South Warwickshire NHS Foundation Trust Impact Report by Social Mobility Pledge

1CONTENTS ImpactReport

2 CONTENTS

3CONTENTS Contents01 RtForewordHonAnne Milton NHSSouthForewordWarwickshireFoundationTrust 02 The Journey to the Purpose Goals 03 The role of South Warwickshire NHS Foundation Trust and the NHS in meeting the Purpose Goals 04 South Warwickshire NHS Foundation Trust’s activities benchmarked against the Purpose Goals 05 Analysis

4 FOREWORD Rt Hon Anne Milton Former Parliamentary Under-Secretary of State for Public Health 01Foreword

5FOREWORD

While continuing to fight off the pandemic threat, it is also now in a period of acceleration – of technology adoption, new ways of working and shifting forces in the patient/clinician relationship.

At this time, however, this vital function of public health is needed more than ever.

After the pandemic’s impact on communities, households and the wider economy, the gap between the haves and have nots has widened.

They not only provide job opportunities and careers, and address health inequalities, but also influence infrastructural development, governmental policy and inward investment – including through research work and university relationships. They have direct links into the communities and households most in danger of being left behind, and contribute to reducing the barriers that stop life progression and social mobility.

South Warwickshire is the latest NHS trust to join the Purpose Health Coalition and benchmark itself against the 14 Purpose Goals.

While much of this change has been enforced by the restrictions caused by the virus, in many ways it is making access to services easier and quicker. It might also enable healthcare trusts to be even more influential and impactful as drivers of social change; amid digital technologies that are providing direct links into communities, and remote working opportunities for people that otherwise may not have been able to access them. The role of healthcare trusts in enabling social mobility has been played out since their very inception.

In terms of job prospects and careers, once access to working life in a trust is achieved, a multitude of new opportunities can present, thanks to the commitment of the NHS to the continual development of skills, and its openness to internal progression.

Like other trusts we have worked with through this process, its approach is tailored to carefully match the needs of the communities it serves.

The COVID-19 crisis reinforced the sheer talent, determination and commitment of NHS staff – and reminded us all of the absolutely critical role of the public health institution in British life.

Levelling up Britain in a post-pandemic, increasingly tech savvy world, is urgently needed to avoid undoing years of progress towards making Britain a fairer place where opportunities are accessible to all. NHS trusts, and their extensive networks of facilities, teams, suppliers, staff and partners, are huge contributors to the levelling up agenda.

SWFT and its leadership team has a commitment to resolving inequalities with a focus on population health management rather than treating illness, and helping its local communities address issues which could see them develop bad health. This report provides new insights on innovative and progressive ways that public health can fulfil its potential to drive equality of opportunity. I hope it inspires action and change in other organisations and encourages more leaders and employees to join the levelling up effort.

6 FOREWORD

Foreword

The pandemic necessitated a lot of innovation in our health and care system. The pressures and challenges have only been matched in their magnitude by the dedication and spirit of our staff. It has been truly humbling to work with such amazing, talented people. I could cite here very many examples of the changes teams were empowered to make and the resulting benefits to patients. This includes innovative clinical treatments,the use of technology to support virtual outpatient activity and, for example, virtual breast-feeding classes. This willingness to try new approaches to make improvements is very much part of the culture of the Trust. Also evident in this report is impact collaborative working is having for our population for example our connections with Veterans Alliance, connections with Social Enterprise Organisations, our construction suppliers who are aligned to net zero commitments and our staff networks to drive improvements in diversity and inclusion.

The past two years has been the most extraordinary in my career in the NHS. As you will see from the content of the Impact Report, the Trust and our partners in South Warwickshire Place remained ‘open for business’ throughout the pandemic.

7FOREWORD

The Trust and our partners are very well placed to be influential and impactful as drivers of levelling up and move quickly into this new future. These changes are founded on the strategy that we have developed over the past few years and emerging in South Warwickshire Place one which focuses on population health, prevention, and integration. Having a vision for a better future has been an important driving force for all of the leaders, our partners and indeed staff, in the Trust. As I noted earlier, the last couple of years has shone further light on the excellence of our staff, our work with our partners to collectively be more impactful as drivers of levelling up. But we have also drawn on the goodwill and support of very many volunteers and also been buoyed by the support of our local communities. This report provides new insights on innovative and progressive ways that we can fulfil our potential as a driver of levelling up and I look forward in the months ahead to sharing updates on our collective progress.

Anne Coyle Managing Director of South Warwickshire NHS Foundation Trust

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 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.

