aimed at introducing young people to volunteering in the care sector and finding out more about careers in the NHS. ESNEFT works with schools and partners to raise aspirations and promote organisations within the ICS as employers of choice. Medical career days are held to educate young people on possible routes into jobs and criteria for entry. The Trust is a partner with local primary care services to provide integrated weight management support for severely obese children and young people in Clacton.

3 Positive destinations Post 16+

Does the organisation support young people and adults to have the choice of a high-quality route in education, employment, or training? Participating in the Kickstart scheme and delivering training to all those on it. Placed 1 clinical and 9 non-clinical into the organisation and have interest in a further 34 non-clinical placements. Recently committed to the Apprenticeship Strategy for Suffolk and North East Essex Integrated Care System. The Trust has an annual apprenticeship levy of c£1.8m. The ICENI Centre is an innovation hub and has excellent facilities, such as a lecture theatre linked to the operating theatres, seminar rooms, skills laboratory and a mock operating theatre, for teaching and showcasing medical careers. The Trust has funding for 10 internships, which are typically 3-months in duration and paid at £9.15 per hour. These internships fill a variety of roles, such as HR, marketing and finance. The Trust is developing summer health science workshops for students in years 9 to 12 with practical sessions to explore a wide range of healthcare careers. The Talent for Care Team supports staff across ESNEFT and promotes career opportunities within ESNEFT and the NHS. ESNEFT is part of the Suffolk and North East Essex Integrated Care System’s Integrated Care Academy. The Academy was set up to support the changing needs of health and social care in the region. It will provide for education, training and development for local people. The Tendring Integrated Care Academy aims to raise aspirations and inform young people about careers in the health and care sector. This is delivered through mostly virtual sessions with students both below the age of 16 and 16-18 year olds.

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ASSESSMENT


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Right advice and experiences

Does the organisation provide access to the right advice and experiences at the right time to unlock opportunity through a person’s life? Work with the University of Essex to provide internship opportunities to students. These are paid, time limited projects in a variety of areas - IT, recruitment, fertility services etc. ESNEFT is currently recruiting 8 internships of 3 months duration on average. As part of the University of Essex’s MBA programme, ESNEFT has MBA students undertake real life 4 month business projects. The Trust has over 500 work placements at any one time. All staff have access to in-house ICT training to upskill themselves and ensure that they are ready for progression.

recruitment 5 Open

Are careers and professions open to people of all backgrounds through transparent, accessible, and open recruitment practices? Through the Trust’s recruitment policy, it makes sure that the implementation of the recruitment and selection practices will not discriminate directly or indirectly on the grounds of gender, sexual orientation, marriage or civil partnership, pregnancy and maternity, caring responsibility, ethnic or national origin, religion, culture, disability, age or trade union membership. ESNEFT supports the NHS Graduate management Training Programme. It currently has one general management placement in place and hopes to have a further general management and finance placement confirmed this month to commence in September. Support the education programme for Physicians Associates and have second year placement students from Anglia Ruskin University and the University of Cambridge.

career progression 6 Fair

Does the organisation offer opportunities for career advancement for all based on ability and potential, not connections? The Trust has retention partners who work with the divisions to improve staff retention. Linking closely with the Talent for Care team they assist staff in deciding their career pathways and support managers to have comprehensive career conversations. ESNEFT provides a number of leadership development programmes for staff at all stages of their development. These include Clinical lead development programmes, Operational leadership development programmes and the ‘Licence to Lead’ programme. Every new starter is set clear objectives and has a development plan. Target of having 25% of band 5 and above roles filled from internal candidates. The Trust has a competency framework for middle leaders linked to development opportunities to help them develop in their current role or get ready to make the next move on their career pathway. The Trust is developing a new Faculty of Education and Innovation Centre to bring together the education and training activities of all staff. This will lead to greater staff development across the board. This includes applying to become an employer training provider of Apprenticeships.

ASSESSMENT

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Widening access to savings & credit

Does the organisation help widen access to responsible credit and close the savings gap? ESNEFT offers retirement seminars free to all staff. The Trust has an employee assistance line that can give advice to employees and their families - services include debt and financial management, legal and tax advice.

health and well-being 8 Good

Does the organisation improve mental and physical health at all ages to boost overall well-being to allow people to fulfil their potential? Prevention is embedded in the development of all ESNEFT’s models of care, both internally and with external partners, to address the wider determinants of health and causes of illness. A new Wellbeing Hub, one of the first of its kind, has been created for staff. The Trust runs a Health and Wellbeing service and a Staff Psychology Service led by a Consultant Clinical Psychologist. During Covid-19, numerous virtual wellbeing sessions were held for all staff, covering a variety of physical and emotional wellbeing topics. These sessions have been attended by 1,000 colleagues to date. Staff have 24/7 access to an Employee Assistance Programme. There are almost 300 Mental Health First Aiders trained across ESNEFT, with a target of training 1,000. Staff have access to an Occupational Health duty nurse from Monday to Friday.