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. The SDGs emphasised the interdependent environment, social and economic aspects of development by centralising the role of sustainability.

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).

8 THE JOURNEY TO THE PURPOSE GOALS

The Journey to the Purpose Goals

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.

Crucially, these Goals are a shared framework. Justine and the wider Purpose Coalition, of which South Warwickshire NHS Foundation Trust is a key member, 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.

9THE JOURNEY TO THE PURPOSE GOALS

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.

PostdestinationsPositive16+3 schoolSuccessfulyears2infoundationsStrongEarlyYears1 Right advice and experiences4 Fair progressioncareer6recruitmentOpen5 Good health and well-being8savingsaccessWideningto& credit 7 Closing the digital divide10enterpriseExtending9 Building homes & communitiessustainable12forInfrastructureopportunity11 Achieve equality, through diversity & inclusion 14transitiontheHarnessenergy13

If Britain is to achieve levelling up, I believe that we need a galvanizing set of goals that an unite Parliament, business, communities, and civil society to work in partnership for the common good of our country.

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 ROLE OF SOUTH WARWICKSHIRE NHS FOUNDATION TRUST

The role of FoundationWarwickshireSouthNHSTrust and the NHS in meeting the Purpose Goals

The role of the NHS NHS organisations can, and do, make a real and sustained difference to create positive change for their 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, 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.

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 being faced 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 among 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. NHS organisations have a much wider reach than just health and many, rightly, now see themselves as important anchor institutions within their communities. Aside from the obvious health impacts, there are other aspects of the purpose 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 1,205,362 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 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 Likewiseaccessible.thetransition to a green and net zero economy has also accelerated. As it is such a large institution with large estates, efforts made by NHS organisations to use more renewable energy to run their services more sustainably will have a substantial impact.

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.

Equality of opportunity simply cannot be achieved without the participation of the National Health Service. NHS 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.

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.

South Warwickshire NHS Foundation Trust 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.

“NHS organisations have a much wider reach than just health and many, rightly, now see themselves as important anchor institutions within their communities.”

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 NHS2040.organisations can have a wider impact on the economy through how it procures goods and services.

By utilising the voice, reach and reputation of the NHS, organisations like South Warwickshire NHS Foundation Trust can truly act as anchor institutions to level up the regions in which they operate.

THE ROLE OF SOUTH WARWICKSHIRE NHS FOUNDATION TRUST

Trusted – “we will be open and honest”

This strategy is delivered by an engaged and passionate workforce and key partnerships which support its vision. Its strategy is also aligned to recently published legislation on the delivery of care at “place” level. It delivers services in South Warwickshire, Warwickshire North, Coventry and Rugby, collaborating to “improve health outcomes for the local population”.

South Warwickshire NHS Foundation Trust provides healthcare services to around half a million people in Warwickshire, with additional young people’s and family services also delivered across Coventry and Solihull. WARWICKSHIRE

The trust’s digital transformation has been accelerated during the coronavirus pandemic, with digital ways of working and large-scale initiatives, including a new patient portal, embedded as part of an extensive drive to futureproof its operations and delivery of services.

NHS FOUNDATION TRUST

To do this, its 5,100+ staff are united through a set of key values built around four pillars: Safe – “we put safety above everything” Effective – “we will do the right thing at the right Compassionatetime” – “we offer compassionate care to everyone”

Another fundamental and continual transformation underway at the trust, however, is the stepping up of its contribution to the levelling up agenda.

From a research perspective the Trust has targeted frailty, emergency admissions and the management of long-term health conditions. These have been identified as problems that are not hospital based but societal problems where hospitals play a role.

The trust cites its vision as: “Together with others we will use all expertise and resources to support and improve the wellbeing of all communities.”

As cited in its latest annual report, the trust’s strategy is focused on health, rather than illness, with an emphasis on “helping you to help yourself”.

THE ROLE OF SOUTH

Its work spans four hospitals, including Leamington Spa and Warwick, out of hospital services, a dedicated charity and two business subsidiaries, SWFT Clinical Services and Innovate Healthcare Services.

The role of South Warwickshire NHS Foundation Trust

This report sets out the details of this comprehensive, measured and innovative work in the relevant Purpose Goal areas.

“Together with others we will use all expertise and resources to support and improve the wellbeing of allTHEcommunities.”ROLEOFSOUTHWARWICKSHIRE NHS FOUNDATION TRUST 13

14 SOUTH WARWICKSHIRE NHS FOUNDATION TRUST’S ACTIVITIES NHS Trusts are perhaps in a better position than most organisations to make a real impact against most 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. This section of this report will benchmark several of SWFT’s specific initiatives against the Purpose Goals, to track where progress is being made and where efforts could be redirected or better targeted. 4. South Warwickshire NHS Foundation Trust’s activities benchmarked against the Purpose Goals 04

Many organisations have strong commitments to social responsibility. For NHS organisations this takes the form of addressing the wider determinants of health and therefore improving public health in the community and reducing environmentalassociatedharms.

To achieve this vision, it is working to the recommendations of the Coventry Early Years Needs Assessment (March 2021) to focus on: Shared understanding. Use of existing knowledge and resources to improve partnership working and information sharing. Improved integration. Improved practice. Plans in the above areas include for the trust to continue supporting family health and lifestyle services to promote school readiness in day-to-day work and service development. Also, exploring options on information sharing with parents, for example utilising webinars. The trust also plans to conduct a communications audit to identify and improve distribution channels to parents.

The trust works to give children the best possible start in life, including through its health visiting service. This encompasses complete universal checks for all families, identifying needs and areas of support for social, emotional and physical challenges.

The Red Thread

Other activities to support strong foundations in early years include: Involvement in integrated reviews into multi-organisational work in this area. Link health visiting staff members working in each early years Deliveringsetting.jointwebinars with the Family Information Service and early years staff to discuss roles and how improved communication can better support families andAttendancechildren. of health visiting service staff on early yearsHealthboards.visitors and student health visitors attending sessions at nursery school to discuss public health issues such as oral health and health eating in North Warwickshire.Community nursery nurse supporting a preschool setting in Warwick on oral health. Co-location of early years workers from children and family centres located within health visiting teams in North Warwickshire.

Goal 1: Strong Foundations in Early Years

As part of its commitment to improving practice in school readiness areas, it also plans to set up an integrated workforce development programme with accreditation.

The trust’s family nurse partnership also provides intense support to vulnerable and teenage parents. Its infant feeding service similarly delivers additional support, in this case by promoting good feeding and Schoolattachment.readiness is a dominant theme within the trust’s levelling up work. It works across the early help system to improve school readiness and is a key leader within the early help partnership. Its vision is to see: Reduced inequalities in the early development of physical and emotional health, and cognitive, linguistic, and social Provisionskills.ofhigh-quality maternity services, parenting programmes, childcare and early years education, meeting the level of need across the social gradient. Strong and sustained resilience and wellbeing in young children across the social gradient.

15 infoundationsStrongEarlyYears1 SOUTH WARWICKSHIRE NHS FOUNDATION TRUST’S ACTIVITIES

Further evidence of its work on Goal 1 is seen through its involvement with the Violence Reduction Unit, with services working jointly to reduce crime, with particular focus on support for early years.

A more intensive service is offered for priority families with more need, working with partners to safeguard children. Through this work, and other initiatives, the trust promotes good parenting, highlighting where extra support is required and signposting to other agencies where appropriate.

schoolSuccessfulyears2

PostdestinationsPositive16+3

4 SOUTH WARWICKSHIRE NHS FOUNDATION TRUST’S ACTIVITIES

Annemarie Atkins, who supports families with newborn babies in Coventry as a breastfeeding counsellor and in supporting the trust’s infant feeding team. Sally Keil, who recently set up a weekly online women’s group for those struggling with dependency issues who could not attend physical groups due to COVID-19 restrictions.

An example of the trust’s vast work in providing advice and experiences to staff, is its work to develop the skills within its health visiting service to improve succession planning.

Shining examples of this volunteer work include:

Relaxation sessions for mental wellbeing are among its offerings, for example. Its ‘Be Active, Be Healthy’ team also works to increase physical activity and healthy nutrition in schools.

Goal 4: Right advice and experiences advice and experiences

The service now welcomes band five staff nurses onto the team as of October 2021 and staff have an opportunity to complete an apprenticeship to undertake specialist community public health nursing (SCPHN) training. This is designed to empower staff with a good grasp of the skills required in health visitor roles ahead of an apprenticeship.

Right

Future plans include new apprenticeships, for example in infant feeding support, to better enable access to NHS careers for 16+ candidates.

Goal 3: Positive destinations post 16+

The trust also engages with sixth form colleges. One recent initiative enabled students to provide artwork to the trust and to help with its video projects.