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ASSESSMENT


enterprise 9 Extending

Does the organisation work to extend private enterprise and entrepreneurship to all people and communities? The ICENI Centre is at the forefront of medical innovation and provides cutting edge facilities for training. It works closely with industry and through those links and the work of the Innovation team, helps to support the introduction of new technologies into the Trust e.g. robotic surgery and artificial intelligence tools. The Trust has an innovation voucher scheme which is funded by the Gibbons Innovations fund (Trust charity fund). This scheme allows individuals or teams the chance to apply for a voucher worth £5k to support early stage development of ideas, whether that be for proof of concept, help with early stage concept design or even production of a prototype. The scheme is open to all ESNEFT staff members and is inclusive of all ideas/types of innovation, for example this could be used for medical devices and/or digital innovation, or any other form of innovation. The Trust is developing a Faculty of Education and Innovation Centre, which will include a business incubation space. The Trust uses funding to invest in community foundations, local charities and the voluntary sector. Community foundations can then source additional funding to keep activity going.

the digital divide 10 Closing

Is the organisation working to close the digital divide in technology access, skills, opportunities, and infrastructure? A Patient Portal has been developed to view and manage appointments, and to reduce on-site outpatient follow-up appointments. ESNEFT is involved with the provision of digital equipment (hardware e.g. computers or software) to people or organisations (students, employees, local community) who do not have access. The Trust uses its own internal skills to deliver programmes to boost digital skills and confidence, both to young people or others in the general public. Work to improve internet connectivity or accessibility for those in the community. Introduced an agile working policy to ensure flexibility in working for staff where possible. Implementation included the provision of the relevant technology and training where necessary. The Trust has been involved in ICS wide research, through Healthwatch, into how people’s experiences of care had changed because of digital tools and platforms and the impact on those who may find it harder to engage in receiving digital care. A ‘guiding principles document’ was produced to help anyone delivering digital health or social care services.

for opportunity 11 Infrastructure

Is the organisation developing the physical infrastructure that connects people and places to opportunity? An early adopter Community Diagnostic Centre (CDC) has opened at Clacton Hospital in Tendring. Clacton was chosen as a location because it combines high deprivation with high population density (it is home to the most deprived neighbourhood, Jaywick, within Suffolk and North East Essex). CDCs provide a broad range of elective diagnostic services away from acute facilities, providing easier and quicker access to tests and greater convenience to patients.

ASSESSMENT

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the energy 13 Harness transition

Is the organisation ensuring that the energy transition is fair and creates opportunities across the UK? Monthly Sustainability Network Meetings take place. Signed the NHS Pledge on Reduction of Single Use Plastics. Rollout of LED lighting at Colchester and Ipswich Hospital to cut emissions. Make use of green space on the Trust’s estate, providing natural areas even where land is constrained. An annual staff travel survey is carried out to measure shifts in modes of transport and make an action plan for reducing the environmental, social and financial impacts of travel. Senior level approval is required for all high carbon business travel (e.g. flights or high gCO2/km hire cars). All buildings are currently certified for their environmental and social value through the recognised accreditation route (BREEAM). Catering contracts include a requirement to maximise the use of fresh and seasonal food to minimise the need for transportation. Year on year the Trust is increasing the quantity of waste being recycled. There has been a sharp decrease in organisational carbon footprint at the Trust - 2014/15 - 25,000 tCO2e compared to 2019/20 - 14,000 tCO2e.

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ASSESSMENT


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Achieve equality, through diversity & inclusion

Is the organisation working to create a level playing field on opportunity for all, to fully unleash Britain’s potential for the first time? ESNEFT has a reciprocal mentorship scheme as part of the ‘Move Forward’ programme, which aims to increase the number of BAME staff represented in senior roles. The EMBRACE Network (Equality in Moving beyond Race) supports ESNEFT in its objectives to make the organisation a great place to work, so that every member of staff regardless of race, religion, cultural background or nationality, can reach their full potential. The LGBQT+ Network, represents the interests of LGBQT+ staff and patients led by volunteer staff members. The network aims to engage in positive change in the workplace, which will allow all LGBQT+ staff to excel in a supportive and nondiscriminatory work environment. ESNEFT has a disability staff network, ESNABLE, which provides advice and support to ensure all staff are treated equally and fairly, to raise awareness of a broad range of disabilities and help identify reasonable adjustments to ensure staff feel safe with a sense of belonging, with the ability to express their own additional needs to fulfil their roles. ESNEFT is a registered armed forces recruiter, helping veterans transfer to civilian life and find work that uses their skills. The Trust has signed the ‘Step into Health’ pledge which publicly confirms its support to the recruitment of members of the armed forces community into the NHS.