The trust offers volunteering opportunities to members of local communities, which can serve as a launchpad into paid careers. Peer support workers, for example, work with the infant feeding team and often go on to secure paid employment within healthcare.

Alvaro Grana, a pensioner, originally from Peru, who volunteers with several charitable organisations in Coventry including Carriers of Hope, the Coventry Refugee and Migrant Centre and Coventry Peace House. He also acts as an advisor to male asylum seekers.

The trust impacts on positive destinations post 16+ in a number of ways, including through a range of training programmes and an approach that makes opportunities accessible to all. One initiative involves psychology students undertaking a module within the health visiting service based on marketing and psychology.

The trust’s school nursing service works closely with schools to promote health and wellbeing and good school attendance. It liaises with schools to identify children’s needs and offers sessions to promote good health and wellbeing.

Goal 2: Successful school years

Also, financial wellbeing packages are available as part of its staff benefits programme, which can be accessed via the staff intranet.

The trust works with a range of universities, including Coventry, Warwick, Birmingham City Worcester and Derby; liaising with them on careers fairs, open days and other events aimed at opening up access to Itopportunities.operatesblind shortlisting to ensure fairness and consistency in recruitment processes.

Goal 7: Widening access to savings and credit savingsaccessWideningto& credit 7

Goal 5: Open recruitment Goal 6: Fair career progression recruitmentOpen5 Fair progressioncareer6

The trust enables individual teams to access development opportunities such as insights discovery programmes, ‘team visioning’ and its ‘good to great teams’ initiative.

This is a hugely influential factor on levelling up, directly affecting the ability of individuals in challenging circumstances to achieve social mobility and secure a comfortable future for themselves and their families.

The trust’s organisational development work offers a wide range of leadership programmes, such as ‘Living the Leadership Charter’ and management inductions.

It is currently developing an introductory level coaching course and formal coaching qualifications too.

SOUTH WARWICKSHIRE NHS FOUNDATION TRUST’S ACTIVITIES

Other activities include its role working with the Veterans Alliance and Armed Forces Covenant on a variety of training and development programmes.

Its work on fair career progression is monitored and shaped with support from its equality, diversity and inclusion steering groups.

Other work in this area includes referring into Warwick County Council’s family information service to support households in addressing personal finance challenges.

The trust sends out regular HR newsletters with information about personal finances and access to savings and credit.

Perinatal and infant mental health specialists provide wellbeing packs for staff undertaking emotional wellbeing visit training, as well as other staff within the team.

Other initiatives include the HENRY (health education and nutrition in the really young) programmes, which address childhood obesity.

Digital single point of access has been introduced for collaboration between community, hospital services and social services.

SWFT, however, goes beyond its basic remit as an NHS foundation trust, to deliver a wide range of programmes that proactively support good health and wellbeing in the communities it serves.

South Warwickshire has established several initiatives to help acute care and management of chronic conditions, including remote monitoring for patients with conditions like diabetes.

SOUTH WARWICKSHIRE NHS FOUNDATION TRUST’S ACTIVITIES

Clearly this goal is aligned to the trust’s primary purpose.

Its stop smoking in pregnancy service continues to improve the health and wellbeing of mothers and babies, while its ‘Be Active, Be Healthy’ service offers exercise sessions for children, families and adults in the pre-and postnatal periods.

The infant feeding service, meanwhile, promotes good health and wellbeing, with the latest figures showing that 52 per cent of mothers in Coventry are breastfeeding at six weeks.

Internally, including via HR newsletters, information is provided on various opportunities that support good health and wellbeing. Health and wellbeing representatives within the service also offer interventions to staff, for example through mindfulness sessions.

The trust’s health visiting service, school nursing service and family nurse partnership also contribute to its work in the good health and wellbeing goal area.

The trust also recently ran art sessions to enable staff to take time out from the stresses and pressures of working life, to correspond with Nurses’ Day.

The trust utilises video/interactive guidance to support mental health – and promotes health and wellbeing on social media, targeting family homes and education settings.

Goal 8: Good health and wellbeing Good health and well-being8

4.8.1 Staff health and wellbeing

The trust’s health and wellbeing strategy aims to: Focus on and maintain staff engagement, building a sense of belonging and involvement. Have effective leadership and management across the organisation to support the integration of health and wellbeing into everyday activity, thus developing a culture where health and well-being is trulySupportvalued.staff to develop and maintain a healthy lifestyle and to improve physical and emotional health. Build personal and team resilience and practical strategies training and support to help manageProvidestress.early intervention to support staff with health problems or disabilities to remain at work or to return as soon as possible after a period of absence.