ASSESSMENT

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Outcomes Measuring the impact of the outputs against specific goals This section will consider how the aforementioned activities and their inputs, both financial and in terms of manpower, result in associated outputs and subsequent outcomes. The listed outputs have been noted from available data; while given the absence of current universal measurement for social impact in the company, outcomes have been implied. As the availability of data increases, with increased adoption of impact tracking and measurement, outcomes will be more readily reported against. This will be highly effective for benchmarking the impact of any social impact projects ESNEFT progresses with.

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OUTCOMES


school years 2 Successful

Has the organisation helped to allow every child to successfully achieve their potential in attainment and development? Activity

Output

Outcome (Implied)

These are the measurable things e.g. no of people participating

These are the more intangible benefits

Supports the Health Ambassadors programme across North Essex and South Suffolk by attending school and college events to promote careers in Health.

Currently limited due to covid.

Educating a wider group of young people on careers in healthcare

Medical career days are held to educate young people on possible routes into jobs and criteria for entry.

A small number, currently limited due to covid.

Inform younger children of the possible routes into healthcare.

3 Positive destinations Post 16+ Does the organisation support young people and adults to have the choice of a high-quality route in education, employment, or training? Activity

Output

Outcome (Implied)

These are the measurable things e.g. no of people participating

These are the more intangible benefits

Taking part in the Kickstart scheme.

Placed 1 clinical and 9 non-clinical roles into the organisation and have interest in a further 34 non-clinical placements.

Giving job opportunities to local people.

Internship programme.

Funding of up to 10 internships in a variety of roles.

Give young people the crucial first step on the ladder in healthcare roles.

The ICENI Centre is an innovation hub.

Summer health science workshops for students in years 9 to 12.

Showcase healthcare careers and inspire the next generation. In development.

Will inform students of the 360 different roles available within the NHS.

OUTCOMES

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4

Right advice and experiences

Does the organisation provide access to the right advice and experiences at the right time to unlock opportunity through a person’s life? Activity

Work placements.

Output

Outcome (Implied)

These are the measurable things e.g. no of people participating

These are the more intangible benefits

Over 500 at any one time.

Young people are given a taste of employment in the healthcare sector. Will help with future job applications.

recruitment 5 Open

Are careers and professions open to people of all backgrounds through transparent, accessible, and open recruitment practices? Activity

Output

Outcome (Implied)

These are the measurable things e.g. no of people participating

These are the more intangible benefits

Open recruitment processes which do not discriminate against anyone.

NHS Graduate Training scheme

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OUTCOMES

A diverse workforce which represents the people that the Trust serves. 1 current graduate with another 2 planned

Spreading graduate level opportunities.


career progression 6 Fair

Does the company offer opportunities for career advancement for all based on ability and potential, not connections? Activity

Output These are the measurable things e.g. no of people participating

Leadership development

Outcome (Implied) These are the more intangible benefits

All staff have the opportunity to progress.

programmes for staff. Every new starter is set clear objectives and has a development plan.

Target of having 25% of band 5 and above roles filled from internal candidates.

Internal progression opportunities for staff.

Development of the Faculty of Education and Innovation Centre.

In development.

More training opportunities for staff.

7

Widening access to savings & credit

Does the organisation help widen access to responsible credit and close the savings gap? Activity

Retirement seminars free to all staff.

Output

Outcome (Implied)

These are the measurable things e.g. no of people participating

These are the more intangible benefits

Employees are able to make informed financial decisions.

OUTCOMES

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health and well-being 8 Good

Does the organisation improve mental and physical health at all ages to boost overall well-being to allow people to fulfil their potential? Activity

Output

Outcome (Implied)

These are the measurable things e.g. no of people participating

These are the more intangible benefits Provides a space for staff to think about their wellbeing and ultimately improves

New Wellbeing Hub

mental health. Virtual wellbeing sessions were for all staff.

Over 1,000 members of staff have attended so far.

Improves the wellbeing of staff.

Mental Health First Aiders

Over 300 trained, with plans for 1,000 overall.

Staff can spot the sign of ill mental health in others.

enterprise 9 Extending

Does the organisation work to extending private enterprise and entrepreneurship to all people and communities? Activity

Innovation voucher scheme. Investment in community foundations.