The trust’s staff health and wellbeing group is made up of staff, managers, wellbeing ambassadors and leaders from various teams across the organisation. Its aim is to promote positive wellbeing messages and improve the health and wellbeing of people working at the trust.

The trust also works to implement findings of the Mental Health and Wellbeing Joint Strategic Needs Assessment (JSNA), part of the Mental Health and Wellbeing JSNA toolkit; which includes a set of knowledge guides offering expert advice and links to policy, evidence and additional data sources. This is designed to support health and wellbeing boards and others interested in producing local mental health and wellbeing JSNAs by providing access to metrics on prevalence, risk and protective factors, and care provision. These metrics can be used to benchmark to meaningful comparison groups.

The group is focused on three key actions: To ensure that leaders and managers actively support the health and wellbeing of themselves and theirToteamsgather and use data to make evidence-based decisions on health and wellbeing strategies and interventionsTocommunicate and provide role models for key health and wellbeing messages and to encourage staff across the trust to do something in relation to their health and wellbeing. Trust staff are supported via intranet pages on all aspects of health and wellbeing. This guidance includes information for managers on the Health and Safety Executive’s management standards for managing work-related stress. It also collates the trust’s wellbeing policies, procedures and guidelines in one place, covering a range of areas including alcohol and drugs in the workplace, domestic abuse, flexible working, healthy food and drink, sickness absence, supporting staff through mental ill-health, supporting staff with an autistic spectrum disorder and supporting staff with cancer and other life-threatening diseases.

SOUTH WARWICKSHIRE NHS FOUNDATION TRUST’S ACTIVITIES

Trust staff can also access health and wellbeing discounts, including gym membership.

The trust has applied charitable funds to support vulnerable parents in the provision of tablets to enable them to complete training on parenting, and access video calls with health professionals. The trust works with various social enterprise organisations including those related to breastfeeding support and local parent groups. Various social enterprise organisations are invited to be present at team and locality meetings, ensuring that the voice of the community is heard.

The trust is aware of the issues around digital poverty and where technology is needed for certain services, patients are provided with the correct equipment.

Social Value: actions that leverage our role as a place-based anchor institution to accomplish social value.

Closing the digital divide

10 Due to the pandemic the number of telephone and video consultations has increased significantly. In 2018/19 there were 16,998 appointments, but this has increased to 139,333 a year (41% of total outpatient appointments).

Climate Resilience: reducing the environmental impact of our activities and providing a basis for us to become a climate change-resilient organisation.

Goal 13: Harness the energy transition transitiontheHarnessenergy13

The trust runs a number of programmes and policies designed to boost digital skills and confidence, and works to improve internet connectivity and accessibility across its Staffnetwork.areoffered

The plan has nine areas of focus that will help to achieve the targets set out above: 1. Workforce and Systems Leadership 2. Sustainable Models of Care 3. Digital Transformation 4. Travel and Transport 5. Estates and Facilities (including Capital Projects and Green Spaces)

The vision the plan is three fold: Net Zero: resource consumption and Greenhouse Gas (GHG) emission reductions that align with NHS net zero targets.

Through the provision of digital equipment to individuals or groups – including students, employees and local community members – without access, health organisations are able to help to close the digital divide.

support in accessing electronic patient records and utilising video calling, as well as in standard IT tools such as Excel.

The trust supports agile working, which enables staff to work at home or closer to their home at an appropriate venue, thus providing a closer link between infrastructure and opportunity.

Goal 10: Closing the digital divide

SWFT is committed to achieving net zero carbon for its Carbon Footprint by 2040 and for its Carbon Footprint Plus by 2045. The trust launched its Green Plan in early 2022 to set out its strategy to achieve these targets.

SOUTH WARWICKSHIRE NHS FOUNDATION TRUST’S ACTIVITIES

Goal 9: Extending enterprise Goal 11: Infrastructure for opportunity forInfrastructureopportunity11enterpriseExtending9

SOUTH WARWICKSHIRE NHS FOUNDATION TRUST’S ACTIVITIES

4.12.3 Sustainable travel

4.12.1 Staff

Building energy efficiency standards are considered for all new capital projects at SWFT. For example, BREEAM ‘Excellent’ rating, the Zero Carbon Hospital Standard, and implementation of on-site renewables.

All construction suppliers are aligned to net zero commitments, such as on-site contractor measures on waste reduction and low emission construction plans.