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OUTCOMES

Output

Outcome (Implied)

These are the measurable things e.g. no of people participating

These are the more intangible benefits

Individuals or teams can apply for a voucher of up to £5k.

Encourages innovation. Giving local voluntary sector organisations money to make a difference and leverage further funding.


the digital divide 10 Closing

Is the organisation working to close the digital divide in technology access, skills, opportunities, and infrastructure? Activity

Output

Outcome (Implied)

These are the measurable things e.g. no of people participating

These are the more intangible benefits

Deliver programmes to boost digital skills.

Ensure that the local community has the correct digital skills.

Agile working policy.

Staff are given the equipment and skills to perform agile working.

for opportunity 11 Infrastructure

Is the organisation developing the physical infrastructure that connects people and places to opportunity? Activity

Community Diagnostic Hub in Tendring.

Output

Outcome (Implied)

These are the measurable things e.g. no of people participating

These are the more intangible benefits

Provide easier and quicker access to tests and greater convenience to patients.

OUTCOMES

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the energy 13 Harness transition

Is the organisation ensuring that the energy transition is fair and creates opportunities across the UK? Activity

Output

Outcome (Implied)

These are the measurable things e.g. no of people participating

These are the more intangible benefits

Reduction of single use plastics and increase in waste being recycled.

Part of the journey towards net zero.

Focus on reducing carbon footprint.

14

2014/15 - 25,000 tCO2e compared to 2019/20 - 14,000 tCO2e.

Reducing costs and more environmentally friendly.

Achieve equality, through diversity & inclusion

Is the organisation working to create a level playing field on opportunity for all, to fully unleash Britain’s potential for the first time? Activity

OUTCOMES

Outcome (Implied)

These are the measurable things e.g. no of people participating

These are the more intangible benefits

Reciprocal mentorship scheme.

Increase the number of BAME staff represented in senior roles.

Staff networks for under-represented groups.

Give a voice to all staff members and ensure that they thrive in a working environment.

Raising awareness of disabilities and making reasonable adjustments where necessary.

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Output

Provided 1:1 support for 19 disabled students.


Recommendations 1. Think about introducing a consistent way of measuring the outcomes of outreach initiatives. Time spent in schools and career days need to be quantified and structured feedback should be collected to improve projects moving forward. Collating information on perceptions and feedback of outreach initiatives will allow more in depth analysis of the projects. 2. Work with the local job centre/s to offer a defined number of traineeships and kickstart opportunities. Follow up with all participants to ensure that the programme is fit for purpose and they are kept up to date with current vacancies. 3. Consider new recruitment processes - such as blind recruitment - for appropriate jobs to reduce barriers to recruitment. Best practice in blind recruitment includes: Ensure unbiased job descriptions. Remove name, age and qualifications from the recruitment process. Ensure a diverse hiring panel. Use evidence-based assessment tools that are aligned with an organisation’s culture. Ask behavioral questions rather than focusing on past experiences. 4. ESNEFT has a formal link with Colchester Institute which is helping the organisation with its plans to increase the number of apprentices from 250 to 500. It should consider replicating this agreement with a further education provider in Suffolk. Increasing the number of apprentices will help achieve accurate representation of the communities that ESNEFT serves. 5. There are a huge number of work experience placements at the hospital at any point. Firstly, could this work experience be quantified better and candidates evaluated afterwards to assess its success (see recommendation 1). Secondly, is there, or could there be, a formal way of keeping in touch with those who have done work placements - inviting them back for career days etc. when they are further skilled. They could be the workforce of the future and will already have an understanding of the Trust and how it works. 6. ESNEFT could work with local further education providers and social services to offer opportunities for local care leavers. Working closely with these partners, the Trust could start by providing two placements a year and grow the programme from them.

04

7. Over 7 million people (17.5%) of working age are disabled or have a health condition in the UK. The Trust could create a formal partnership with Mencap (Essex) to offer relevant opportunities to those with disabilities, allowing ESNEFT to tap into a talent pool it has not used before. The Trust could work with Mencap and use best practice to find and employ those with learning disabilities. One way the Trust could be more open to those with a disability is ‘job-carving’. Instead of asking an individual to perform a set job description, it can be much more effective to identify different tasks that a person with a learning disability can do, and ‘carve’ out a new job from these different tasks.