Renewable energy technologies have been installed throughout the trust’s facilities including solar panels at Warwick and Royal Leamington Spa. Working alongside the University of Warwick, in the first half of 2022 the trust is going out to tender for a new, more efficient energy solution for Warwick, Leamington and Stratford hospitals.

While the trust can’t reserve spend locally, it does take proactive steps to support inclusive growth, including a policy on the payment of the Real Living Wage for its service suppliers.

The trust is also committed to reducing the amount of waste - it has been a signatory of the NHS Single Use Plastics Pledge since October 2021 and already widely uses non-plastic based material, in its catering

The trust puts in place various energy efficiency initiatives - including LED lighting, building management systems and boiler replacement schemes. engagement

Thereoperations.isatravel plan in place for all sites across SWFT. Sustainable travel is promoted to all staff and incentives are promoted for people to cycle to work and also for car sharing.

SWFT promotes access to greenspace, and in many cases actively incorporates it into patient therapies. Therapy gardens are provided in the Nicol Unit at Stratford, Ellen Badger and Royal Leamington Spa TheHospitals.trustpromotes the use of green spaces to staff, patients and visitors while ensuring that future developments incorporate greenspace provision.

4.12.4 Green spaces

From 1 April 2021 - all the electricity that SWFT procures at its hospital sites is renewable. This was brought into place a year in advance of the NHS requirement.

LED lights are default in replacement, refurbishment and capital projects. Specific lighting projects were carried out during 2021 meaning that approximately 75% of lights are now LEDs in hospitals and car parks (up from 45% in 2019).

SWFT has mapped out walks at Warwick Hospital to encourage active travel. Communications campaigns are run once a month to ensure that staff are aware of the trust’s sustainability strategy, including through the internal newsletter, ePulse.

The trust recognises that staff have an important role to play in reaching sustainability targets. It aims to empower employees to deliver its Green Plan at all levels of the organisation.

around sustainability4.12.2Energy savings 6. Medicines 7. Supply Chain and Procurement 8. Food and Nutrition 9. SWFTAdaptationhasaSustainability

Steering Group which meets every two months to ensure that progress is being made against the relevant targets. This group then reports to the Trust board once a year. A new NHS Sustainable Supplier Framework will be launched in January 2022 and will require all suppliers to publish progress reports and continued carbon emissions reporting by 2030.

The trust has a Pathway Team to support and coordinate the care and discharge of people who are experiencing Under-representedhomelessness.groupsor those with complex care needs are targeted with extra support by the trust. Those with cerebral palsy have a senior nurse advocating for them.

The trust provides support to Black, asian and minority ethnic women and families, prioritising those who have been in the UK for less than three years, working to reduce health inequalities.

SOUTH WARWICKSHIRE NHS FOUNDATION TRUST’S ACTIVITIES

Black, asian and minority ethnic candidates also had a higher chance of being appointed from shortlisting than white candidates, who had a 12.27 per cent chance compared to a 13.28 per cent chance among Black, asian and minority ethnic applicants.

The trust has a variety of networks within, which provide further support on diversity and inclusion. These include an LGBTQ+ staff network which has a remit to: Learn from national and regional equality, diversity and inclusion groups and disseminate that to the trust via regular communication channels. Update and share knowledge within the trust on keyActissues.asa support network for LGBTQ+ staff and allies. Create an organisational culture which retrains and attracts staff, as well as contributing to clinical effectiveness, provision of quality services and new service developments by ensuring that equality, diversity and inclusion needs of the workforce are identified.Ensure learning activities are aligned to trust values and support an inclusive culture Support the health and wellbeing needs of staff.

SWFT analyses data to identify those who are most at risk and targets them for services - for example people with no fixed abode or where their ethnicity is unknown. These people are targeted through the trust’s work with the local voluntary sector - for example it works with a charity called Tribe that links voluntary, social and healthcare services to target vulnerable people.

The aim of the service is to improve health outcomes of Black, asian and minority ethnic women in pregnancy and after giving birth. Peer workers from the community support women alongside health professionals in clinics on a oneto-one basis – reinforcing important key health messages, with vital connections to other services in the trust and wider communities.

Peer support workers play an important part of this work. These are recognised within local communities and help to reinforce health messages to Black, asian and minority ethnic women, and support good health and wellbeing in the antenatal and postnatal periods. This service also works to identify social isolation among women.