8. Introduce workplace mentors for those who are disadvantaged within the workforce to give them a fair chance of career progression. These include those from Black, Asian and minority ethnic backgrounds, care leavers, carers and those from low socio-economic backgrounds. It is important to define the goals of the programme and ensure that mentors have received the correct training. Within the West Midlands there is a cohort of mentors from different organisations that work together in one system (MentorNet). All of the mentors attend regular CPD sessions designed to ensure they are up-to-date with best practice and developments within mentoring. The system provides a confidential service for mentees to choose a mentor, as well as an online facility to manage the mentoring relationship. 9. Work closely with others on a place-based approach to levelling up within Essex. The Purpose Coalition now works with a number of organisations across the county, including the University of Essex, Basildon Borough Council and Essex County Council. ESNEFT should also consider working more closely with organisations such as Mencap, DWP and YMCA. 10. ESNEFT could introduce the subject of social value recruitment into already established forums in the region such as the Anchor Organisations group. Social value recruitment is a commitment to, and the development of, organisational policies that drive active recruitment and job progression for groups facing disadvantage in the labour market. This includes people with disabilities, ex-offenders, blakc, asian or minority ethnic communities that face employability challenges and people with lower educational attainment or lower social capital.

R E C O M M E N D AT I O N S

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05

The Journey to the Purpose Goals In 2015, as Secretary of State for International Development, Justine Greening MP led the UK delegation to the United Nations (UN). Along with 184 international partners, she helped to establish the UN’s Sustainable Development Goals (SDGs).

In 2015, as Secretary of State for International Development, Justine Greening MP led the UK delegation to the United Nations (UN). Along with 184 international partners, she helped to establish the UN’s Sustainable Development Goals (SDGs). In 2017, the SDGs were made more ‘actionable’ by a UN resolution adopted by the General Assembly which identified specific targets for each goal, along with indicators used to measure progress towards each target. These 17 interlinked, global goals were designed to be ‘a blueprint to achieve a better and more sustainable future for all’. They marked a shift from the previously established Millennium Development Goals (MDGs), following the Millennium Summit of the United Nations in 2000. In contrast to the MDGS, the SDGs were nationally-owned, country-led and targeted wealthy, developed nations as well as developing countries.

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PURPOSE GOALS

The SDGs emphasised the interdependent environment, social and economic aspects of development by centralising the role of sustainability. As Secretary for State, Justine recognised how useful a common set of accessible but ambitious objectives could be in galvanising action to effect change. Since then the COVID-19 pandemic has only exacerbated many of the problems relating to social inequality in the UK. The recovery is a chance for the United Kingdom to address these issues and level up but that requires updated and specific goals in order to outline, inspire and measure progress. The Purpose Coalition aims to improve social mobility in the UK and has responded to this challenge with the launch of their own Purpose Goals in February 2021.


Successful 1 Strong foundations school years 2 in Early Years

3 Positive destinations Post 16+

4

recruitment 5 Open

career progression 6 Fair

7

Widening access to savings & credit

enterprise 9 Extending

Right advice and experiences

health and well-being 8 Good

the digital divide 10 Closing

for opportunity 12 11 Infrastructure

Building homes & sustainable communities

the energy 13 Harness 14 transition

Achieve equality, through diversity & inclusion

These new Goals build on the foundations laid by the UN’s SDGs by outlining 14 clear goals, and draw on expertise provided by academia and businesses which has been applied to the unique challenges facing the UK in levelling up. They focus on key life stages and highlight the main issues that need to be resolved in order to create a level playing field for all in this country. The Purpose Goals, also known as the Levelling Up Goals in the UK, are intended to guide how the urgent ambition to level up the UK can actually be achieved. The impact of the work carried out to do this can, and should, be measurable. Sub-goals with quantifiable targets and measurements against which progress can be charted within the 14 goals are being developed in partnership with Purpose Coalition partners. This will create a more transparent and measurable framework with which to monitor and subsequently address problems of social mobility and inequality. The Purpose Goals are designed to look at the outcomes of CSR strategies and measures that organisations operate. Many organisations are doing outstanding work and making important contributions to society but are still measuring this via inputs – a measure that focuses on pounds, shillings and pence rather than real impact to human lives. Crucially, these Goals are a shared framework. Justine and the wider Purpose Coalition believe that with a common understanding and objectives, there can be action that drives change on the ground. Distinct entities, including universities, businesses, NHS Trusts, councils, policy-makers, communities and NGOs, can work together, with the shared Goals being a uniting and motivating foundation for progress. As the problems which cause social inequality in the UK are interlinked, it seems that the response to these problems must also be collaborative. The Purpose Coalition has encouraged businesses, universities and public sector bodies to share their own best practice with other organisations so they are not only demonstrating their own commitment, but creating a shift towards being purpose-led. The Goals can encourage an extension of this co-operative exchange of information which can be used to help level up Britain.

PURPOSE GOALS

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CONTENTS


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