4.13.1 Utilising networks to drive diversity and inclusion

Goal 14: Achieve equality through diversity and inclusion Achieve equality, through diversity & inclusion 14

The trust supports MAMTA - an initiative aimed at improving child and maternal health outcomes for Black, asian and minority ethnic women in Coventry. It was launched in 2001 as a response to poor child and maternal health outcomes evidenced within Black, asian and minority ethnic groups compared with the overall population.

The service has been recognised nationally, with one specialist health visitor, Veera Samira, receiving the RCN Making a Difference award as part of Black History Month in October 2021.

Within Coventry’s health visiting team, is a vulnerable families team which supports asylum seekers and the Ithomeless.worksclosely with the Meridian practice, a GP surgery for asylum seekers in Coventry, to ensure they are able to access the care they require when they come to the UK.

Data shows that more Black, asian and minority ethnic staff were recruited by the trust in 2020/21 than in 2019/2020. It also shows that Black, asian and minority ethnic applicants had a slightly higher chance of being appointed from shortlisting in 2021 than in 2020.

The trust supports Pride and engages with local events to play a bigger role in influencing and supporting change.

The network influences the trust’s support and development programmes to help bridge inequalities, and also supports the zero tolerance work currently underway within the trust.

The trust’s Black, asian and minority ethnic network, established in 2018, encourages membership from both Black, asian and minority ethnic and other backgrounds.

SOUTH WARWICKSHIRE NHS FOUNDATION TRUST’S ACTIVITIES

The aims of the Black, asian and minority ethnic network are to: Enable Black, asian and minority ethnic staff to feel they have a vital role to play in the trust.

The trust also works with Warwickshire County Council to raise awareness of hate crime and has supported the authority’s inclusion of LGBTQ+ concerns within its own cultural awareness training.

Advising on equality impact assessments and ensuring LGBTQ+ staff are fully considered, advising on policy amendments were necessary.

The trust has also influenced civility and microaggression training to ensure that LGBTQ+ issues are represented in these sessions, as well as those of other protected characteristics.

The trust also has a network of ‘speak up’ wellbeing and inclusion ambassadors that represent various departments and staff groups and are supported by their managers to provide signposting and information to peers. They also link into pastoral and wellbeing support within the trust.

Act as a resource for supporting, developing and networking with internal and external stakeholders.

Influence and support organisation policy and practice.Provide a safe, confidential and supportive environment where staff can be honest and confident with each other. Act as a point of contact and work with the equality and diversity steering group. Provide a forum for linking with other staff network groupsAssist with identifying development needs and raise awareness of barriers and challenges. Increase understanding. Receive feedback via expectation surveys. Celebrate achievements.

Run a reverse mentoring scheme involving the CEO and Black, asian and minority ethnic staff. Raise the profile of Black, asian and minority ethnic staff within and beyond the trust.

Monitor the results of trust impact assessments

People with disabilities are also supported, in part, by a dedicated network.

to ensure equality, diversity, inclusion and LGBTQ+ is considered in the development of all policies, services andWorkprocesses.withthe local LGBTQ+ community and representative groups to learn from them and their needs from the services provided.

Service users and staff are encouraged to share their stories on LGBTQ+ issues and the trust is currently considering a new video-based initiative that enables these stories to support greater awareness.

Ambassadors have received training in a spectrum of issues, while they are also supported via annual webinars, conferences and networking events.

The trust has LGBTQ+ officers in place to make sure issues of concern are raised with members of staff and to act as a focal point for LGBTQ+ members.

Raise the profile of LGBTQ+ equality across the trust through supporting good practice and promoting and monitoring equality, diversity and inclusion training.

It has provided information on content for various policies, including on same sex accommodation, supporting transgender staff and its appearance at work policy; particularly focusing on LGBTQ+ perspectives.

The LGBTQ+ network leads are invited to attend senior leader meetings to talk about the network, which also has an input in leadership development sessions within the trust.

The trust’s workforce disability network provides a confidential and supportive environment to discuss good and bad experiences of being disabled in order to establish good practices. It also offers networking opportunities, regular discussions on disability matters and a mechanism for enabling disabled staff to come together to share information and support by providing a space for the safe discussion of disability issues.

The trust also recently launched a campaign on pronouns, which includes the renaming of its family health division and various work streams.

SWFT board members take part in an Inclusive Board Leadership Development Programme to learn about different biases that can take place within an organisation. Importantly this also looks at how this can impact on patient experience.

SOUTH WARWICKSHIRE NHS FOUNDATION TRUST’S ACTIVITIES

Time off to attend appointments –recognition that disability and ill-health are not the same thing. Disabled staff may require time off to help them manage their disability.

Other key factors set out in the trust’s disability policy include: Redeployment – staff who have developed disability and are unable to carry out their substantive role should be considered for redeployment. This includes the opportunities for temporary redeployment.

A number of workshops are held to explore the impact of inclusive leadership and an action plan has been developed to implement ideas to tackle current inequalities.

4.13.2 Innovative solutions to disability challenges 4.13.4

Reasonable adjustments should be explored to assist the employee to remain or re-enter the workplace and maintain attendance with ongoingAppealssupport.–employees who are dissatisfied with the way the policies have been applied may be able to use the trust’s grievance policy after all attempts to resolve the matter informally have been explored.

The trust also uses HEAT (Health Equity Assessment Tool) to assess health inequalities and identify what action needs to be taken. Through its public health team, who work closely with local authorities, the trust looks at various data sets to identify possible inequity in access to services or admissions. For example, it has been identified that there are particular inequalities in admission around respiratory illnesses. The trust is therefore liaising with stakeholders around issues like smoking and air quality.

Via its workforce disability network, the trust utilises the Passport of Reasonable Adjustments; originally developed by the TUC and GMP unions to help trust employees with disabilities that already have, or may require, reasonable adjustments to enable them to continue working. It gives these employees an opportunity to set out and shape the plans and strategies in place to support them at work.

A lot of the trust’s ongoing work is around early population health management and prevention. This can only truly be achieved by joined up working with others in the region and inter-connection between services. The trust delivers equality and diversity training at mandatory training sessions for both clinical and non-clinical staff throughout the year. Inclusive Board Leadership Development Programme 4.13.3 Equality and diversity training

Sickness absence and return to work –managers conducting return to work interviews must carefully consider whether the member of staff has a disability under the Equality Act 2010 or a developing disability.

25SOUTH WARWICKSHIRE NHS FOUNDATION TRUST’S ACTIVITIES

Goals directly influenced by South Warwickshire NHS Foundation Trust indicates, not only public health’s vast potential as a driver of social change, but also an organisation that has taken its responsibility far beyond the remit of director-level or ESG functions.

26 ANALYSIS

TheAnalysisrangeofPurpose

Good health and wellbeing, Goal 8, is clearly a major performance area for the trust. As this report shows, however, this work extends beyond the basic remit of healthcare trusts, into communities and schools, with a concerted effort to change behaviours and address Inclusioninequalities.and diversity awareness underpin the work of all departments and the trust continually strives to develop a culture of openness, support and Theunderstanding.trusthasapartnership with Warwick Business School to look at how effective its innovations are in improving patient care. Both in objective measurements such as reduced time in hospitals or reduced admissions but also whether those services can be accessed equally by those from different Bybackgrounds.engagingwith the University of Warwick, SWFT is gaining a different perspective on the levelling up work that is taking place and evaluating the results. The work with Warwick Business School is going to increase in the future with the development of a clinical trials unit and a data analytics unit. This collaboration is being used to identify gaps, improve care and have short-term operational benefits. Only by studying what works and where there are gaps can progress be made and SWFT understands the importance of this.

27ANALYSIS

On Goal 4, providing the right experiences and advice, volunteering is enlisted to great effect, empowering people, perhaps themselves affected by social mobility challenges, to support progression in their local communities.

Despite the many pressures faced by trusts, on resources and in terms of growing demand for services, South Warwickshire has enabled levelling up to become embedded in all departments, programmes and care settings.

Once employment is secured within the trust, an array of practices and programmes helps to encourage and enable progression.

Its input on levelling up begins at the very start of life, including by identifying the most vulnerable parents and children, through to its extensive work on school Itreadiness.spansschool years, the important post-16+ stage, working life and post retirement, addressing health, as well as societal, circumstantial and financial, inequalities along the way. Health visitors play an important part of its early years work, helping to ensure the best possible start in life regardless of background or the challenges being faced by families at the time of birth. Its activities with schools, meanwhile, not only promote exciting NHS careers, but also address the barriers which can prevent progression in the education system, such as poor attendance and health and wellbeing challenges.

Open recruitment policies utilised by the trust are helping to spread opportunity by removing the potential hurdles to exciting and rewarding NHS Oncecareers.employment is secured within the trust, an array of practices and programmes helps to encourage and enable progression. As well as upskilling and guiding towards promotions and new opportunities, this work also entails targeting factors which may hinder progression, such as financial problems, disability, homelessness and the challenges often experienced by military veterans.

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